/ 28 July 2000

Southern Africa’s biggest parasite

Khadija Magardie Malaria is by far Africa’s most important tropical parasitic disease, and kills more people than any other communicable disease except tuberculosis. And though the geographical

area affected by malaria has shrunk over the past 50 years, the Southern African region continues to experience a resurgence in malaria transmission, especially in the past four years. The National Malaria Research Programme, run by the Medical Research Council (MRC), attributes this to factors such as population migration, drug and insecticide resistance, and climatic changes. Falling within the high-risk areas in the region are all border areas, which the MRC says indicates the need for the disease to be viewed as “a regional, rather than country- specific problem”. Specifically, areas in close proximity to Mozambique, like the “buffer zone” of the Kruger Park area, are high-risk areas.

The Department of Health has expressed concern that the disease appears to be moving further into the country, away from the high-risk areas. Outbreaks of malaria have moved as far as Nelspruit, Northern Province. Cases are also being found as far south as Richards Bay in KwaZulu-Natal and there have been isolated cases in Pretoria on the highveld. Malaria cases normally peak at certain times, like during summer, but health authorities say the rapid increase in malaria cases is often not even within “malaria season”. The World Health Organisation (WHO) has identified five Southern African countries, including South Africa, as experiencing an overall increase in malaria transmission.

Countries from this region constitute more than 90% of all malaria cases. Among the high-risk groups are pregnant women, non-immune travellers, refugees, displaced people and labourers entering epidemic areas. The number of deaths attributed to malaria in the region exceed 180E000 a year. This is further exacerbated by the fact that many countries use the majority of their health budgets to fight the HIV/Aids pandemic, leaving little money to fight clinical deaths from malaria. According to the WHO, the direct and indirect costs of malaria in sub-Saharan Africa exceed $2- billion.