Epidemiology of malaria in South Africa: From control to elimination

Maharaj, Rajendra; Raman, Jaishree; Morris, Natashia; Moonasar, Devanand; Dürrheim, David N; Seocharan, Ishen; Kruger, Philip; Shandukani, B; Kleinschmidt, Immo

doi:10.7196/samj.7441

Cited by 60 publications

(64 citation statements)

References 17 publications

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“…funestus) can have on an IRS-based vector control programme. 2,19,20 The occurrence of multiple vector species carrying multiple resistance mecha nisms coupled to ongoing outdoor transmission in northern KwaZulu-Natal means that special attention and commitment needs to be given to the principles of insecticide resistance management as outlined in the GPIRM document 4 as well as to investigations into alternative control techniques designed to target outdoor-resting An. arabiensis.…”

Section: Resultsmentioning

confidence: 99%

Insecticide resistance in the malaria vector Anopheles arabiensis in Mamfene, KwaZulu-Natal

Brooke¹,

Robertson²,

Kaiser³

et al. 2015

S. Afr. J. Sci.

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The control of malaria vector mosquitoes in South Africa’s affected provinces is primarily based on indoor spraying of long-lasting residual insecticides. The primary vectors in South Africa are Anopheles arabiensis and An. funestus. South Africa’s National Malaria Control Programme has adopted a malaria elimination agenda and has scaled up vector control activities accordingly. However, despite these plans, local transmission continues and is most likely because of outdoor feeding by populations of An. arabiensis. An outdoor Anopheles surveillance system has been set up in three sections of the Mamfene district in northern KwaZulu- Natal in order to assess the extent of outdoor resting An. arabiensis in Mamfene and to assess the current insecticide susceptibility status of this population. According to WHO criteria, the An. arabiensis samples tested showed evidence of resistance to deltamethrin (pyrethroid), DDT (organochlorine) and bendiocarb (carbamate), and full susceptibility to the organophosphates pirimiphos-methyl and fenitrothion. Pre-exposure to piperonyl butoxide completely nullified the deltamethrin resistance otherwise evident in these samples, supporting previous studies implicating monooxygenase-based detoxification as the primary mechanism of pyrethroid resistance. The data presented here affirm the presence of pyrethroid and DDT resistance previously detected in this population and also indicate the comparatively recent emergence of resistance to the carbamate insecticide bendiocarb. These data show that special attention and commitment needs to be given to the principles of insecticide resistance management as well as to investigations into alternative control techniques designed to target outdoor-resting An. arabiensis in northern KwaZulu-Natal.

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Section: Resultsmentioning

confidence: 99%

Insecticide resistance in the malaria vector Anopheles arabiensis in Mamfene, KwaZulu-Natal

Brooke¹,

Robertson²,

Kaiser³

et al. 2015

S. Afr. J. Sci.

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“…These conditions can be broadly divided into those that interfere with HbA 1c measurement, such as haemoglobin variants which affect the accuracy of the measurements, and those that affect the interpretation of the HbA 1c results, such as anaemia and chronic infection. In South African populations, the prevalence of haemoglobin variants and malaria is low and usually restricted to high risk populations, such as immigrants from other countries, for haemoglobin variants, and in populations near the northern border of the country, for malaria [19, 20, 31]. Other studies have shown that anaemia and HIV can falsely raise or lower the HbA 1c measurement [32, 33].…”

Section: Discussionmentioning

confidence: 99%

Burden of Diabetes and First Evidence for the Utility of HbA1c for Diagnosis and Detection of Diabetes in Urban Black South Africans: The Durban Diabetes Study

et al. 2016

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ObjectiveGlycated haemoglobin (HbA1c) is recommended as an additional tool to glucose-based measures (fasting plasma glucose [FPG] and 2-hour plasma glucose [2PG] during oral glucose tolerance test [OGTT]) for the diagnosis of diabetes; however, its use in sub-Saharan African populations is not established. We assessed prevalence estimates and the diagnosis and detection of diabetes based on OGTT, FPG, and HbA1c in an urban black South African population.Research Design and MethodsWe conducted a population-based cross-sectional survey using multistage cluster sampling of adults aged ≥18 years in Durban (eThekwini municipality), KwaZulu-Natal. All participants had a 75-g OGTT and HbA1c measurements. Receiver operating characteristic (ROC) analysis was used to assess the overall diagnostic accuracy of HbA1c, using OGTT as the reference, and to determine optimal HbA1c cut-offs.ResultsAmong 1190 participants (851 women, 92.6% response rate), the age-standardised prevalence of diabetes was 12.9% based on OGTT, 11.9% based on FPG, and 13.1% based on HbA1c. In participants without a previous history of diabetes (n = 1077), using OGTT as the reference, an HbA1c ≥48 mmol/mol (6.5%) detected diabetes with 70.3% sensitivity (95%CI 52.7–87.8) and 98.7% specificity (95%CI 97.9–99.4) (AUC 0.94 [95%CI 0.89–1.00]). Additional analyses suggested the optimal HbA1c cut-off for detection of diabetes in this population was 42 mmol/mol (6.0%) (sensitivity 89.2% [95%CI 78.6–99.8], specificity 92.0% [95%CI: 90.3–93.7]).ConclusionsIn an urban black South African population, we found a high prevalence of diabetes and provide the first evidence for the utility of HbA1c for the diagnosis and detection of diabetes in black Africans in sub-Saharan Africa.

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“…The apparent decrease in odyssean malaria during the period under review, compared with the previous series (Table 1), is probably largely due to SA's sustained success in controlling malaria since 2000, [5] but odyssean malaria will remain a risk in the nonendemic provinces until malaria is eliminated in the region.…”

Section: Clinical Aspects Of Odyssean Malariamentioning

confidence: 82%

Odyssean malaria outbreaks in Gauteng Province, South Africa, 2007 - 2013

et al. 2014

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Background. Odyssean malaria refers to malaria transmitted by translocated mosquitoes and is a diagnosis of exclusion, as the probability of finding the responsible vector is miniscule. We believe that road traffic from endemic areas in and around South Africa is the source of most of the infected mosquitoes. Because of the unexpected nature of the disease, diagnosis is often delayed and severe and complicated malaria is common. Objectives. To describe outbreaks of odyssean malaria during the period 2007 through 2013 in Gauteng Province, South Africa, and to educate healthcare workers about this form of malaria. Methods. Site visits, environmental hygiene inspections, patient interviews, and entomological investigations for adult mosquitoes and larvae in potential breeding sites were done in each identified outbreak. Results. Over the period, 14 laboratory-proven and 7 probable cases of odyssean malaria were investigated. There were 2 deaths (9.5% case fatality rate, approximately 10 times higher than the national fatality rate for malaria). We describe two recent clusters of cases in detail, and emphasise the importance of clinician awareness of this rare but frequently severe form of malaria. Conclusion. Odyssean malaria cases are inevitable in South Africa, given the volume of road, rail and air traffic from malaria risk areas into Gauteng and other non-endemic provinces. It is likely that many cases are missed, owing to the rare and sporadic nature of the condition. Malaria should always be kept in mind as a cause of unexplained fever and thrombocytopenia, even in the absence of a travel history.

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Epidemiology of malaria in South Africa: From control to elimination

Cited by 60 publications

References 17 publications

Insecticide resistance in the malaria vector Anopheles arabiensis in Mamfene, KwaZulu-Natal

Insecticide resistance in the malaria vector Anopheles arabiensis in Mamfene, KwaZulu-Natal

Burden of Diabetes and First Evidence for the Utility of HbA1c for Diagnosis and Detection of Diabetes in Urban Black South Africans: The Durban Diabetes Study

Odyssean malaria outbreaks in Gauteng Province, South Africa, 2007 - 2013

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