Is malaria elimination a distant dream? Reconsidering malaria elimination strategies in Zimbabwe

Abstract

Malaria remains a public health problem decimating vulnerable populace especially in resource-constrained areas in Zimbabwe. Significant progress towards malaria elimination has beenik made in the previous decades through intensified and improved malaria control measures such as indoor residual spraying (IRS), distribution of long-lasting insecticidal nets (LLIN), artemisinin-based combination therapy and administration of intermittent preventive treatment in pregnancy. However, the outbreak of pandemics like coronavirus disease (COVID-19), cyclones and tropical storms, lack of funding, porous political environment, dearth of resources for vector control, changes in vector behaviour, vector resistance to insecticides, community behavioural change and lack of feasible and sustainable digital technologies for managing malaria control interventions retards progress made towards malaria elimination. Also, arbitrary political environment and unstable economic situation often interfere with health programmes which subsequently lead to malaria outbreaks. Most recently, the country recorded a sharp increase in malaria incidences in malaria-endemic areas especially during the pandemic due to some factors such as movement restrictions, temporary cancellation of IRS activities, delayed delivery of IRS chemicals and recursive lockdown. Therefore, we propose ways to mitigate future malaria outbreaks and advocate for reconsidering malaria elimination strategies to addresses emerging challenges in eradicating malaria in Zimbabwe.

Effects of the COVID-19 pandemic on general health and malaria control in Ghana: a qualitative study with mothers and health care professionals

“…In absolute numbers, disruptions due to the COVID-19 pandemic have led to additional 13.4 million malaria cases and 63,000 malaria deaths in 2020 and 2021 [11]. Some statistics from malaria-endemic countries revealed diverse effects on malaria morbidity and mortality; in high malaria-endemic countries, fewer cases were seen in health facilities while in low malaria-endemic countries cases increased [12][13][14][15][16][17][18][19]. For northern Ghana, a retrospective analysis of quantitative data from April to September 2020 compared to the pre-COVID-19 period from 2015 to 2019 found a 26% decrease in overall OPD malaria cases with even stronger reductions in children under the age of five and inpatients (up to 67%) [20].…”

Malaria prevention knowledge, attitudes, and practices (KAP) among adolescents living in an area of persistent transmission in Senegal: Results from a cross-sectional study

“…Malaria cases declined globally from 238 million in 2000 to 229 million in 2019 [ 1 ], while the incidence rate decreased from 80 per 1000 population at risk in 2000 to 57 in 2019 [ 1 ]. However, the Coronavirus (COVID-19) pandemic has disrupted malaria control activities, threatening progress in the fight against the disease [ 2 , 3 ], leading in 2020 to an increase in malaria morbidity and mortality worldwide, with an estimated 241 million cases and 627 000 deaths [ 4 ]. The incidence rate (per 1000 population at risk) increased from 57 in 2019 to 59 in 2020 [ 1 ].…”

Evaluation of the malaria elimination programme in Muara Enim Regency: a qualitative study from Indonesia

“…Inadequate financing, necessary behavioural changes in the community, and the absence of sustainable digital tools contribute to the slow progress in malaria elimination. The study recommends that donors adopt practices facilitating flexible funding at sub-national levels, integrating case management, vector control, surveillance, and evaluation to enhance the effectiveness of malaria control and elimination efforts [ 17 , 18 ]. .…”