PROGRAMS • AID TO AFRICA STATISTICS• MALARIA According to statistics, close to 3000 people (mostly children under 5 years) die daily from malaria worldwide. Malaria is mainly concentrated in tropical areas and since most of the population in these areas have a low income, there are no funds for research and development of a novel drug and even if a pharmaceutical company endeavoured to try, the cost to do so is so high that the price of the new drug will be unaffordable. This crisis called for a Multilateral Initiative on Malaria (MIM) and the inter global networking of scientists which lead to the third MIM Pan-African Malaria Conference in Arushia , Tanzania . It turned out to be the largest conference on malaria ever, attended by 950 scientists from all over the world. DFL was sponsored by the MIM to attend the conference with a poster presentation on DFL’s artimisinin based product, Malarlife.
At the conference, artemisinin products were again highlighted by the WHO as the answer to drug-resistant malaria. Although artemisinin kills Plasmodium falciparum even faster than quinine, it has a very short half life and therefore the chance of developing resistance is small. Artemisinin cannot be manufactured synthetically due to its unique structure and therefore needs to be cultivated, extracted and formulated for commercial purposes.
It is DFL’s vision to supply affordable effective medicine to the needy in Africa . For more information visit the MALARLIFE home page.
South African malaria update
This update serves to provide feedback to a range of persons involved in the malaria programmes. For this edition, malaria cases and deaths for the three endemic areas as well as for the rest of the country are presented. The total number of malaria cases reported as per malaria season for 1999/2000, 2000/2001 and 2001/2002 are graphed below. The provinces have been consulted for comments regarding the general trends. However, any further inputs or comments regarding the data are encouraged.
In general, KwaZulu-Natal , Mpumalanga and the Northern Province have recorded a decrease in the number of reported cases for this malaria season in comparison to previous ones. This decrease can largely be attributed to re-introducing the spraying with DDT. The decrease in these three provinces has created a “knock-on effect” resulting in a reduction of overall transmission within in the region as well as within each individual province. The cumulative reduction has resulted in the presence of fewer parasites and therefore a decrease in transmission.
Northern Province
The figures thus far for the 2001/2002 season indicate a decrease in comparison to other years. Figures were low early in the season, with two peaks occurring in November and January. A large percentage of cases are reported from the Mutare and Thoyando districts. The overall decrease in the area can be attributed to several factors. Firstly, additional sprayers (50) were employed and new vehicles (30) were purchased. These additions have resulted in early spraying particularly to high risk areas and greater coverage of spraying has been achieved. High risk areas have received greater protection, earlier. Secondly, DDT has been used for spraying. For this season thus far, 32 deaths have been notified resulting a case-fatality rate of 0.7%. This rate is above that set by Department of Health National Policy.
Mpumalanga
Overall, the 2001/2002 season has notified fewer cases. From January to March there has been a sharp decrease in the number of notified cases. This decrease may be attributed to the lack of rain and the introduction of spraying with DDT. The Tonga area continues to report a high number of cases. For this period, January – March, 65-70% were reported from this area. The area reports a large number of imported cases. For this season thus far, 9 deaths have been reported resulting in a case-fatality rate of 0.2%.
KwaZulu-Natal
The figures for this season are considerably lower than those of previous ones. Spraying has taken place over wider areas especially in the low risk areas. Spraying has taken place with DDT. Large decreases in transmission have been observed following spraying e.g. DukaDuka area. In April, treatment with Coartemether began which may have impacted on transmission and possibly resulted in improved diagnosis. The southern areas and Ingwavuma continue to report a large number of cases. A total of 20 deaths have been reported thus far for the season resulting in a case-fatality rate of 0.7%.
Other provinces
The number of cases reported throughout the rest of the provinces has decreased this season. This may be a result of the “overall reduction” in cases within the endemic areas. In addition, there may be late or under reporting. For this season, a large number of cases were reported from the North West Province and the Free State . No deaths have been reported.
Compiled by Caron Johnson with the assistance of the Programme Managers
National Department of Health
e-mail: johnsc@health.gov.za
