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

Travel patterns and demographic characteristics of malaria cases in Swaziland, 2010–2014
Travel patterns and demographic characteristics of malaria cases in Swaziland, 2010–2014
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.
imported malaria, Travel history, Malaria elimination, Reactive case detection, Surveillance system
1475-2875
1-18
Tejedor Garavito, Natalia
26fd242c-c882-4210-a74d-af2bb6753ee3
Dlamini, Nomcebo
431ebc1d-fbc7-456c-ba5e-3b816a8e95fa
Pindolia, Deepa
d3447abb-696b-4789-b47e-2a07ac6b967c
Soble, Adam
f2670f61-d771-4183-9178-ffe697014fcf
Ruktanonchai, Nick
fe68cb8d-3760-4955-99fa-47d43f86580a
Alegana, Victor
6fdaa47e-c08c-48bc-b881-1dc7b89085e4
Le Menach, Arnaud
112ed28c-c8d5-433f-9df4-e5121562df56
Ntshalintshali, Nyasatu
a9001856-6950-46c4-917a-6f1342773067
Dlamini, Bongani
4123dae1-1df4-4a8b-8edf-5e8b1f9d308a
Smith, David L.
567dbcc2-7782-417b-96d6-dbc55a0ace22
Tatem, Andrew
6c6de104-a5f9-46e0-bb93-a1a7c980513e
Kunene, Simon
40050fff-6313-4c8d-be61-65aa60bd01bc
Tejedor Garavito, Natalia
26fd242c-c882-4210-a74d-af2bb6753ee3
Dlamini, Nomcebo
431ebc1d-fbc7-456c-ba5e-3b816a8e95fa
Pindolia, Deepa
d3447abb-696b-4789-b47e-2a07ac6b967c
Soble, Adam
f2670f61-d771-4183-9178-ffe697014fcf
Ruktanonchai, Nick
fe68cb8d-3760-4955-99fa-47d43f86580a
Alegana, Victor
6fdaa47e-c08c-48bc-b881-1dc7b89085e4
Le Menach, Arnaud
112ed28c-c8d5-433f-9df4-e5121562df56
Ntshalintshali, Nyasatu
a9001856-6950-46c4-917a-6f1342773067
Dlamini, Bongani
4123dae1-1df4-4a8b-8edf-5e8b1f9d308a
Smith, David L.
567dbcc2-7782-417b-96d6-dbc55a0ace22
Tatem, Andrew
6c6de104-a5f9-46e0-bb93-a1a7c980513e
Kunene, Simon
40050fff-6313-4c8d-be61-65aa60bd01bc

Tejedor Garavito, Natalia, Dlamini, Nomcebo, Pindolia, Deepa, Soble, Adam, Ruktanonchai, Nick, Alegana, Victor, Le Menach, Arnaud, Ntshalintshali, Nyasatu, Dlamini, Bongani, Smith, David L., Tatem, Andrew and Kunene, Simon (2017) Travel patterns and demographic characteristics of malaria cases in Swaziland, 2010–2014. Malaria Journal, 16 (359), 1-18. (doi:10.1186/s12936-017-2004-8).

Record type: Article

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.

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s12936-017-2004-8 - Version of Record
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More information

Accepted/In Press date: 30 August 2017
e-pub ahead of print date: 8 September 2017
Keywords: imported malaria, Travel history, Malaria elimination, Reactive case detection, Surveillance system

Identifiers

Local EPrints ID: 414701
URI: http://eprints.soton.ac.uk/id/eprint/414701
ISSN: 1475-2875
PURE UUID: fee29ecc-a9b3-4909-b06a-25c226ed7ec4
ORCID for Natalia Tejedor Garavito: ORCID iD orcid.org/0000-0002-1140-6263
ORCID for Andrew Tatem: ORCID iD orcid.org/0000-0002-7270-941X

Catalogue record

Date deposited: 06 Oct 2017 16:31
Last modified: 07 Oct 2020 02:07

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Contributors

Author: Nomcebo Dlamini
Author: Deepa Pindolia
Author: Adam Soble
Author: Victor Alegana
Author: Arnaud Le Menach
Author: Nyasatu Ntshalintshali
Author: Bongani Dlamini
Author: David L. Smith
Author: Andrew Tatem ORCID iD
Author: Simon Kunene

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