School of Agricultural, Earth, and Environmental Sciences, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban, 4000, South Africa.
School of Agricultural, Earth, and Environmental Sciences, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban, 4000, South Africa.
J Infect Public Health. 2017 May-Jun;10(3):334-338. doi: 10.1016/j.jiph.2017.02.011. Epub 2017 Mar 18.
The change of the malaria control intervention policy in South Africa (SA), re-introduction of dichlorodiphenyltrichloroethane (DDT), may be responsible for the low and sustained malaria transmission in KwaZulu-Natal (KZN). We evaluated the effect of the re-introduction of DDT on malaria in KZN and suggested practical ways the province can strengthen her already existing malaria control and elimination efforts, to achieve zero malaria transmission. We obtained confirmed monthly malaria cases in KZN from the malaria control program of KZN from 1998 to 2014. The seasonal autoregressive integrated moving average (SARIMA) intervention time series analysis (ITSA) was employed to model the effect of the re-introduction of DDT on confirmed monthly malaria cases. The result is an abrupt and permanent decline of monthly malaria cases (w=-1174.781, p-value=0.003) following the implementation of the intervention policy. The sustained low malaria cases observed over a long period suggests that the continued usage of DDT did not result in insecticide resistance as earlier anticipated. It may be due to exophagic malaria vectors, which renders the indoor residual spraying not totally effective. Therefore, the feasibility of reducing malaria transmission to zero in KZN requires other reliable and complementary intervention resources to optimize the existing ones.
南非（SA）疟疾控制干预政策的改变，即重新引入滴滴涕（DDT），可能是夸祖鲁-纳塔尔省（KZN）疟疾低水平持续传播的原因。我们评估了重新引入滴滴涕对 KZN 疟疾的影响，并提出了该省加强现有疟疾控制和消除工作的实用方法，以实现零疟疾传播。我们从 1998 年至 2014 年从 KZN 的疟疾控制项目中获得了 KZN 的确诊每月疟疾病例。采用季节性自回归综合移动平均（SARIMA）干预时间序列分析（ITSA）来模拟重新引入滴滴涕对确诊每月疟疾病例的影响。结果是，干预政策实施后，每月疟疾病例突然且永久性下降（w=-1174.781，p 值=0.003）。长期观察到的持续低疟疾病例表明，人们先前预期的滴滴涕持续使用不会导致抗药性。这可能是由于外吸性疟疾病媒，这使得室内滞留喷洒不完全有效。因此，要在 KZN 将疟疾传播率降低到零，需要其他可靠和补充的干预资源来优化现有的资源。
