How Did Malaria Cases Evolve During the 2022-2023 Season?
Malaria is a dangerous illness transmitted by certain species of mosquitoes, primarily in tropical regions, posing a significant threat to human health. The disease is caused by a parasite and does not spread directly between individuals.
Malaria symptoms can range from mild, such as fever, chills, and headaches, to severe, including fatigue, confusion, seizures, and respiratory distress. Certain populations, such as infants, young children, pregnant women, travelers, and individuals with compromised immune systems, are particularly vulnerable to severe infections.
Prevention of malaria involves avoiding mosquito bites through measures like using insect repellent and sleeping under mosquito nets. Additionally, medications are available for both prevention and treatment, effectively managing mild cases and preventing them from escalating into life-threatening conditions.
Despite being preventable and treatable, malaria persists as a significant public health challenge globally. The World Health Organization has pinpointed various obstacles exacerbating this issue, such as climate change, dwindling funding, ongoing conflicts, and inadequate implementation of crucial interventions.
In 2022, there was a notable surge of five million additional malaria cases compared to the previous year, totaling 249 million cases globally, with Africa bearing the brunt at 94%. South Africa, situated on the southernmost fringe of malaria prevalence in the continent, experiences endemic transmission mainly in low-altitude border regions of Limpopo, Mpumalanga, and KwaZulu-Natal provinces, with seasonal peaks typically occurring between September and May, particularly after holiday periods. As part of its elimination efforts, South Africa emphasizes the utilization of precise case surveillance data to strategically target control and elimination measures.
This report summarizes the findings of a retrospective review of malaria case data collected by the Notifiable Medical Conditions Surveillance System(NMC-SS) throughout the 2022-2023 malaria season in South Africa. This type of review provides valuable insights into case trends, patterns, and distribution, enabling malaria programs to make informed decisions regarding the targeting of control interventions for the upcoming season.
Materials and Methods
A line list of malaria cases for the period 01 September 2022 to 31 August 2023 was extracted from the NMC-SS database. A malaria case was defined using the standard NMC case definition as any person who had a malaria diagnosis confirmed through a rapid or laboratory test. Severe malaria cases were identified as those who were admitted to a healthcare facility and treated with an intravenous antimalarial.
Through ArcGIS Pro, the case notifications were mapped using the residential address of the case or reporting facility. Lastly, we obtained DHIS2 data from the National Department of Health for the same review period to compare and quantify the differences in case notifications for the endemic provinces.
Results
A total of 5 813 malaria case notifications, 4 137 from endemic provinces and 1 676 from non-endemic provinces, was received by the NMC-SS between September 2022 and August 2023. The majority of the cases were males (61%, 3 574/5 813) aged between 20 and 39 years. Malaria in children under the age of five years (8%, 461/5 813) was reported almost equally to those between five and nine years (8%, 458/5 813). Although a large proportion of case notifications (45%, 2 621/5 813) did not contain information on the diagnostic method used, of the 3 192 notifications that did, cases diagnosed by microscopy (70%, 2 221/3 192) were reported more frequently than those diagnosed by rapid diagnostic tests (30%, 971/3 192). The majority of the case notifications were from public healthcare facilities (91%, 5 311/5 813).
For a more in-depth look into this thought-provoking study, download the full article below.
