title: Re-defining the extent of malaria transmission in South Africa: implications for chemoprophylaxis.
abstract: BACKGROUND
  Malaria case numbers reported in South Africa have reduced considerably over the last decade, necessitating a revision of the national risk map to guide malaria prevention, including the use of chemoprophylaxis.
  
  
  OBJECTIVE
  To update the national malaria risk map based on recent case data and to consider the implications of the new transmission profile for guiding prophylaxis.
  
  
  METHODS
  The geographical distribution of confirmed malaria cases detected both passively and actively over the last six malaria seasons was used to redefine the geographic distribution and intensity of malaria transmission in the country.
  
  
  RESULTS
  The national risk map was revised to reflect zones of transmission reduced both in their extent and their intensity. Most notably, the area of risk has been reduced in the north-western parts of Limpopo Province and is limited to the extreme northern reaches of KwaZulu-Natal Province. Areas previously considered to be of high risk are now regarded to be of moderate risk.
  
  
  CONCLUSIONS
  Chemoprophylaxis is now only recommended from September to May in the north-eastern areas of Limpopo and Mpumalanga Provinces. The recommended options for chemoprophylaxis have not changed from mefloquine, doxycycline or atovaquone-proguanil.
authors.affiliation: Malaria Research Unit, South African Medical Research Council, Durban, South Africa. nmorrism@gmail.com.
authors.forename: N
authors.initials: N
authors.lastname: Morris
authors.forename: J
authors.initials: J
authors.lastname: Frean
authors.forename: L
authors.initials: L
authors.lastname: Baker
authors.forename: I S
authors.initials: IS
authors.lastname: Ukpe
authors.forename: K I
authors.initials: KI
authors.lastname: Barnes
authors.forename: P
authors.initials: P
authors.lastname: Kruger
authors.forename: A
authors.initials: A
authors.lastname: Mabuza
authors.forename: E
authors.initials: E
authors.lastname: Raswiswi
authors.forename: R
authors.initials: R
authors.lastname: Maharaj
authors.forename: L
authors.initials: L
authors.lastname: Blumberg
authors.forename: D
authors.initials: D
authors.lastname: Moonasar
mesh_terms: D000962:Antimalarials / Q000627:therapeutic use*; D018890:Chemoprevention; D006801:Humans; D008288:Malaria / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D008377:Maps as Topic; D013019:South Africa / Q000453:epidemiology
chemical_list: D000962:Antimalarials