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Analytical summary - Malaria

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Malaria is a notifiable disease endemic in the northern part of Botswana and is second to diarrhoea in the number of death recorded over the years. Transmission mainly occurs in five districts. Even though malaria is a seasonal disease, trends in clinical and laboratory diagnoses suggest that the disease occurs throughout the year. The malaria vector in Botswana is the Anopheles mosquito and the main parasite is Plasmodium falciparum, which is responsible for over 98% of cases. Other parasites are P. ovale and P. malariae.

Malaria cases and deaths in Botswana, 2000–2012[1]

Diagnosis is based on a set of clinical criteria, supplemented by detection of the parasite in the blood. Epidemics occurred in 1988, 1993, 1996 and 1997. Since then, the disease burden has gone down, with a progressive decline in the prevalence and number of deaths (see figure). In line with the regional and international efforts, Botswana has made a commitment to achieve universal coverage and to eliminate malaria by 2015. Recent Government of Botswana's initiatives have been the development of:

Supporting structures at the national level include the malaria reference group for technical advice on policy issues and the malaria epidemic preparedness and response committee that oversees logistic support during the peak transmission season. Malaria policy emphasizes:

  • prompt diagnosis and treatment
  • epidemic preparedness and response
  • public–private partnership
  • cross-border collaboration
  • community participation
  • monitoring and evaluation
  • research.

Achievements of the Malaria Strategic Plan have been:

  • weekly surveillances
  • epidemic preparedness with rapid (2-week) response during peak transmission seasons
  • drug efficacy studies
  • roll out of artemisinin-based combination therapy to all the districts
  • availability of laboratory diagnostics in all the districts.

Key challenges include:

  • shortage of human resources
  • low private sector participation, including reporting
  • low community acceptance of vector control interventions
  • low community participation.

The floods that usually prevail during malaria outbreaks make transportation of medications difficult, and lead to delayed treatment and high fatalities.

References

  1. National Malaria Programme data base. Gaborone, Government of Botswana, Ministry of Health