Targeting imported malaria through social networks: a potential strategy for malaria elimination in Swaziland

Malaria Journal

Research

Monica Gandhi¹  Kadiatou Koita²  Roland Gosling²  Joseph Novotny³  Nyasatu Ntshalintshali³  Simon Kunene⁴  Zulizile Zulu⁴ 

[1] Divisions of HIV/AIDS and Infectious Disease, University of California, San Francisco, CA, USA;Global Health Group, University of California, San Francisco, CA, USA;Global Health Group, University of California, San Francisco, CA, USA;Clinton Health Access Initiative, Mbabane, Swaziland;National Malaria Control Programme, Manzini, Swaziland;

关键词: Malaria;    Elimination;    Importation;    Swaziland;    Active case detection;    Social networks;   

DOI  :  10.1186/1475-2875-12-219

 received in 2013-04-02, accepted in 2013-06-23,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundSwaziland has made great progress towards its goal of malaria elimination by 2015. However, malaria importation from neighbouring high-endemic Mozambique through Swaziland’s eastern border remains a major factor that could prevent elimination from being achieved. In order to reach elimination, Swaziland must rapidly identify and treat imported malaria cases before onward transmission occurs.MethodsA nationwide formative assessment was conducted over eight weeks to determine if the imported cases of malaria identified by the Swaziland National Malaria Control Programme could be linked to broader social networks and to explore methods to access these networks.ResultsUsing a structured format, interviews were carried out with malaria surveillance agents (6), health providers (10), previously identified imported malaria cases (19) and people belonging to the networks identified through these interviews (25). Most imported malaria cases were Mozambicans (63%, 12/19) making a living in Swaziland and sustaining their families in Mozambique. The majority of imported cases (73%, 14/19) were labourers and self-employed contractors who travelled frequently to Mozambique to visit their families and conduct business. Social networks of imported cases with similar travel patterns were identified through these interviews. Nearly all imported cases (89%, 17/19) were willing to share contact information to enable network members to be interviewed. Interviews of network members and key informants revealed common congregation points, such as the urban market places in Manzini and Malkerns, as well as certain bus stations, where people with similar travel patterns and malaria risk behaviours could be located and tested for malaria.ConclusionThis study demonstrated that imported cases of malaria belonged to networks of people with similar travel patterns. This study may provide novel methods for screening high-risk groups of travellers using both snowball sampling and time-location sampling of networks to identify and treat additional malaria cases. Implementation of a proactive screening programme of importation networks may help Swaziland halt transmission and achieve malaria elimination by 2015.

【 授权许可】

CC BY   
© Koita et al.; licensee BioMed Central Ltd. 2013