W, Harry Feinstone Department of Molecular Microbiology & Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Malar J. 2013 Dec 20;12:458. doi: 10.1186/1475-2875-12-458.
Botswana has made substantial progress towards malaria elimination across the country. This work assessed interventions and epidemiological characteristics of malaria in Botswana, during a period of decreasing transmission intensity.
National passive malaria surveillance data for five years (2008-2012) were analysed. A district-level, random effects model with Poisson regression was used to explore the association between malaria cases and coverage with long-lasting insecticide-treated nets (LLINs) and indoor residual spraying (IRS). Malaria cases were mapped to visualize spatio-temporal variation in malaria for each year.
Within five years, a reduction in malaria prevalence (approximately 98%) and number of deaths (12 to three) was observed. Between 2008 and 2012, 237,050 LLINs were distributed and 596,979 rooms were sprayed with insecticides. Coverage with LLINs and IRS was not uniformly distributed over the study period and only targeted the northern districts with a high malaria burden. The coverage of IRS was associated with a reduction in malaria cases.
Botswana has made significant strides towards its goal of country-wide elimination of malaria. A major challenge in the future will be prevention and management of imported malaria infections from neighbouring countries. In order to accurately monitor progress towards the elimination goal, the malaria control programme (NMP) should strengthen the reporting and capturing of data at household and individual level. Systematic, periodic operational research to feedback the NMP will help to guide and achieve elimination.
博茨瓦纳在全国范围内消除疟疾方面取得了重大进展。这项工作评估了博茨瓦纳在疟疾传播强度降低期间的干预措施和流行病学特征。
对五年（2008-2012 年）的国家被动疟疾监测数据进行了分析。采用区县级随机效应泊松回归模型，探讨疟疾病例与长效驱虫蚊帐（LLINs）和室内滞留喷洒（IRS）覆盖率之间的关联。将疟疾病例映射到每年的疟疾时空变化图上。
在五年内，疟疾的流行率（约 98%）和死亡人数（从 12 人降至 3 人）有所下降。2008 年至 2012 年间，共发放了 237,050 顶蚊帐，对 596,979 个房间进行了杀虫剂喷洒。在整个研究期间，LLINs 和 IRS 的覆盖范围并不均匀，仅针对疟疾负担较高的北部地区。IRS 的覆盖范围与疟疾病例的减少有关。
博茨瓦纳在实现全国消除疟疾的目标方面取得了重大进展。未来的一个主要挑战将是预防和管理来自邻国的输入性疟疾感染。为了准确监测消除目标的进展情况，国家疟疾控制规划（NMP）应加强家庭和个人层面的数据报告和采集。有针对性的、定期的运营研究将有助于指导和实现消除疟疾的目标。
