Volume 76, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


The Lubombo Spatial Development Initiative is a joint development program between the governments of Mozambique, Swaziland, and South Africa, which includes malaria control as a core component of the initiative. Vector control through indoor residual spraying (IRS) was incrementally introduced in southern Mozambique between November 2000 and February 2004. Surveillance to monitor its impact was conducted by annual cross-sectional surveys to assess the prevalence of infection, entomologic monitoring, and malaria case notification in neighboring South Africa and Swaziland. In southern Mozambique, there was a significant reduction in prevalence after the implementation of IRS, with an overall relative risk of 0.74 for each intervention year ( < 0.001), ranging from 0.66 after the first year to 0.93 after the fifth intervention year. Substantial reductions in notified malaria cases were reported in South Africa and Swaziland over the same period. The success of the program in reducing malaria transmission throughout the target area provides a strong argument for investment in regional malaria control.


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  1. Sharp BL, Craig MH, Mnzava A, Curtis B, Maharaj R, Kleinschmidt I, 2001. Review of malaria in South Africa. Available at http://www.hst.org.za/uploads/files/chapter18_00.pdf. Accessed October 19, 2006.
  2. Gallup JL, Sachs JD, 2001. The economic burden of malaria. Am J Trop Med Hyg 64 (1–2 Suppl): 85–96. [Google Scholar]
  3. Sharp BL, le Sueur D, 1996. Malaria in South Africa–the past, the present and selected implications for the future. S Afr Med J 86 : 83–89. [Google Scholar]
  4. Mabaso MLH, Sharp BL, le Sueur D, Lengeler C, 2004. Historical review of malaria control in southern African with emphasis on the use of indoor residual house spraying. Trop Med Int Health 9 : 846–856. [Google Scholar]
  5. Maharaj R, Mthembu DJ, Sharp BL, 2005. The impact of the reintroduction of DDT on malaria transmission in KwaZulu-Natal, South Africa. S Afr Med J 95 : 871–874. [Google Scholar]
  6. Hargreaves K, Koekemoer LL, Brooke BD, Hunt RH, Mthembu J, Coetzee M, 2000. Anopheles funestus resistant to pyrethroid insecticides in South Africa. Med Vet Entomol 14 : 181–189. [Google Scholar]
  7. Casimiro S, Coleman M, Moholai P, Hemingway J, Sharp B, 2006. Insecticide resistance in Anopheles funestus (Diptera: Culicidae) from Mozambique. J Med Entomol 43 : 267–275. [Google Scholar]
  8. Barnes K, Durrheim D, Little F, Jackson A, Mehta U, Allen E, Dlamini S, Tsoka J, Bredenkamp B, Mthembu J, White N, Sharp B, 2005. Effect of artemether-lumefantrine policy and improved vector control on malaria burden in KwaZulu-Natal, South Africa. PLoS Med 2 : 1–12. [Google Scholar]
  9. Rao JNK, Scott AJ, 1981. The analysis of categorical data from complex sample surveys: chi-squared tests for goodness of fit and independence in two-way tables. J Am Stat Assoc 76 : 221–230. [Google Scholar]
  10. StataCorp, 2005. Stata Statistical Software: Release 9. College Station, TX: StataCorp LP.
  11. Gillies MT, Coetzee M, 1987. A Supplement to the Anophelinae of Africa South of the Sahara. Johannesburg: The South African Institute for Medical Research.
  12. Boom R, Sol CJA, Salimans MM, Jansen CL, Wertheim-Van Dillen PME, Van Der Noordaa J, 1990. Rapid and simple method for purification of nucleic acids. J Clin Microbiol 28 : 495–503. [Google Scholar]
  13. Scott A, Brogdon WG, Collins FH, 1993. Identification of single specimens of the Anopheles gambiae group by polymerase chain reaction. Am J Trop Med Hyg 49 : 520–529. [Google Scholar]
  14. Koekemoer LL, Kamau L, Hunt RH, Coetzee M, 2002. A cocktail polymerase chain reaction assay to identify members of the Anopheles.funestus (Diptera: Culicidae) group. Am J Trop Med Hyg 6 : 804–811. [Google Scholar]
  15. Snounou G, Viriyakosol S, Zhu XP, Jarra W, Pinheiro L, do Rosario VE, Thaithong S, Brown KN, 1993. High sensitivity of detection of human malaria parasites by the use of nested polymerase chain reaction. Mol Biochem Parasitol 61 : 315–320. [Google Scholar]
  16. Zeger SL, Liang KY, Albert PS, 1988. Models for longitudinal data: A generalised estimating equation approach. Biometrics 44 : 1049–1060. [Google Scholar]
  17. Martins P, 1941. Contribuicao para a Confeccao da Carta Sezonatica da Colonia de Mocambique. Maputo, Mozambique: Primeiro Congresso Medico De Lourenco Marques.
  18. Baird JK, Masbar S, Basri H, Tirtokusumo S, Subianto B, Hoff-man SL, 1998. Age-dependent susceptibility to severe disease with primary exposure to Plasmodium falciparum. J Infect Dis 178 : 592–595. [Google Scholar]
  19. Schwalbach JFL, De La Maza MCR, 1974. A Malaria em Mocambique (1937-1973). Republica Populat De Mocambique: Ministerio Da Saude, Instituto Nacional De Saude.
  20. Draper CC, Smith A, 1960. Malaria in the pare area of Tanganyika. Effects of 3 years of spraying of huts with dieldrin. Trans R Soc Trop Med Hyg 54 : 342. [Google Scholar]
  21. Payne D, Grab B, Fontaine RE, Hempel JHG, 1976. Impact of control measures on malaria transmission and general mortality. Bull WHO 54 : 369–377. [Google Scholar]
  22. Kouznetsov R, 1977. Malaria control by application of residual insecticides in tropical Africa and its impact on community health. Trop Doct 7 : 81–91. [Google Scholar]
  23. Kleinschmidt I, Sharp B, Benavente L, Schwabe C, Torrez M, Kuklinski J, Morris N, Raman J, Carter J, 2006. Reduction in infection with P. falciparum one year after the introduction of malaria control interventions on Bioko Island, Equatorial Guinea. Am J Trop Med Hyg 74 : 972–978. [Google Scholar]
  24. Conteh L, Sharp BL, Streat E, Barreto A, Konar S, 2004. The cost and cost-effectiveness of malaria vector control by residual insecticide house-spraying in southern Mozambique: A rural and urban analysis. Trop Med Int Health 9 : 125–132. [Google Scholar]
  25. Goodman CA, Coleman PG, Mills AJ, 2000. Economic Analysis of Malaria Control in Sub-Saharan Africa. Geneva: Global Forum for Health Research.
  26. Sharp BL, Ngxongo S, Botha S, Ridl F, le Sueur D, 1988. An analysis of 10 years retrospective data from the KwaZulu areas of Natal. S Afr J Sci 84 : 102–106. [Google Scholar]
  27. Ngxongo SM, 1993. The epidemiology of malaria in KwaZulu, 1980–1991. MSc thesis, University of Natal, Durban, South Africa.

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  • Received : 27 Jul 2006
  • Accepted : 05 Sep 2006

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