Abstract
BackgroundSwaziland has made great progress towards its goal of malaria elimination by 2015. However, malaria importation from neighbouring high-endemic Mozambique through Swaziland’s eastern border remains a major factor that could prevent elimination from being achieved. In order to reach elimination, Swaziland must rapidly identify and treat imported malaria cases before onward transmission occurs.MethodsA nationwide formative assessment was conducted over eight weeks to determine if the imported cases of malaria identified by the Swaziland National Malaria Control Programme could be linked to broader social networks and to explore methods to access these networks.ResultsUsing a structured format, interviews were carried out with malaria surveillance agents (6), health providers (10), previously identified imported malaria cases (19) and people belonging to the networks identified through these interviews (25). Most imported malaria cases were Mozambicans (63%, 12/19) making a living in Swaziland and sustaining their families in Mozambique. The majority of imported cases (73%, 14/19) were labourers and self-employed contractors who travelled frequently to Mozambique to visit their families and conduct business. Social networks of imported cases with similar travel patterns were identified through these interviews. Nearly all imported cases (89%, 17/19) were willing to share contact information to enable network members to be interviewed. Interviews of network members and key informants revealed common congregation points, such as the urban market places in Manzini and Malkerns, as well as certain bus stations, where people with similar travel patterns and malaria risk behaviours could be located and tested for malaria.ConclusionThis study demonstrated that imported cases of malaria belonged to networks of people with similar travel patterns. This study may provide novel methods for screening high-risk groups of travellers using both snowball sampling and time-location sampling of networks to identify and treat additional malaria cases. Implementation of a proactive screening programme of importation networks may help Swaziland halt transmission and achieve malaria elimination by 2015.
Highlights
Swaziland has made great progress towards its goal of malaria elimination by 2015
This study demonstrated that imported cases of malaria belonged to networks of people with similar travel patterns
This study has shown that patients identified through passive surveillance and classified as imported cases by the Swaziland National Malaria Control Program (NMCP) have networks of contacts who can be reached and screened for malaria infection
Summary
Swaziland has made great progress towards its goal of malaria elimination by 2015. malaria importation from neighbouring high-endemic Mozambique through Swaziland’s eastern border remains a major factor that could prevent elimination from being achieved. In order to reach elimination, Swaziland must rapidly identify and treat imported malaria cases before onward transmission occurs. 109 countries have succeeded in eliminating malaria [1], and 34 of the 99 countries with ongoing transmission are in the process of elimination [2] Included in this number is Swaziland, a small country in southern Africa sharing borders with South Africa and Mozambique. Swaziland has introduced a strategic plan to reach its elimination goal by 2015 [7] This includes targeted vector control using indoor residual spraying and insecticidetreated bed nets, confirmation of suspected malaria cases with a diagnostic test, immediate reporting of cases via an automated notifiable diseases tracking system, and an active surveillance system that aims to investigate all cases within 48 hours of notification [5]. All reported cases are swiftly treated with artemisinin combination therapy; information, education and communication (IEC) campaigns target travellers to high risk areas and chemoprophylaxis is provided in local clinics [5]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
