Exploring 30 years of malaria case data in KwaZulu-Natal, South Africa: part II. The impact of non-climatic factors


Craig, MH; Kleinschmidt, I; le Sueur, D; Sharp, BL; (2004) Exploring 30 years of malaria case data in KwaZulu-Natal, South Africa: part II. The impact of non-climatic factors. Tropical medicine & international health, 9 (12). pp. 1258-66. ISSN 1360-2276 DOI: https://doi.org/10.1111/j.1365-3156.2004.01341.x

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Abstract

Malaria transmission is a multifactorial phenomenon. Climate is a major limiting factor in the spatial and temporal distribution of malaria, but many non-climatic factors may alter or override the effect of climate. Thirty years of monthly malaria incidence data from KwaZulu-Natal province, South Africa, reveal strong medium and long-term trends, which were not present in the climate data. This paper explores various non-climatic factors that may have contributed towards the observed trends. The development of antimalarial drug resistance, available information on human immunodeficiency virus (HIV) prevalence, cross-border people movements, agricultural activities, emergence of insecticide resistance and the case reporting system are reviewed and their potential effect on malaria transmission examined. Single-variable linear regression analysis showed significant association between seasonal case totals (log-transformed) and the measured level of drug resistance (log-transformed) (r2=0.558, n=10, P=0.013) as well as relative measures of HIV infection since 1990 (r2=0.846, n=11, P=0.001). The other factors appear to have affected the level of malaria transmission at certain periods and to some degree. The importance of surveillance and inclusion of non-climatic variables in analysis of malaria data is demonstrated.

Item Type: Article
Keywords: Agriculture/trends, Climate, Disease Outbreaks, Drug Resistance, Emigration and Immigration/statistics & numerical data, HIV Infections/epidemiology, Humans, Incidence, Insecticide Resistance, Linear Models, Malaria/*epidemiology/etiology/transmission, Risk Factors, Seasons, South Africa/epidemiology, Agriculture, trends, Climate, Disease Outbreaks, Drug Resistance, Emigration and Immigration, statistics & numerical data, HIV Infections, epidemiology, Humans, Incidence, Insecticide Resistance, Linear Models, Malaria, epidemiology, etiology, transmission, Risk Factors, Seasons, South Africa, epidemiology
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Malaria Centre
PubMed ID: 15598257
Web of Science ID: 225637800004
URI: http://researchonline.lshtm.ac.uk/id/eprint/9977

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