Towards malaria elimination in Mpumalanga, South Africa: a population-level mathematical modelling approach

Sharing borders with both Mozambique and Swaziland, Mpumalanga experiences seasonal unstable transmission that is prone to sporadic outbreaks from the first rains in October to late May. The Ehlanzeni District on the eastern border of Mpumalanga is most affected by malaria with the number of imported cases overtaking locally sourced cases in recent years. Between 2002 and 2012, 41% of cases were sourced in South Africa and 54% sourced from Mozambique (the remaining 5% being sourced from other African and Asian countries). Source of infection has been determined for all cases in the province, whereby a case is classified as imported if the patient travelled to a malaria-endemic area in the past month or if there is no evidence of local transmission (vectors or cases within 500 m radius of the place of residence). The proportion of imported cases has increased from 39% in 2002 to 87% in 2012. The model presented in this study is used to assess the impact of proposed policy interventions in Mpumalanga.

A deterministic population-based non-linear ordinary differential equation model fitted to the Mpumalanga malaria data, is used to predict the impact of the following interventions (alone and in combination): scale-up of vector control, MDA, MSAT and foreign source reduction.

Combination of Interventions
Drug-based Strategies
Impact of Interventions
Indigenous Cases & Importation
Modeling
Operational Research
Vector Control

South Africa

Mathematical modelling for malaria elimination in Mpumalanga, South Africa