Towards the elimination of malaria in South Africa: a review of surveillance data in Mutale Municipality, Limpopo Province, 2005 to 2010
Towards the elimination of malaria in South Africa: a review of surveillance data in Mutale Municipality, Limpopo Province, 2005 to 2010
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DOI：
10.1186/1475-2875-12-7
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发表时间：
2013-01-08
期刊：
影响因子：
3
通讯作者：
Maimela, Eric
中科院分区：
文献类型：
--
作者：
Khosa, Ester;Kuonza, Lazarus R.;Maimela, Eric
背景：南非的目标是到2018年消除疟疾。因此，不断监测受影响亚群体的疟疾发病率和死亡率趋势对于指导和完善控制干预措施至关重要。林波波省的穆塔莱市是该国疟疾风险最高的地区之一。方法：对2005年7月至2010年6月林波波省疟疾信息系统常规采集的疟疾资料进行回顾性描述性分析。确定了五个疟疾季节。年疟疾发病率，病死率（CFR）和IRS覆盖率进行了计算。结果：累计，4,663例疟疾病例和21例疟疾死亡报告在2005年7月至2010年6月之间的穆塔莱。对3，517名患者的疟疾可能来源的调查显示，6.6%是输入性病例，主要来自邻国津巴布韦（222/231）。疟疾发病率从2005-2006年季节的每1 000人年13.6例下降到2009-2010年季节的每1 000人年2.7例。前四个季节的平均疟疾病死率稳定在0.3%至0.6%之间，2009-2010年季节急剧上升至2.1%。21名疟疾死亡者的中位年龄为34岁（范围：16至60岁）。15岁以下儿童的CFR为0%，24岁以上患者的CFR高于0.5%。常规IRS在所有五个seasons.Conclusion：疟疾控制干预措施在Mutale实施的覆盖率达到80%以上，显著降低了人群中疟疾的发病率。为了准确监测实现消灭疟疾目标的进展情况，疟疾控制方案应加强省级疟疾信息系统的报告和数据收集;应调查所有被诊断患有疟疾的病人，以确定疟疾的可能来源，并应审计与疟疾有关的死亡，以改善病例发现和管理。此外，该国应加强跨境疟疾控制合作，以尽量减少疟疾输入。
Background: South Africa has targeted to eliminate malaria by the year 2018. Constant monitoring of malaria morbidity and mortality trends in affected subpopulations is therefore crucial in guiding and refining control interventions. Mutale Municipality in Limpopo Province is one of the areas with the highest risk of malaria in the country. This paper describes trends in malaria incidence, case fatality and household indoor residual spraying (IRS) coverage in Mutale Municipality, during the period 2005 to 2010.Methods: A retrospective descriptive analysis was conducted on malaria data routinely collected through the Limpopo provincial malaria information system between July 2005 and June 2010. Five malaria seasons were defined. Annualized malaria incidence rates, case fatality rates (CFR) and IRS coverage rates were calculated.Results: Cumulatively, 4,663 malaria cases and 21 malaria deaths were reported in Mutale between July 2005 and June 2010. Investigation of likely origin of the malaria in 3,517 patients revealed that 6.6% were imported cases, mostly from neighbouring Zimbabwe (222/231). Malaria incidence rates fell from 13.6 cases per 1,000 person-years in the 2005-2006 season to 2.7 cases per 1,000 person-years in the 2009-2010 season. The mean malaria CFR was stable between 0.3 and 0.6% during the first four seasons, and increased sharply to 2.1% in the 2009-2010 season. The median age of the 21 malaria deaths was 34 years (range: 16 to 60 years). CFRs were 0% in children below 15 years and above 0.5% in patients more than 24 years old. Regular IRS achieved coverage above 80% in all five seasons.Conclusion: Malaria control interventions implemented in Mutale significantly reduced the incidence of malaria in the population. In order to accurately monitor progress towards the elimination goal, the malaria control programme should strengthen the reporting and capturing of the data in the provincial malaria information system; all patients diagnosed with malaria should be investigated to determine the likely source of the malaria, and malaria related deaths should be audited to improve case detection and management. Furthermore, the country should strengthen cross border malaria control collaborations in order to minimize malaria importation.