International Centre of Insect Physiology and Ecology, Nairobi, Kenya.
University of Dar Es Salaam, Mbeya College of Health and Allied Sciences, Mbeya, Tanzania.
Malar J. 2021 Mar 20;20(1):159. doi: 10.1186/s12936-021-03699-x.
Eswatini was the first country in sub-Saharan Africa to pass a National Malaria Elimination Policy in 2011, and later set a target for elimination by the year 2020. This case study aimed to review the malaria surveillance data of Eswatini collected over 8 years between 2012 and 2019 to evaluate the country's efforts that targeted malaria elimination by 2020. Coverage of indoor residual spraying (IRS) for vector control and data on malaria cases were provided by the National Malaria Programme (NMP) of Eswatini. The data included all cases treated for malaria in all health facilities. The data was analysed descriptively. Over the 8 years, a total of 5511 patients reported to the health facilities with malaria symptoms. The case investigation rate through the routine surveillance system increased from 50% in 2012 to 84% in 2019. Incidence per 1000 population at risk fluctuated over the years, but in general increased from 0.70 in 2012 to 1.65 in 2019, with the highest incidence of 3.19 reported in 2017. IRS data showed inconsistency in spraying over the 8 years. Most of the cases were diagnosed by rapid diagnostic test (RDT) kits in government (87.6%), mission (89.1%), private (87%) and company/industry-owned facilities (84.3%), either singly or in combination with microscopy. Eswatini has fallen short of achieving malaria elimination by 2020. Malaria cases are still consistently reported, albeit at low rates, with occasional localized outbreaks. To achieve elimination, it is critical to optimize timely and well-targeted IRS and to consider rational expansion of tools for an integrated malaria control approach in Eswatini by including tools such as larval source management, long-lasting insecticidal nets (LLINs), screening of mosquito house entry points, and chemoprophylaxis. The establishment of rigorous routine entomological surveillance should also be prioritized to determine the local malaria vectors' ecology, potential species diversity, the role of secondary vectors and insecticide resistance.
斯威士兰是撒哈拉以南非洲第一个在 2011 年通过国家消除疟疾政策的国家，并随后设定了到 2020 年消除疟疾的目标。本案例研究旨在审查 2012 年至 2019 年期间收集的斯威士兰疟疾监测数据，以评估该国到 2020 年消除疟疾的努力。斯威士兰国家疟疾规划（NMP）提供了媒介控制的室内残留喷洒（IRS）覆盖率和疟疾病例数据。该数据包括所有在所有卫生机构治疗疟疾的病例。数据进行了描述性分析。在 8 年期间，共有 5511 名有疟疾症状的患者向卫生机构报告。通过常规监测系统进行的病例调查率从 2012 年的 50%增加到 2019 年的 84%。每年的发病率在风险人群中波动，但总体从 2012 年的 0.70 增加到 2019 年的 1.65，2017 年报告的发病率最高为 3.19。IRS 数据显示 8 年来喷洒不一致。大多数病例是在政府（87.6%）、传教（89.1%）、私营（87%）和公司/工业拥有的设施（84.3%）中通过快速诊断检测（RDT）试剂盒单独或组合显微镜诊断的，无论是单独使用还是组合使用。斯威士兰未能实现到 2020 年消除疟疾的目标。尽管发病率较低，但仍持续报告疟疾病例，偶尔会出现局部暴发。为了实现消除目标，至关重要的是优化及时和有针对性的 IRS，并考虑在斯威士兰通过包括幼虫源管理、长效杀虫蚊帐（LLINs）、蚊子进入点筛查和化学预防等工具，合理扩大综合疟疾控制方法的工具。还应优先建立严格的常规昆虫学监测，以确定当地疟疾媒介的生态、潜在物种多样性、次要媒介的作用和抗药性。
