Seven years of regional malaria control collaboration--Mozambique, South Africa, and Swaziland.
The Lubombo Spatial Development Initiative is a joint development program between the governments of Mozambique, Swaziland, and South Africa, which includes malaria control as a core component of the initiative. Vector control through indoor residual spraying (IRS) was incrementally introduced in southern Mozambique between November 2000 and February 2004. Surveillance to monitor its impact was conducted by annual cross-sectional surveys to assess the prevalence of Plasmodium falciparum infection, entomologic monitoring, and malaria case notification in neighboring South Africa and Swaziland. In southern Mozambique, there was a significant reduction in P. falciparum prevalence after the implementation of IRS, with an overall relative risk of 0.74 for each intervention year (P < 0.001), ranging from 0.66 after the first year to 0.93 after the fifth intervention year. Substantial reductions in notified malaria cases were reported in South Africa and Swaziland over the same period. The success of the program in reducing malaria transmission throughout the target area provides a strong argument for investment in regional malaria control.
Sharp
Brian L
BL
Malaria Research Programme, Medical Research Council, Durban, South Africa.
Kleinschmidt
Immo
I
Streat
Elisabeth
E
Maharaj
Rajendra
R
Barnes
Karen I
KI
Durrheim
David N
DN
Ridl
Frances C
FC
Morris
Natasha
N
Seocharan
Ishen
I
Kunene
Simon
S
LA Grange
Jacobus J P
JJ
Mthembu
Jotham D
JD
Maartens
Francois
F
Martin
Carrin L
CL
Barreto
Avertino
A
D000293:Adolescent; D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D013541:Eswatini / Q000453:epidemiology; D006801:Humans; D007303:Insect Vectors; D007391:International Cooperation; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000517:prevention & control*; D009032:Mosquito Control / Q000379:methods; D009073:Mozambique / Q000453:epidemiology; D010963:Plasmodium falciparum / Q000302:isolation & purification; D015995:Prevalence; D013019:South Africa / Q000453:epidemiology; D013997:Time Factors
D000962:Antimalarials