SEVEN YEARS OF REGIONAL MALARIA CONTROL COLLABORATION—MOZAMBIQUE, SOUTH AFRICA, AND SWAZILAND
Open accessAbstract
The Lubombo Spatial Development Initiative is a joint development program between the governments of Mozambique, Swaziland, and South Africa, which includes malaria control as a core component of the initiative. Vector control through indoor residual spraying (IRS) was incrementally introduced in southern Mozambique between November 2000 and February 2004. Surveillance to monitor its impact was conducted by annual cross-sectional surveys to assess the prevalence of Plasmodium falciparum infection, entomologic monitoring, and malaria case notification in neighboring South Africa and Swaziland. In southern Mozambique, there was a significant reduction in P. falciparum prevalence after the implementation of IRS, with an overall relative risk of 0.74 for each intervention year (P < 0.001), ranging from 0.66 after the first year to 0.93 after the fifth intervention year. Substantial reductions in notified malaria cases were reported in South Africa and Swaziland over the same period. The success of the program in reducing malaria transmission throughout the target area provides a strong argument for investment in regional malaria control.
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Effective monitoring and decision support systems can enable insecticide resistance to be detected at an early stage, which should lead to the implementation of changes in insecticide policy.
“Effective monitoring and decision support systems can enable insecticide resistance to be detected at an early stage, which should lead to the implementation of changes in insecticide policy (Sharp et al. 2007).”
From Global Status of DDT and Its Alternatives for Use in Vector Control to Prevent Disease (2009) · cites this paper as Sharp et al. 2007
The Interventions section reports that DDT was reintroduced in KwaZulu-Natal after pyrethroid resistance was detected, supporting the link between detecting resistance and changing insecticide use. It does not say that monitoring and decision-support systems detected the resistance early; the resistance described had already led to program failure. No page number is provided in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredDDT resistance developed relatively fast in An. stephensi, while its development in Anopheles funestus in South Africa where IRS with DDT started in 1946 was rather slow.
“While DDT resistance developed relatively fast in some species, e.g., An. stephensi, its development in some other species, e.g., Anopheles funestus in South Africa where IRS with DDT started in 1946 was rather slow [98].”
From Evolution of insecticide resistance and its mechanisms in Anopheles stephensi in the WHO Eastern Mediterranean Region (2020) · cites this paper as [98]
The Interventions section states that indoor residual spraying with DDT began in South Africa in 1946. It does not compare the speed of resistance development in An. stephensi and An. funestus; the resistance it describes in South Africa is to pyrethroids, not DDT. No page number is available in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredIn South Africa, in part of the malarious areas, DDT IRS is used for malaria vector control whereas in other states, different insecticides are being used.
“In South Africa, in part of the malarious areas, DDT IRS is used for malaria vector control whereas in other states, different insecticides are being used [1, 98].”
From Evolution of insecticide resistance and its mechanisms in Anopheles stephensi in the WHO Eastern Mediterranean Region (2020) · cites this paper as [98]
The Interventions section reports DDT indoor residual spraying in the South African provinces of Mpumalanga and KwaZulu-Natal, alongside pyrethroid use in homes with painted walls and bendiocarb use in such homes in KwaZulu-Natal. It does not support the claimed geographic contrast that different insecticides were used in other South African states; the alternatives described were used in areas where DDT was also used. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIn 1996, DDT was replaced with pyrethroid in South Africa, which had to be reversed due to the detection of monooxygenase-based pyrethroid insecticide resistance with no cross-resistance to DDT in An. funestus in KwaZulu-Natal Province in 2000.
“In 1996, DDT was replaced with pyrethroid [99], which had to be reversed due to the detection of monooxygenase-based pyrethroid insecticide resistance with no cross-resistance to DDT in An. funestus in KwaZulu-Natal Province in 2000 [98].”
From Evolution of insecticide resistance and its mechanisms in Anopheles stephensi in the WHO Eastern Mediterranean Region (2020) · cites this paper as [98]
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Research works printed but not linked: 3
- Sharp BL, Craig MH, Mnzava A, Curtis B, Maharaj R, Klein- schmidt I, 2001. Review of malaria in South Africa. Available at http://www.hst.org.za/uploads/files/chapter18_00.pdf. Ac- cessed October 19, 2006.
- Mabaso MLH, Sharp BL, le Sueur D, Lengeler C, 2004. Histori- cal review of malaria control in southern African with empha- sis on the use of indoor residual house spraying. Trop Med Int Health 9: 846-856.
- Ngxongo SM, 1993. The epidemiology of malaria in KwaZulu, 1980-1991. MSc thesis, University of Natal, Durban, South Africa.
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Global Status of DDT and Its Alternatives for Use in Vector Control to Prevent Disease
van den Berg, H. (2009) · Environmental Health Perspectives · doi:10.1289/ehp.0900785 · Cited by 376 · see citing works
“…costeffectiveness of DDT have been based on the positive experience from the malaria eradication era (Mabaso et al. 2004) supplemented with more recent results on reductions in malaria morbidity and incidence associated with the use of DDT (Curtis 2002; Gunasekaran et al. 2005; Sharp et al. 2007).”
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“Operationally, however this produced a change in insecticide use policy, with the national programmes in South Africa, Mozambique and Swaziland shifting to bendiocarb or DDT to counter the pyrethroid resistance [20].”
BackgroundLessons from the past: managing insecticide resistance in malaria control and eradication programmes
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- Authors
- SHARP, B. L., KLEINSCHMIDT, I., STREAT, E., MAHARAJ, R., BARNES, K. I., DURRHEIM, D. N., RIDL, F. C., MORRIS, N., SEOCHARAN, I., KUNENE, S., LA GRANGE, J. J. P., MTHEMBU, J. D., MAARTENS, F., MARTIN, C. L., & BARRETO, A.
- Affiliations
- University of Cape Town (ZA)
- Malaria Research Programme, Medical Research Council, Durban, South Africa; Maputo Province Directorate of Health, Lubombo Spatial Development Initiative Malaria Program, Matola, Maputo Province, Mozambique; Division of Clinical Pharmacology, University of Cape Town, Cape Town, South Africa; Hunter New England Population Health, Newcastle, New South Wales, Australia; School of Public Health and Tropical Medicine, James Cook University, Townsville, Australia; Malaria Control Programme...
- Corresponding author
- KLEINSCHMIDT, IMMO
- Venue
- The American Journal of Tropical Medicine and Hygiene
- Published
- 2007-01
- Volume
- 76
- Issue
- 1
- Pages
- 42-47
- ISSN
- 0002-9637 (ISSN-L)
- PMC
- PMC3749812
- OpenAlex
- W4297845758
- Cited by
- 269
- References
- 0
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 4 · 2023: 8 · 2022: 17 · 2021: 9 · 2020: 13 · 2019: 8 · 2018: 5 · 2017: 13 · 2016: 17 · 2015: 14 · 2014: 12 · 2013: 23 · 2012: 26
- FWCI
- 24.37
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Tropical Medicine and Hygiene (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- ResearchOnline at James Cook University (James Cook University) (submittedVersion)
- PubMed
- Funders
- University of Cape Town
- Medical Research Council
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Mosquito-borne diseases and control
- Life Sciences › Immunology and Microbiology › Parasitology › Bird parasitology and diseases
- Keywords
- malaria control, indoor residual spraying, Plasmodium falciparum, malaria prevalence, malaria case notification, regional cooperation, Mozambique, Swaziland, South Africa, malaria transmission reduction
- MeSH terms
- Adolescent, Animals, Antimalarials, Child, Child, Preschool, Humans, Insect Vectors, International Cooperation, Mosquito Control, Mozambique, Plasmodium falciparum, South Africa, Eswatini, Time Factors, Prevalence, Malaria, Falciparum
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