Smart surveillance towards malaria elimination in Mpumalanga: novel approaches for mapping antimalarial resistance

Antimalarial drug resistance is one of the biggest threats to the control & eventual elimination of malaria. Resistance is confirmed to all currently available antimalarials. Resistance to the most pivotal antimalarial group, the artemisinins, has spread from Cambodia to, or emerged in, another five neighbouring countries across South-East Asia, nearing the Indian border – from where global spread is considered inevitable. Areas of lowest malaria transmission intensity, like South Africa, are at the highest risk of antimalarial drug resistance. In these very low transmission areas, the incidence of infection is too infrequent for development of the partial malaria immunity needed to compensate for failing treatments, & drug pressure is increased as all cases are symptomatic. Thus, the areas of lowest intensity transmission most need efficient, up to date & effective targeted information system, such as our proposed “Smart Surveillance 4 Elimination”, in order to rapidly detect & respond to emerging drug resistance, before it increases malaria transmission, morbidity & mortality & derails elimination efforts. The goal of this project is to develop a draft strategic plan, that can be pilot tested in Mpumalanga Province to improve malaria treatment & surveillance approaches to advance malaria elimination in South Africa & beyond.

New approaches, knowledge & skills sharing are urgently needed to advance malaria elimination in South Africa. The key challenges that need to be overcome include fragmented malaria information systems & health information systems, & very high levels of cross border migration from areas of high intensity malaria transmission, as well as the ever-present threat of antimalarial drug resistance. Developing & evaluating novel technology to consolidate & exp& current surveillance activities will provide the information needed to understand & address these challenges. Leveraging existing resources to amplify their impact through data integration will be of great value not just for South Africa, but also for other countries working towards malaria elimination, particularly neighboring countries within southern Africa & regional collaborations such as MOSASWA & the Elimination8. Such smart surveillance approaches could also be applied more broadly to geospatial mapping of antibiotic & other antimicrobial resistance.

Project details

Drug Resistance
Indigenous Cases & Importation
Surveillance

Mar 2017 — Mar 2019

$77,287

South Africa