Travel patterns and demographic characteristics of malaria cases in Swaziland, 2010–2014

Malaria Journal

Research

Nyasatu Ntshalintshali¹  Adam Soble¹  Deepa Pindolia¹  Bongani Dlamini¹  Arnaud Le Menach¹  David L. Smith²  Simon Kunene³  Nomcebo Dlamini³  Natalia Tejedor‐Garavito⁴  Victor Alegana⁵  Andrew J. Tatem⁵  Nick W. Ruktanonchai⁵ 

[1] Clinton Health Access Initiative, Boston, MA, USA;Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA;National Malaria Control Programme, Manzini, Swaziland;WorldPop, University of Southampton, Southampton, UK;WorldPop, University of Southampton, Southampton, UK;Flowminder Foundation, Stockholm, Sweden;

关键词: Imported malaria;    Travel history;    Malaria elimination;    Reactive case detection;    Surveillance system;   

DOI  :  10.1186/s12936-017-2004-8

 received in 2017-05-24, accepted in 2017-08-30,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAs Swaziland progresses towards national malaria elimination, the importation of parasites into receptive areas becomes increasingly important. Imported infections have the potential to instigate local transmission and sustain local parasite reservoirs.MethodsTravel histories from Swaziland’s routine surveillance data from January 2010 to June 2014 were extracted and analysed. The travel patterns and demographics of rapid diagnostic test (RDT)-confirmed positive cases identified through passive and reactive case detection (RACD) were analysed and compared to those found to be negative through RACD.ResultsOf 1517 confirmed cases identified through passive surveillance, 67% reported travel history. A large proportion of positive cases reported domestic or international travel history (65%) compared to negative cases (10%). The primary risk factor for malaria infection in Swaziland was shown to be travel, more specifically international travel to Mozambique by 25- to 44-year old males, who spent on average 28 nights away. Maputo City, Inhambane and Gaza districts were the most likely travel destinations in Mozambique, and 96% of RDT-positive international travellers were either Swazi (52%) or Mozambican (44%) nationals, with Swazis being more likely to test negative. All international travellers were unlikely to have a bed net at home or use protection of any type while travelling. Additionally, paths of transmission, important border crossings and means of transport were identified.ConclusionResults from this analysis can be used to direct national and well as cross-border targeting of interventions, over space, time and by sub-population. The results also highlight that collaboration between neighbouring countries is needed to tackle the importation of malaria at the regional level.

【 授权许可】

CC BY   
© The Author(s) 2017