Targeting imported malaria through social networks: a potential strategy for malaria elimination in Swaziland

Swaziland has made great progress towards its goal of malaria elimination by 2015. However, malaria importation from neighbouring high-endemic Mozambique through Swaziland's eastern border remains a major factor that could prevent elimination from being achieved. In order to reach elimination,...

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Bibliographic Details
Published in:Malaria journal 2013-06, Vol.12 (1), p.219-219, Article 219
Main Authors: Koita, Kadiatou, Novotny, Joseph, Kunene, Simon, Zulu, Zulizile, Ntshalintshali, Nyasatu, Gandhi, Monica, Gosling, Roland
Format: Article
Language:English
Subjects:
Adolescent
Adult
Anopheles
Child
Child, Preschool
Communicable Disease Control - methods
Control
Disease transmission
Epidemiological Monitoring
Female
Humans
Malaria
Malaria - epidemiology
Malaria - prevention & control
Malaria - transmission
Male
Middle Aged
Prevention
Social networks
Social Support
Swaziland - epidemiology
Travel
Travelers
Young Adult
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Summary:Swaziland has made great progress towards its goal of malaria elimination by 2015. However, malaria importation from neighbouring high-endemic Mozambique through Swaziland's eastern border remains a major factor that could prevent elimination from being achieved. In order to reach elimination, Swaziland must rapidly identify and treat imported malaria cases before onward transmission occurs. A nationwide formative assessment was conducted over eight weeks to determine if the imported cases of malaria identified by the Swaziland National Malaria Control Programme could be linked to broader social networks and to explore methods to access these networks. Using a structured format, interviews were carried out with malaria surveillance agents (6), health providers (10), previously identified imported malaria cases (19) and people belonging to the networks identified through these interviews (25). Most imported malaria cases were Mozambicans (63%, 12/19) making a living in Swaziland and sustaining their families in Mozambique. The majority of imported cases (73%, 14/19) were labourers and self-employed contractors who travelled frequently to Mozambique to visit their families and conduct business. Social networks of imported cases with similar travel patterns were identified through these interviews. Nearly all imported cases (89%, 17/19) were willing to share contact information to enable network members to be interviewed. Interviews of network members and key informants revealed common congregation points, such as the urban market places in Manzini and Malkerns, as well as certain bus stations, where people with similar travel patterns and malaria risk behaviours could be located and tested for malaria. This study demonstrated that imported cases of malaria belonged to networks of people with similar travel patterns. This study may provide novel methods for screening high-risk groups of travellers using both snowball sampling and time-location sampling of networks to identify and treat additional malaria cases. Implementation of a proactive screening programme of importation networks may help Swaziland halt transmission and achieve malaria elimination by 2015.
ISSN:1475-2875
1475-2875
DOI:10.1186/1475-2875-12-219