Bednets ordered as best defence against Africa’s biggest killer

With over 60 000 cases seen during the last year’s malaria season, South Africa is planning to make 85 000 insecticide treated bednets available in KwaZulu-Natal during the peak season starting in October as part of an effort to curb the epidemic.

This is in line with the aims for the Africa Malaria Day on Wednesday (April 25) that will see the launch of massive campaigns to increase the distribution, purchase and use of insecticide treated mosquito nets for prevention and control.

South Africa has opted not to participate in Wednesday’s Africa Malaria Day, but to wait until the peak season in November to create increasing awareness around a disease that kills more people on this continent than any other illness.

Patrick Moonasar, Assistant Director: Vector-borne Diseases in the Department of Health, said KwaZulu-Natal’s health department and the Medical Research Council has been actively involved in research assessing the impact of bednets.

“The findings have shown that the bednets are effective for the control of malaria, easy to implement, cheaper than that of residual house spraying and has been well accepted by local communities,” Moonasar said.

He said the bednets would be used in the coming malaria season (October to May) coupled with residual house spraying.  

The implementation of bednets in the Northern Province and Mpumalanga will commence shortly, with 45 000 bednets ordered, according to Moonasar.  

Professor Maureen Coetzee, head of the Department of Medical Entomology at the SA Institute for Medical Research, said there had been a seven fold increase in malaria cases from 1996 to 2000 after the national malaria mosquito control policy was changed, moving away from house spraying with DDT to the more eco-friendly pyrethroid insecticides.

Research carried out by Coetzee’s department showed that one of the most dangerous malaria-transmitting mosquitoes in Africa, the Anopheles funestus, has re-entered South Africa after an absence of over 50 years.  

“The reason for its return is because it is resistant to pyrethroid insecticides,” Coetzee said.

Field and laboratory studies showed that this mosquito was still susceptible to DDT and after intensive debate in government, environmental circles and the health sector, the KwaZulu-Natal Malaria Control Programme took the decision to revert to DDT for house spraying.

“Current figures from the Department of Health indicate that the spraying is bringing the epidemic under control,” Coetzee said.  

Coetzee also recently attended the launch of the Anopheles gambiae genome project in Paris.

The mosquito, Anopheles gambiae, is one of the most prolific transmitters of malaria in Africa. “The mosquito genome project will open a huge new field of research into one of the main scourges of the developing world. Major research efforts are being focussed on genetic manipulation of the mosquitoes, transforming them into harmless, non-vector insects, by changing their ability to harbour malaria parasites,” Coetzee explained.  

Malaria reaches into South Africa only at its fringes, affecting the three northeastern provinces of KwaZulu-Natal, Mpumalanga and the Northern Province.

Due to the local climate, malaria transmission follows a distinctly seasonal pattern, resulting in periodic epidemics. Peak rates in malaria outpatients at health facilities usually occur in April and decline by June.  

Last year 423 deaths were reported. This year almost 8 000 cases have been reported with 21 deaths.

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