title: Malaria control in Botswana, 2008-2012: the path towards elimination.
abstract: BACKGROUND
  Botswana has made substantial progress towards malaria elimination across the country. This work assessed interventions and epidemiological characteristics of malaria in Botswana, during a period of decreasing transmission intensity.
  
  
  METHODS
  National passive malaria surveillance data for five years (2008-2012) were analysed. A district-level, random effects model with Poisson regression was used to explore the association between malaria cases and coverage with long-lasting insecticide-treated nets (LLINs) and indoor residual spraying (IRS). Malaria cases were mapped to visualize spatio-temporal variation in malaria for each year.
  
  
  RESULTS
  Within five years, a reduction in malaria prevalence (approximately 98%) and number of deaths (12 to three) was observed. Between 2008 and 2012, 237,050 LLINs were distributed and 596,979 rooms were sprayed with insecticides. Coverage with LLINs and IRS was not uniformly distributed over the study period and only targeted the northern districts with a high malaria burden. The coverage of IRS was associated with a reduction in malaria cases.
  
  
  CONCLUSIONS
  Botswana has made significant strides towards its goal of country-wide elimination of malaria. A major challenge in the future will be prevention and management of imported malaria infections from neighbouring countries. In order to accurately monitor progress towards the elimination goal, the malaria control programme (NMP) should strengthen the reporting and capturing of data at household and individual level. Systematic, periodic operational research to feedback the NMP will help to guide and achieve elimination.
authors.forename: Chihanga
authors.initials: C
authors.lastname: Simon
authors.forename: Kentse
authors.initials: K
authors.lastname: Moakofhi
authors.forename: Tjantilili
authors.initials: T
authors.lastname: Mosweunyane
authors.forename: Haruna Baba
authors.initials: HB
authors.lastname: Jibril
authors.forename: Bornapate
authors.initials: B
authors.lastname: Nkomo
authors.forename: Mpho
authors.initials: M
authors.lastname: Motlaleng
authors.forename: Davies Sedisa
authors.initials: DS
authors.lastname: Ntebela
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Chanda
authors.affiliation: W, Harry Feinstone Department of Molecular Microbiology & Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. ubydul.kth@gmail.com.
authors.forename: Ubydul
authors.initials: U
authors.lastname: Haque
mesh_terms: D000818:Animals; D000852:Anopheles / Q000187:drug effects; D001902:Botswana / Q000453:epidemiology; D003430:Cross-Sectional Studies; D006801:Humans; D007303:Insect Vectors; D057148:Insecticide-Treated Bednets; D007306:Insecticides; D008288:Malaria / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D009032:Mosquito Control
chemical_list: D007306:Insecticides