In early October 2025, the National Institute for Communicable Diseases (NICD) was notified of three malaria cases in the Free State, a non-endemic province, involving three family members with no recent travel to a malaria-endemic area. Preliminary investigations suggest these are odyssean malaria cases.

Odyssean malaria in South Africa

High volumes of people, goods and vehicles regularly entering Gauteng from malaria‐endemic areas increases the likelihood of infected mosquitoes being inadvertently transported (via road, rail, air, or freight) into the province; hence, most odyssean malaria cases have been detected in this province. According to the Public Health Bulletin South Africa report  “Odyssean Malaria in South Africa, 2014 – 2023”, 82 of the 99 (97 laboratory-confirmed and two probable) odyssean malaria cases reported and investigated between 2014 and 2023 were from Gauteng. However, these cases can occur anywhere, as demonstrated by the recent cluster in the Free State. Although odyssean malaria cases are sporadic and relatively uncommon, awareness and prompt responses are critical, as odyssean malaria is associated with an unacceptably high fatality rate.

What should healthcare workers do?

Delayed diagnosis and treatment of malaria can lead to severe illness or death. Healthcare workers should maintain a high index of suspicion for malaria in any patient presenting with fever or unexplained illness, even when there is no travel history to a malaria-endemic area. Although odyssean malaria cases are rare, malaria should always be included as a differential diagnosis in patients with unexplained fever and thrombocytopenia. A multidisciplinary approach – involving clinicians, laboratories, entomologists, and public-health teams is essential to investigate, confirm and respond effectively to odyssean malaria cases.

Malaria endemic areas in South Africa

Malaria transmission in South Africa generally occurs in the low-altitude regions of northern KwaZulu-Natal, Limpopo, and Mpumalanga provinces, bordering Mozambique, Eswatini, Botswana, and Zimbabwe. All countries neighbouring South Africa, except Lesotho, are malaria-endemic. The high transmission malaria season in South Africa generally runs from September to May, coinciding with the hot, rainy summer months, when the breeding conditions for malaria mosquitoes are optimal.

Malaria symptoms

The early symptoms of malaria are non-specific and can therefore easily be misdiagnosed with other infections, such as COVID-19, tick bite fever, and pneumonia. Common malaria symptoms include:

• Fever and flu-like illness
• Shivering, chills, and sweating
• Muscle aches and fatigue
• Abdominal discomfort, nausea, vomiting, or diarrhoea
• Loss of appetite, sore throat, or cough

How is malaria managed and treated?

Uncomplicated malaria can be treated effectively with oral antimalarial medication, provided diagnosis and treatment are prompt. If diagnosis and/or treatment are delayed, malaria rapidly progresses to severe disease, particularly in non-immune individuals, increasing the risk of adverse outcomes. The choice of medication depends on the severity of the illness and must be informed by the national malaria treatment guidelines.

What should the public do to prevent malaria?

• Reduce mosquito breeding: Drain standing water and cover containers.
• Use personal protection: Consider the use of non-pharmaceutical (e.g. DEET-based repellents, pyrethroid based plug-ins) and/or pharmaceutical (e.g. doxycycline, atovaquone-proguanil) measures. The effectiveness data of natural remedies like citronella and lemon verbena are limited.
• Dress appropriately: Wear long-sleeved shirts, trousers and socks when outdoors in the evenings.
• Sleep safely: Keep windows and doors shut at night. If available, use window/door screens, air conditioners or bed nets.

Odyssean malaria is uncommon and sporadic, but awareness and early action can save lives. Stay alert, not alarmed – recognising malaria early, wherever you are, makes all the difference. Malaria is preventable, treatable, and curable – let’s stay vigilant and keep South Africa malaria-free.

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This is a welcome declaration from high-burden African countries. But a similar commitment accompanied by tangible actions is required from all African malaria-endemic countries, irrespective of malaria burden.

In 2016 the African Union released its catalytic framework to end HIV, tuberculosis, and malaria in Africa by 2030. Despite being signatories of the framework, political commitment by African governments has not translated into increases in domestic investment in malaria control. Between 2021 and 2023, funding for malaria control decreased by $4.8 billion greatly limiting the breadth of control measures that can be effectively implemented.

South Africa is one of the few malaria-endemic African countries whose malaria control programme has been and continues to be almost entirely domestically funded. This has allowed the country to implement interventions in a sustained manner and support research that allows for evidence-based decision-making, collectively contributing to significant decreases in malaria cases. However, the hope of eliminating malaria is being threatened by an ever-increasing funding gap. High-level political support for malaria elimination has not translated to increased investment in malaria elimination on the ground. Competing health priorities and the perception that malaria elimination requires less funding are partly to blame.

Malaria rebounds quickly

Malaria rebounds rapidly when control measures are not implemented sustainably with dire consequences. Sri Lanka had significantly reduced local transmission during the World Health Organisation (WHO) malaria eradication campaign in 1955. However, when the campaign ended abruptly, the country was unable to effectively implement the required interventions, resulting in an upsurge in cases. It took the country another 50 years to eliminate malaria.

Addressing the malaria burden in Africa only became a priority in 2000 when it was identified as a significant obstacle to global development and included as a target in the Millennium Development Goals. Between 2000 and 2015, there was increased international funding allowing national malaria programmes to implement effective malaria control measures. As a result, malaria cases and deaths decreased significantly. Unfortunately, over this period domestic funding for malaria control hardly increased.

Progress against malaria has stalled since 2016, with some countries reporting increases in malaria burden. There were two million more cases in 2022 compared to 2021. This is partly driven by decreases in international funding to implement essential control measures and surveillance activities.

Rather counter-intuitively, malaria elimination costs more than malaria control. In countries like South Africa, which is in the cusp of elimination, investment in malaria must be increased and sustained to prevent the re-establishment of malaria, particularly if they share borders with malaria-endemic countries.

The politics of malaria control

What is needed now is for the political will that’s been shown to be backed by solid financial commitments. Malaria control and politics have a long intertwined history dating back many years. The disease is thought to have evolved in Africa, and spread across the globe through colonisation efforts and the forced migration of labourers from Africa to other parts of the world.

Victory in wars and advances in the name of colonisation were severely impacted by malaria. The French abandoned the construction of the Panama Canal in central America in the late 1880s due to the debilitating effects of malaria on the workforce. More soldiers died from malaria than from combat during World War I.

Ironically, we have world wars and colonisation efforts to thank for the development and implementation of large-scale control measures too. The construction of the Panama Canal was completed only after an integrated programme to control mosquitoes and infection was implemented. The plan included draining water bodies, treating water bodies that could not be drained with chemicals to kill the mosquito larvae, killing adult mosquitoes with insecticides, screening of living quarters and office buildings and administering quinine to all construction workers on a daily basis. Wide-scale implementation of many of these measures including spraying houses with the insecticide DDT, led to the US eliminating malaria by 1949.

Dr Jaishree Raman, Principal Medical Scientist and Head of Laboratory for Antimalarial Resistance Monitoring and Malaria Operational Research, National Institute for Communicable Diseases

This article is republished from Health-e News under a Creative Commons license. Read the original article.

Any individual presenting with fever or ‘flu-like illness, if they reside in a malaria-risk area in Limpopo, KwaZulu-Natal and Mpumalanga or have travelled to a malaria-risk area, in the past six weeks, must be tested for malaria by blood smear microscopy or malaria rapid diagnostic test. If they test positive for malaria, the patient must be started on malaria treatment, immediately.

Patients must remember to inform their healthcare provider of their recent travel, particularly to neighbouring countries and malaria risk areas in South Africa, so that the healthcare provider is made aware of the possibility of malaria.

Odyssean or “taxi malaria”, transmitted by hitch-hiking mosquitoes, should be considered in a patient with unexplained fever who has not travelled to a malaria-endemic area but is getting progressively sicker, with a low platelet count.

Seek medical attention early, both malaria and COVID-19 have similar non-specific early symptoms including fever, chills, headaches, fatigue and muscle pain.

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The World Health Organization (WHO) acknowledged these factors when it excluded Africa from its first Global Malaria Eradication Campaign, which ran from 1955 until 1969. Since then, there have been many advances in malaria control. These include long-lasting insecticide-treated nets, malaria rapid diagnostic tests and artemisinin-based combination therapies (ACTs) for malaria treatment. But malaria elimination is still a challenge. Only two African countries, Algeria and Morocco, have been certified malaria-free by the WHO. There are many reasons for the elimination targets remaining out of reach. In this article, we highlight four: poverty, human movement, resistance and climate change.

Poverty

The limited progress towards malaria elimination is not surprising considering that some of the most malaria-burdened countries in Africa are also some of the poorest countries in the world. Malaria is both a cause and a consequence of poverty. The disease will therefore remain a significant problem in Africa if more is not done to improve the socio-economic status of malaria-affected communities. Eliminating poverty to improve the health and well-being of all, is part of both the millennium and sustainable development goals. This should be a priority for governments of malaria-endemic countries.

Mobility

Africa has one of the fastest-growing populations, with a high level of mobility. Marginalised and vulnerable populations are some of the most mobile groups within Africa. They travel vast distances across countries with varying malaria transmission intensities. Human mobility is strongly associated with the global spread of infectious diseases, as demonstrated by the recent COVID-19, Ebola and monkeypox outbreaks. This presents a challenge to Africa’s malaria elimination aspirations. Malaria parasites and mosquitoes do not respect country borders, so malaria services must expand to mobile and marginalised populations. Universal access to effective malaria diagnostics and treatment will reduce the malaria burden by decreasing onward transmission.

Resistance

One of the biggest threats to eliminating and eradicating malaria is the emergence and spread of insecticide, diagnostic and drug resistance. Both the malaria vectors and parasites have proved to be very adaptable. They have rapidly developed mechanisms to survive and multiply in the presence of insecticides and antimalarial drugs, respectively. Insecticide resistance is widespread across the African region. It reduces the efficacy of strategies based on suppressing vectors, such as long-lasting insecticide-treated nets and indoor residual spraying. To extend the effective lifespan of the available insecticides, the WHO has provided new guidance in its handbook for integrated vector management. The handbook highlights the importance of routine entomological surveillance to determine the type of vectors present, changes in vector behaviour and the insecticide susceptibility status of the vector. All this information can guide effective vector suppression if available in good time.

Having the correct diagnostic method and treatment in place also hinges on having a robust surveillance system. The system must be capable of generating efficacy data in near real-time to allow for prompt evidence-based decision-making. The need for this type of routine surveillance has become even more urgent as African malaria parasites have developed mutations that allow them to evade detection by the most widely used rapid diagnostic tests on the continent. These undetected cases will go untreated, potentially sustaining onward transmission. The result will be major increases in malaria cases, severe disease, and potentially death.

Besides becoming invisible to rapid diagnostic tests, P. falciparum parasites in many central and west African countries have become resistant to artemisinins. This is a component of the most widely used antimalarials in Africa, ACTs. The spread of artemisinin-resistant parasites will potentially raise case numbers and deaths, repeating the devastating trend observed when drug-resistant parasites previously emerged. The loss of ACTs would severely set back elimination efforts as there are no novel WHO-approved antimalarials currently available. Efforts are needed to prevent the spread of artemisinin-resistant parasites through strong surveillance and containment responses.

Climate change

The impact of climate change is complex, but there are suggestions that more places will become malaria-risk areas. Mosquitoes will now be able to survive and transmit malaria in these warmer areas. This, in turn, will increase malaria cases, severe illness and deaths in non-immune communities.

Positive developments

In spite of these challenges, there is some light at the end of the tunnel. After years of research, there are two new malaria vaccines. The first, Mosquirix, has been prequalified for use by the WHO. The second, R21/Matrix M, has shown promising results in phase 2 clinical trials. There are new long-lasting insecticide treated nets and insecticide formulations for vector control. There are also novel strategies for parasite suppression. Adding these tools to the elimination toolbox will assist Africa to get closer to malaria elimination.

Jaishree Raman, Principal Medical Scientist and Head of the Laboratory for Antimalarial Resistance Monitoring and Malaria Operational Research, National Institute for Communicable Diseases and Shüné Oliver, Medical scientist, National Institute for Communicable Diseases

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Viruses transmitted by insects like mosquitoes are called arthropod-borne or arboviruses. Like malaria, these viruses are transmitted to vertebrate hosts through the bite of a female mosquito when she takes a blood meal to assist with her egg development. Most vertebrate hosts for these arboviruses are non-human. They include birds, primates and agricultural animals. But some arboviruses can be transmitted to humans with severe negative outcomes.

Five of the most important arboviruses affecting communities in Africa include the chikungunya, dengue, West Nile, yellow fever and Zika viruses. It is estimated that half of the world’s population is at risk of being infected by an arbovirus.

Some mosquito-borne diseases – but not all – can be fatal to humans. This confirms that every effort must be made to prevent being bitten by a mosquito and infected using both pharmaceutical and non-pharmaceutical measures.

Chikungunya

The name chikungunya is derived from the Kimakonde language (used in Tanzania and Mozambique) and means “to become contorted”. The symptoms of chikungunya virus include headaches, a rash, fatigue, fever and muscle and joint pain. Generally, these symptoms clear within a week. Occasionally, an infection can result in a severe fever and extremely painful joints, which can last for months or years, inducing a hunched, contorted appearance. Unfortunately, there are no antiviral or vaccine treatments available for chikungunya virus. Deaths from chikungunya are rare and are generally associated with other underlying health problems.

The chikungunya virus was first identified in 1952 during an outbreak in Tanzania. It is transmitted by Aedes aegypti and Aedes albopictus mosquitoes. Over 100 countries across the globe have reported chikungunya virus cases. The risk of outbreaks is extremely high wherever these mosquito species are present around homes and urban areas.

Female Aedes mosquitoes tend to feed just after sunrise and around sunset. They lay eggs that can survive drying out. This makes vector control rather challenging. Current control strategies focus on reducing the number of water containers that these mosquitoes like to breed in, the use of insecticides against adult mosquitoes and personal protection to prevent mosquito bites.

Dengue

The World Health Organization has classified dengue virus as one of the top ten global health threats. It’s one of the fastest spreading mosquito-borne diseases. At least half of the world’s population is at risk of infection.

Like chikungunya virus, dengue is spread by Aedes aegypti and Aedes albopictus mosquitoes. Both viruses share the same control interventions and non-specific symptoms of headaches, a rash, fever and muscle and joint pain, so they are often misdiagnosed.

Most human cases of dengue are asymptomatic or present with mild symptoms, which last for two to seven days. In certain individuals, dengue virus progresses to severe disease and symptoms include persistent vomiting, bleeding gums or nose and enlarged liver. This must be treated as a medical emergency as these complications can be lethal. Dengue virus can be diagnosed using a rapid diagnostic test or a polymerase chain reaction (PCR) test.

But there is no treatment available. A vaccine has been developed and has been approved for use in a few countries – but is not widely available in Africa at present.

Zika

The Zika virus was identified in humans in the 1950s. But it only became a pathogen of major public concern in 2016 following the 2015 Zika virus pandemic. The virus is transmitted by Aedes aegypti and Aedes albopictus mosquitoes, and is generally non-lethal in humans. Most people infected with Zika virus do not show any symptoms. A few have non-specific symptoms like fever, rash, headaches, muscle and joint pains and conjunctivitis. These can last two to seven days.

Individuals infected with Zika virus while pregnant are at an increased risk of stillbirth, abortion, neurological disorders or delivering children with birth defects, including microcephaly. PCR testing can be used to diagnose Zika virus, but there is no treatment available.

Yellow fever

Aedes aegypti and Aedes albopictus mosquitoes are also responsible for the transmission of yellow fever, so named because the virus causes jaundice (yellowing of eyes and skin due to impaired liver function).

Symptoms in mild cases include fever, headaches, chills, back pain, fatigue, jaundice, vomiting and bleeding from the mouth, nose, eyes or stomach. These generally clear within five days. Approximately 50% of the small number of patients who develop severe symptoms will die with 10 days of becoming infected. Yellow fever can be diagnosed by PCR or enzyme-linked immunosorbent assay (ELISA). Although there is no treatment for yellow fever, a very effective vaccine is widely available. A single vaccine dose provides lifelong immunity, so all individuals living in or travelling to areas endemic for yellow fever should take the vaccine.

West Nile

The West Nile virus was first isolated from a woman in the West Nile region of Uganda. It is transmitted by mosquitoes belonging the genus Culex. The natural vertebrate hosts are wild birds. But the virus can be transmitted to a number of different animals, including humans, through the bite of an infected mosquito. Approximately 80% of the people infected with West Nile virus will not show any symptoms. Those who do become symptomatic have mild non-specific symptoms that include headaches, fever, tiredness, body aches, nausea, vomiting and, occasionally, a rash. A small proportion of symptomatic patients, however, develop severe disease. This is associated with neurological impairment, and can be fatal in extreme cases.

West Nile virus infection can be diagnosed by PCR or ELISA, with only supportive treatment available for neurological impairment. It has been suggested that people who are older than 50 or immunocompromised are at greater risk of severe infection. An integrated approach comprising water management together with chemical and biological interventions is needed to control the spread of the Culex vectors.

Jaishree Raman, Principal Medical Scientist and Head of Laboratory for Antimalarial Resistance Monitoring and Malaria Operational Research, National Institute for Communicable Diseases and Shüné Oliver, Medical scientist, National Institute for Communicable Diseases

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Researchers from Djibouti reported the presence of An. stephensi in the Horn of Africa in 2012. Until then it had not been found in Africa although it was known to be widespread in Southeast Asia and parts of the Arabian Peninsula. By 2017 it had spread through the Horn of Africa, reaching Ethiopia, Somalia and Sudan.

The spread of An. stephensi is particularly concerning because the mosquito has a number of characteristics that make it difficult to control. This species can thrive in urban areas and likes being near humans. They lay their eggs in any available water source – such as water containers, abandoned tyres and flowerpots – and their eggs can survive being dry for a long period of time. In addition, An. stephensi feeds on its vertebrate host both indoors and outdoors. This reduces the impact of commonly used vector control methods such as insecticide-treated nets and indoor residual spraying.

The invasion of this urban mosquito into Africa threatens the malaria elimination aspirations of the continent, particularly as 42.5% of Africa’s population now live in urban areas.

As a result, national malaria control programmes have increased surveillance efforts in urban areas to enable early detection and control. Countries have also run awareness campaigns to encourage communities to reduce potential breeding sites.

The species has not yet been detected in southern Africa. Nevertheless the South African national malaria control programme, with the support of the National Institute for Communicable Diseases, is increasing surveillance activities in areas where this species may occur.

Invasive species

Many epidemics and pandemics have been driven by pathogens, hosts and vectors invading new areas. These include the Black Death in 14th century Europe, caused by the invasion of rats carrying fleas infected with the plague.

The Asian tiger mosquito (Aedes albopictus) and the yellow fever mosquito (Aedes aegypti) both carry dangerous diseases such as dengue, yellow fever and Zika. The spread of these mosquito species into North America and Europe during the 1970s and 1980s was associated with large increases in these diseases.

While Aedes mosquitoes transmit viral diseases, Anopheles mosquitoes transmit malaria. Of the 500 Anopheles species, only 30-40 can spread malaria. Common species that transmit malaria in Africa are Anopheles gambiae, An. arabiensis and An. funestus.

Anopheles gambiae is one of the most effective malaria vectors in the world. It invaded South America in the 1930s. This species rapidly established itself in Brazil, causing a malaria epidemic with an estimated fatality rate of 13%. Anopheles gambiae was eventually eliminated from Brazil in the 1940s after a highly co-ordinated and resource-intensive effort.

Anopheles stephensi is a malaria vector native to South Asia. It transmits both Plasmodium falciparum and P. vivax. It rapidly adapts to changes in the environment and is found in both rural and urban areas. This is different from African malaria vectors, which are typically found in rural areas.

Controlling this invasive mosquito is very challenging. It is difficult to find, particularly in urban areas, and is resistant to a number of insecticides. Although there are no specific programmes to eliminate this species from Africa, the affected countries are implementing a range of control measures.

Urgent action

The presence of An. stephensi in Africa is a call to action to all interested in controlling and eliminating malaria.

It is imperative that entomological surveillance (the search for and biological investigation of insects, including malaria vectors) is strengthened across the continent. New information about the species must be shared promptly to ensure malaria control programmes use the correct methods to prevent it from spreading further into the continent.

And an integrated approach to vector control is urgently required. Vector control measures, adapted to local conditions, are key to preventing the spread of An. stephensi. National malaria control programmes cannot rely solely on insecticides to control this mosquito. They must invest in novel vector control methods that target outdoor-biting mosquitoes.

Governments must also invest in educating communities on the appropriate methods for storing water as well as eliminating potential breeding sources. South America has implemented strong policies to reduce breeding areas for Aedes mosquitoes. Similar approaches in Africa would reduce the presence of An. stephensi, as well as of Aedes mosquitoes, which carry many dreaded diseases including dengue, yellow fever, chikungunya and Zika.

Crucially, a healthy population without circulating parasites is key to a malaria-free future. Integrating clinical care, vector control and community awareness of the disease is the best way to ensure a malaria-free future for the continent.

Shüné Oliver, Medical scientist, National Institute for Communicable Diseases and Jaishree Raman, Principal Medical Scientist and Head of Laboratory for Antimalarial Resistance Monitoring and Malaria Operational Research, National Institute for Communicable Diseases

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Even more concerning was the marked increase in malaria-related deaths. These were mainly in children under the age of five living in sub-Saharan Africa. This is a sombre finding. Malaria is a preventable disease. Effective point-of-care diagnostic tools (rapid diagnostic tests) and treatments (artemisinin-based combination therapies) are widely available.

Progress towards achieving a malaria-free world had begun stalling – and in some regions reversing – from 2015. But the COVID-19 pandemic, continual Ebola outbreaks and ongoing humanitarian crises have posed additional challenges for national malaria control programmes. These factors have increased the chances that the 2030 targets set by the World Health Organization (WHO) won’t be met. The Global Malaria Strategy goals are to reduce malaria cases and deaths by 90%, and eliminate the disease in 35 countries by 2030.

The WHO warns that without immediate decisive action, all the impressive gains made against malaria since 2000 will be eroded. This will allow malaria to rebound and expose at least half of the world’s population to an increased risk of malaria.

Responding to the COVID-19 threat

National malaria control programmes across Africa have been commended for acting against the threat that COVID-19 posed to the delivery of essential malaria services. Disruptions did occur. But prompt innovative actions ensured they were not at the scale many experts predicted at the start of the pandemic.

Encouragingly, in 2020 many malaria endemic countries achieved their targets for delivering insecticide treated nets and spraying indoors. The number of children receiving seasonal chemoprevention in Africa exceeded the initial target.

However, more needs to be done to get malaria control efforts back on track. There must be improved access to essential malaria services. This is especially important for populations most at risk. Of particular concern are people in sub-Saharan Africa. In this region, six countries – Nigeria, Uganda, Democratic Republic of the Congo, Angola, Mozambique and Burkina Faso – accounted for over 50% of all malaria cases and deaths reported in 2020.

Threats to effective malaria control

Both the malaria parasite and the mosquito vector are continually developing mechanisms to evade control interventions.

Malaria parasites resistant to the artemisinin component of the WHO- recommended artemisinin-based combination therapies have now been confirmed in Uganda and Rwanda. This raises concerns over whether the therapies will continue to work.

There are currently no effective alternatives to these drugs. The WHO recommends that national malaria control programmes routinely assess whether drugs are still effective and whether parasites are mutating. Countries are also advised to develop feasible, fully costed containment and response plans to use as soon as they detect resistant parasites.

The widespread use of rapid diagnostic tests and artemisinin-based combination therapies enables prompt diagnosis and effective treatment. These actions have made a positive difference to treatment outcomes.

But the current World Malaria Report sounds the alarm over the spread of malaria parasites with genetic changes that make them invisible to the rapid diagnostic tests most widely used in sub-Saharan Africa.

Malaria in pregnancy remains another challenge in Africa. In 2020, about 11.6 million pregnancies were exposed to malaria. As a result, 819,000 infants had low birthweights – which is strongly associated with death in childhood. The WHO recommends making greater efforts to reach pregnant women with interventions. These include insecticide treated nets and intermittent preventive treatment – where pregnant women are treated for malaria whether they have the disease or not. If 90% of women at risk had been treated, it would have prevented at least 200,000 low-weight births in 2020.

Improved surveillance and innovation

Insecticide-treated nets and indoor residual spraying are essential to control and eventually eliminate malaria. The WHO applauded all countries that achieved optimal coverage in these efforts, despite the challenges faced in 2020.

Resistance is a threat here too, however. Over 88% of the countries that contributed to the 2020 World Malaria Report reported mosquito resistance to at least one class of insecticide. Nineteen countries reported resistance to all four classes of approved insecticides.

But it’s not all doom and gloom.

Earlier this year the WHO approved the roll-out of the first malaria vaccine, RTS,S, in highly burdened African countries. This vaccine has the potential to significantly improve outcomes in young African children. This group suffers disproportionately from malaria.

There are also new insecticides which could help sustain the efficacy of nets and spraying. And there is increased funding to integrate genomic surveillance into routine malaria surveillance systems.

These and other novel interventions, together with strong political commitment and sustained funding, have the potential to get malaria control efforts back on track and make malaria elimination a reality in our lifetime.

Jaishree Raman, Principal Medical Scientis and Head of Laboratory for Antimalarial Resistance Monitoring and Malaria Operational Research, National Institute for Communicable Diseases

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The patient likely acquired malaria from the bite of an infective Anopheles mosquito inadvertently transported from a malaria-endemic area via a road vehicle, a phenomenon known as odyssean malaria (see NICD Communiqués vol. 18 (5) May 2019 and vol. 18 (1) January 2019).  No specific vector control interventions are required and such cases do not represent an expansion of the malaria transmission zone in South Africa. Malaria awareness education activities were done in the area.

Increases in imported and odyssean malaria cases are anticipated during and after the festive season holidays. All healthcare practitioners are encouraged to consider malaria as a differential diagnosis in patients presenting with unexplained fever (>38°C) and progressive ‘flu-like illness, even in the absence of a travel history to a malaria-endemic region. Primary health clinics in Gauteng Province are supplied with rapid diagnostic test kits and artemether-lumefantrine (Coartem) for early diagnosis and treatment of malaria. Malaria alerts, treatment and prevention guidelines are available here.