Molecular detection of sub-microscopic infections and Plasmodium falciparum histidine-rich protein-2 and 3 gene deletions in pre-elimination settings of South Africa.

South Africa's efforts toward eliminating malaria have positioned the country in the pre-elimination stage. Imported and sub-microscopic cases still contribute to the persistence of malaria in regions of low transmission as identified in this study where diagnostics is built largely on the use of Rapid Diagnostic Test (RDT). However, the presence of Pfhrp2/3 gene deletion is known to interfere with the accuracy of diagnosis with the use of RDT.

Modeling the effect of imported malaria on the elimination programme in KwaZulu-Natal province of South Africa.

Introduction: with imported malaria cases in a given population, the question arises as to what extent the local cases are a consequence of the imports or not. We perform a modeling analysis for a specific area, in a region aspiring for malaria-free status.

Methods: data on malaria cases over ten years is subjected to a compartmental model which is assumed to be operating close to the equilibrium state.

Field evaluation of the residual efficacy of new generation insecticides for potential use in indoor residual spray programmes in South Africa.

Background: The decreasing residual efficacy of insecticides is an important factor when making decisions on insecticide choice for national malaria control programmes. The major challenge to using chemicals for vector control is the selection for the development of insecticide resistance. Since insecticide resistance has been recorded for most of the existing insecticides used for indoor residual spraying, namely, DDT, pyrethroids, organophosphates and carbamates, and new chemicals are necessary for the continued success of indoor residual spraying.

A Comparative Study of Genetic Diversity and Multiplicity of Infection in Uncomplicated Infections in Selected Regions of Pre-Elimination and High Transmission Settings Using and Genes.

Background: Understanding the genetic structure of . population in different regions is pivotal to malaria elimination. Genetic diversity and the multiplicity of infection are indicators used for measuring malaria endemicity across different transmission settings.

Towards malaria elimination: analysis of travel history and case forecasting using the SARIMA model in Limpopo Province.

Despite various efforts and policy implementation aimed at controlling and eliminating malaria, imported malaria remains a major factor posing challenges in places that have made progress in malaria elimination. The persistence of malaria in Limpopo Province has largely been attributed to imported cases, thus reducing the pace of achieving the malaria-free target by 2025. Data from the Limpopo Malaria Surveillance Database System (2010-2020) was analyzed, and a seasonal auto-regressive integrated moving average (SARIMA) model was developed to forecast malaria incidence based on the incidence data's temporal autocorrelation.

The effect of the COVID-19 lockdown on malaria transmission in South Africa.

Background: For a country such as South Africa which is targeting malaria elimination, mobile and migrant populations pose a substantial risk to importation of malaria parasites. It has been hypothesized that halting cross-border movement of mobile and migrant populations will decrease the importation of malaria, however this option is not a politically, operationally, and financially viable prospect. It has social impacts as well, since families live on either side of the border and preventing travel will challenge family ties.

A Systematic Review and Meta-Analysis of Malaria Test Positivity Outcomes and Programme Interventions in Low Transmission Settings in Southern Africa, 2000-2021.

Malaria is one of the most significant causes of mortality and morbidity globally, especially in sub-Saharan Africa (SSA) countries. It harmfully disturbs the public’s health and the economic growth of many developing countries. Despite the massive effect of malaria transmission, the overall pooled proportion of malaria positivity rate in Southern Africa is still elusive.

Malaria diagnostic methods with the elimination goal in view.

Malaria control measures have been in use for years but have not completely curbed the spread of infection. Ultimately, global elimination is the goal. A major playmaker in the various approaches to reaching the goal is the issue of proper diagnosis.

Chloroquine and Sulfadoxine-Pyrimethamine Resistance in Sub-Saharan Africa-A Review.

Malaria is a great concern for global health and accounts for a large amount of morbidity and mortality, particularly in Africa, with sub-Saharan Africa carrying the greatest burden of the disease. Malaria control tools such as insecticide-treated bed nets, indoor residual spraying, and antimalarial drugs have been relatively successful in reducing the burden of malaria; however, sub-Saharan African countries encounter great challenges, the greatest being antimalarial drug resistance. Chloroquine (CQ) was the first-line drug in the 20th century until it was replaced by sulfadoxine-pyrimethamine (SP) as a consequence of resistance.

Exploring rural hospital admissions for diarrhoeal disease, malaria, pneumonia, and asthma in relation to temperature, rainfall and air pollution using wavelet transform analysis.

Background: Climate variables impact human health and in an era of climate change, there is a pressing need to understand these relationships to best inform how such impacts are likely to change.

Objectives: This study sought to investigate time series of daily admissions from two public hospitals in Limpopo province in South Africa with climate variability and air quality.

Methods: We used wavelet transform cross-correlation analysis to monitor coincidences in changes of meteorological (temperature and rainfall) and air quality (concentrations of PM and NO) variables with admissions to hospitals for gastrointestinal illnesses including diarrhoea, pneumonia-related diagnosis, malaria and asthma cases.

Immunoinformatics approach for multi-epitope vaccine design against P. falciparum malaria.

Plasmodium falciparum (P. falciparum) is a leading causative agent of malaria, an infectious disease that can be fatal. Unfortunately, control measures are becoming less effective over time.

Effectiveness and cost-effectiveness of reactive, targeted indoor residual spraying for malaria control in low-transmission settings: a cluster-randomised, non-inferiority trial in South Africa.

Background: Increasing insecticide costs and constrained malaria budgets could make universal vector control strategies, such as indoor residual spraying (IRS), unsustainable in low-transmission settings. We investigated the effectiveness and cost-effectiveness of a reactive, targeted IRS strategy.

Methods: This cluster-randomised, open-label, non-inferiority trial compared reactive, targeted IRS with standard IRS practice in northeastern South Africa over two malaria seasons (2015-17).

High levels of imported asymptomatic malaria but limited local transmission in KwaZulu-Natal, a South African malaria-endemic province nearing malaria elimination.

Background: KwaZulu-Natal, one of South Africa's three malaria endemic provinces, is nearing malaria elimination, reporting fewer than 100 locally-acquired cases annually since 2010. Despite sustained implementation of essential interventions, including annual indoor residual spraying, prompt case detection using malaria rapid diagnostics tests and treatment with effective artemisinin-based combination therapy, low-level focal transmission persists in the province. This malaria prevalence and entomological survey was therefore undertaken to identify the drivers of this residual transmission.

Publisher Correction: Malaria predictions based on seasonal climate forecasts in South Africa: A time series distributed lag nonlinear model.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Malaria predictions based on seasonal climate forecasts in South Africa: A time series distributed lag nonlinear model.

Although there have been enormous demands and efforts to develop an early warning system for malaria, no sustainable system has remained. Well-organized malaria surveillance and high-quality climate forecasts are required to sustain a malaria early warning system in conjunction with an effective malaria prediction model. We aimed to develop a weather-based malaria prediction model using a weekly time-series data including temperature, precipitation, and malaria cases from 1998 to 2015 in Vhembe, Limpopo, South Africa and apply it to seasonal climate forecasts.

Decadal epidemiology of malaria in KwaZulu-Natal, a province in South Africa targeting elimination.

Background: Although malaria remains a noteworthy disease in South Africa, the provinces are at differing stages of the malaria elimination continuum. KwaZulu-Natal has consistently reported the lowest number of cases over the past 5 years and it is expected that the goal of elimination will be achieved in this province over the next few years. The study reports on few key indicators that realistically represents the provinces progress over the past decade.

Assessing Kwa-Zulu-Natal's progress towards malaria elimination and its readiness for sub-national verification.

Background: The South African province of KwaZulu-Natal is rapidly approaching elimination status for malaria with a steady decline in local cases. With the possibility of achieving elimination in reach, the KZN malaria control programme conducted a critical evaluation of its practices and protocols to identify potential challenges and priorities to achieving elimination. Three fundamental questions were addressed: (1) How close is KZN to malaria elimination; (2) Are all systems required to pursue subnational verification of elimination in place; and (3) What priority interventions must be implemented to reduce local cases to zero?

Methods: Based on the 2017 World Health Organization Framework for Elimination, twenty-eight requirements were identified, from which forty-nine indicators to grade elimination progress were further stratified.

Exploring the Impact of Climate Variability on Malaria Transmission Using a Dynamic Mosquito-Human Malaria Model.

Introduction: The reasons for malaria resurgence mostly in Africa are yet to be well understood. Although the causes are often linked to regional climate change, it is important to understand the impact of climate variability on the dynamics of the disease. However, this is almost impossible without adequate long-term malaria data over the study areas.

A promising azeotrope-like mosquito repellent blend.

Topical repellents play a key role in reducing the outdoor transmission of mosquito-borne diseases by reducing human-vector contact. Excellent repellents are available, but there is always room for improvement. This article reports on a particularly effective binary repellent blend of ethyl butylacetylaminopropionate and nonanoic acid.

Seasonally lagged effects of climatic factors on malaria incidence in South Africa.

Globally, malaria cases have drastically dropped in recent years. However, a high incidence of malaria remains in some sub-Saharan African countries. South Africa is mostly malaria-free, but northeastern provinces continue to experience seasonal outbreaks.

Towards malaria elimination in the MOSASWA (Mozambique, South Africa and Swaziland) region.

The substantial impact of cross-border collaborative control efforts on the burden of malaria in southern Africa has previously been demonstrated through the successes of the Lubombo Spatial Development Initiative. Increases in malaria cases recorded in the three partner countries (Mozambique, South Africa, Swaziland) since termination of that programme in 2011 have provided impetus for the resuscitation of cooperation in the form of the MOSASWA malaria initiative. MOSASWA, launched in 2015, seeks to renew regional efforts to accelerate progress towards malaria elimination goals already established in the region.

Sustaining control: lessons from the Lubombo spatial development initiative in southern Africa.

Background: The Lubombo Spatial Development Initiative (LSDI) was a tri-country project between South Africa, Swaziland and Mozambique with the aim of accelerating socio-economic development in the region. The malaria component of the project was introduced to decrease the transmission of malaria in the region. This goal was met but with termination of this project resulted in an upsurge of malaria cases in the sub-region mainly as a result of migration from high transmission areas to low transmission ones.

Modelling the influence of temperature and rainfall on the population dynamics of Anopheles arabiensis.

Background: Malaria continues to be one of the most devastating diseases in the world, killing more humans than any other infectious disease. Malaria parasites are entirely dependent on Anopheles mosquitoes for transmission. For this reason, vector population dynamics is a crucial determinant of malaria risk.