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Case study
Malaria in Eswatini, 2012-2019: A Case Study of the Elimination Effort.
Theresia Estomih Nkya
University of Dar es Salaam, Mbeya College of Health and Allied Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3015-1363
License:
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Eswatini was the first country in sub-Saharan Africa to pass a National Malaria Elimination Policy in 2011 and later set a target for elimination by the year 2020. This case study aimed to review Eswatini’s progress towards malaria elimination by 2020. Coverage of indoor residual spraying (IRS) for vector control and data on malaria cases were provided by the National Malaria Programme (NMP) of Eswatini. The data included all cases treated for malaria in all health facilities. The data was analysed descriptively. Over the eight-year period, a total of 5,511 patients reported to the health facilities with malaria symptoms. Case investigation rate through the routine surveillance system increased from 50% in 2012 to 84% in 2019. Incidence per 1000 population at risk fluctuated between the years but in general increased from 0.70 in 2012 to 1.65 in 2019 with highest incidence of 3.19 reported in 2017. IRS data showed inconsistency in spraying over the eight-year period. Eswatini has fallen short of achieving malaria elimination by 2020. Malaria cases are still consistently reported, albeit at low rates, with occasional localised outbreaks. To achieve elimination, it is critical to optimise timely and well-targeted IRS and to consider rational expansion of tools for an integrated malaria control approach in Eswatini by including tools such as larval source management, long-lasting insecticidal nets (LLINs), screening of mosquito house entry points and chemoprophylaxis. The establishment of rigorous routine entomological surveillance should be among the priorities in order to determine the local malaria vectors’ ecology, potential species diversity and the role of secondary vectors and insecticide resistance.
Keywords
Malaria, Surveillance, Elimination, Integrated vector management
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CURRENT STATUS: Under Review
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Received 17 Jan, 2021
Reviewer #2 agreed
On 30 Dec, 2020
Reviewer #1 agreed
On 25 Dec, 2020
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Editor invited
On 13 Dec, 2020
Editor assigned
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This preprint is under consideration at Malaria Journal. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Case study
Malaria in Eswatini, 2012-2019: A Case Study of the Elimination Effort.
Theresia Estomih Nkya
University of Dar es Salaam, Mbeya College of Health and Allied Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3015-1363
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 22 Dec, 2020
No community comments so far
Review #1 received
Received 17 Jan, 2021
Reviewer #2 agreed
On 30 Dec, 2020
Reviewer #1 agreed
On 25 Dec, 2020
Reviewers invited
Invitations sent on 25 Dec, 2020
Editor invited
On 13 Dec, 2020
Editor assigned
On 10 Dec, 2020
Submission checks complete
On 10 Dec, 2020
First submitted
On 08 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Eswatini was the first country in sub-Saharan Africa to pass a National Malaria Elimination Policy in 2011 and later set a target for elimination by the year 2020. This case study aimed to review Eswatini’s progress towards malaria elimination by 2020. Coverage of indoor residual spraying (IRS) for vector control and data on malaria cases were provided by the National Malaria Programme (NMP) of Eswatini. The data included all cases treated for malaria in all health facilities. The data was analysed descriptively. Over the eight-year period, a total of 5,511 patients reported to the health facilities with malaria symptoms. Case investigation rate through the routine surveillance system increased from 50% in 2012 to 84% in 2019. Incidence per 1000 population at risk fluctuated between the years but in general increased from 0.70 in 2012 to 1.65 in 2019 with highest incidence of 3.19 reported in 2017. IRS data showed inconsistency in spraying over the eight-year period. Eswatini has fallen short of achieving malaria elimination by 2020. Malaria cases are still consistently reported, albeit at low rates, with occasional localised outbreaks. To achieve elimination, it is critical to optimise timely and well-targeted IRS and to consider rational expansion of tools for an integrated malaria control approach in Eswatini by including tools such as larval source management, long-lasting insecticidal nets (LLINs), screening of mosquito house entry points and chemoprophylaxis. The establishment of rigorous routine entomological surveillance should be among the priorities in order to determine the local malaria vectors’ ecology, potential species diversity and the role of secondary vectors and insecticide resistance.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6