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

Abstract:

BACKGROUND:As 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. METHODS:Travel 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. RESULTS:Of 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. CONCLUSION:Results 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.

journal_name

Malar J

journal_title

Malaria journal

authors

Tejedor-Garavito N,Dlamini N,Pindolia D,Soble A,Ruktanonchai NW,Alegana V,Le Menach A,Ntshalintshali N,Dlamini B,Smith DL,Tatem AJ,Kunene S

doi

10.1186/s12936-017-2004-8

subject

Has Abstract

pub_date

2017-09-08 00:00:00

pages

359

issue

1

issn

1475-2875

pii

10.1186/s12936-017-2004-8

journal_volume

16

pub_type

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