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[afro-nets] KwaZulu-Natal's successful fight against malaria

KwaZulu-Natal's successful fight against malaria

05 October 2005
Public Library of Science

A new drug is demonstrating impressive results in the fight
against malaria, according to a forthcoming paper in the open
access journal PLoS Medicine. The study of a malaria control
program in South Africa shows how hospital admissions for ma-
laria were dramatically reduced following the introduction of an
antimalarial combination called artemether-lumefantrine (AL) and
the partial reintroduction of the insecticide DDT. The malaria
epidemic has been particularly resurgent in recent years as the
parasites transmitting the disease have developed resistance to
many of the existing drugs. Approximately a million people are
killed by malaria every year, predominantly in Africa. KwaZulu-
Natal was the first Ministry of Health in Africa to introduce an
artemisinin-based combination therapy (ACT) malaria treatment

Karen Barnes and colleagues describe and evaluate the new meas-
ures against malaria put in place in the KwaZulu-Natal province,
where cases had risen fifteen-fold during the 1990s. AL was in-
troduced to the area in 2000 alongside an intensified effort to
control mosquitoes with insecticides. Reviewing data from four
health care facilities representative of the province, the re-
searchers found that admissions for malaria had declined by 89%
in the year following the changes. By 2003 the decline in ma-
laria had been sustained throughout the province: outpatient
cases fell by 99% and malaria-related deaths had decreased by

The authors are keen to stress the vital importance of a health
care infrastructure that can deliver prompt diagnosis, as well
as perceptions within the community that treatment for malaria
should be sought urgently and completed at public-health care
facilities. These favourable factors combined with better con-
trol of mosquitoes, including the use of DDT for reed and mud
homesteads, maximized the benefits of AL treatment in Africa. It
makes KwaZulu-Natal an encouraging example of how to combat ma-
laria following its dramatic and deadly increase.

In an accompanying Perspective, Patrick Duffy (of the Seattle
Biomedical Research Institute) and Thehonest Mutabingwa (of the
National Institute for Medical Research in Tanzania) highlight
lessons learned from the "notable success" in KwaZulu-Natal
"amid the dire statistics showing a deadly resurgence of ma-

Citation: Barnes KI, Durrheim DN, Little F, Jackson A, Mehta U,
et al. (2005) Effect of artemetherlumefantrine policy and im-
proved vector control on malaria burden in KwaZulu¡VNatal, South
Africa. PLoS Med 2(11): e330.

Related Perspectives article:

Citation: Duffy PE, Mutabingwa TK (2005) Rolling back a malaria
epidemic in South Africa. PLoS Med 2(11): e368.

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brary of Science uses the Creative Commons Attribution License.

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