Malaria Research Unit
Current projects
Entomological
Repellants
The spread of
drug resistance in malaria parasites has decreased the effectiveness of many
chemo-prophylactic regimes. This has re-emphasised the importance of personal
protection against mosquito bites as the first line of malaria prevention.
Novel repellents and new formulations of existing repellents are tested under
controlled conditions in the laboratory.
Insecticide treated
bed nets vs residual house-spraying
The results
of this study will assist in reaching a policy decision on the role of insecticide
house spraying and insecticide-treated bednets within the malaria control
strategy in South Africa.
In order to reach this
decision, there is a need to establish:
- the impact of bednets
on the reduction of malaria incidence;
- their acceptability
by communities who traditionally do not use them;
- how best to disseminate/distribute
bednets; and
- whether bednets are
cheaper in comparison to traditional spraying of houses with insecticides.
A study involving about
14 000 people in KwaZulu-Natal compared the use of insecticide-treated bednets
with traditional spraying of houses for malaria control. The study is a collaboration
between the MRC and the Department of Health, Jozini. It has policy implications
for malaria control not only in South Africa, but in the whole of southern
Africa, where malaria transmission is seasonal and insecticide house spraying
has been the mainstay of vector control for over five decades.
Development and implementation
of a molecular and biochemical capability for insecticide resistance monitoring
and management in Southern Africa
Up until 1999,
there was little or no expertise in Southern Africa to assess possible insecticide
resistance in natural populations of the malaria vector mosquitoes.
Two PhD students from
the MRC and the South African Institute for Medical Research (SAIMR) have
been trained at the Molecular Entomology group, University of Wales Cardiff,
in molecular and biochemical techniques in order to carry out research on
the genetics of insecticide resistance and gene flow.
This training is critical
for obtaining the specialised knowledge required to train partners from the
three research institutes in southern Africa and to conduct research on insecticide
resistance. The timing of support by the Multilateral Initiative on Malaria
for this project has proved to be fortuitous in terms of the recent development
of insecticide resistance in Southern Africa and critical to the sustainability
of existing and new control activities in the region.
Gene flow in Arabiensis
and seasonal variation: potential for winter larviciding
The project,
using molecular techniques (polymorphic microsatellite and mitochondrial DNA
markers), describes the dynamics and population genetics of a seasonally fluctuating
vector population (Anopheles arabiensis) in northeastern Kwazulu/Natal. In
addition, it compares the relative importance of resident (possibly dormant)
mosquitoes with immigrants in founding the wet season population expansions
and malaria epidemics.
It also tests the efficacy
of targeting seasonally varying populations for control intervention during
the period when they are least abundant.
Malaria Transmission
and Control in African Refugee Camps
Malaria one
of the top causes of death and suffering in acute refugee settings. The western
part of Tanzania is one such area, accommodating refugees from Burundi, Rwanda
and the Democratic Republic of the Congo (DRC)
This project aims to:
- integrate various
aspects of malaria control in complex humanitarian emergencies;
- develop and strengthen
the Health Information Systems to include important indicators for malaria;
- establish a rational
policy for antimalarial drug use;
- develop a comprehensive
plan for malaria vector control;
- build capacity among
the NGOs for malaria control;
- stratify malaria high
risk areas using GIS for efficient planning and targeting of malaria control
measures.
The latter will be achieved
by monitoring changes in the distribution and incidence of malaria morbidity
and mortality in the different refugee camps, with the targeting of malaria
control activities being applied to areas of highest risk.
The MRP in collaboration
with the United Nations High Commissioner for Refugees (UNHCR) and the Atlanta-based
Centre for Diseases Control (CDC) has been involved in:
- training entomological
teams for entomological monitoring and evaluation of malaria vector control
measures;
- developing and implementing
vector control measures involving insecticide-treated bednets and selective
insecticide house spraying;
- evaluating the impact
of the vector control measures and identifying health education needs as
related to malaria transmission and control (UNHCR Engineering and Environment
Services Section Mission Report 99/29 - Mnzava AEP).
Information
Systems
Malaria
information system
Health Information Systems are central to monitoring intervention programmes
and form the basis for effective management, enabling data based decisions
leading to appropriate use of resources and deployment of staff.
Data entry, validation
and reporting systems were developed by the MRP using Microsoft Access, and
then distributed to regional centres as stand-alone applications to be used
for data entry and standard reporting.
Currently the system is
being used for malaria data collection in all three malarious Provinces of
South Africa ie. KwaZulu-Natal (2 centres), Mpumalanga and Northern Province.
This system is replacing the previous manual system for recording and reporting
malaria case data collected by the Malaria Control Programmes.
In order for health data
to be useful to decision-makers, it needs to be accurate, available on time
and provided in the format required. These aims may be achieved by the use
of computerised data entry and validation systems, which also provide an automated
means of producing standard reports, summaries and maps for health personnel
who do not necessarily have the time or skills necessary to perform complicated
analysis of data. Similar systems have been developed for Swaziland and Mozambique.
Developing Models for
the Prediction of Malaria Epidemics
The Southern
African countries encompass the southern fringe of malaria and malaria transmission
in Africa, where malaria is characterised by being distinctly seasonal and
epidemic (le Sueur & Sharp, 1996).
The severity of these
epidemics can be such that the capacity of health systems are stretched, resulting
in pronounced detrimental effects on the communities at risk. This situation
further highlights the need for an "Early Warning System" which
will enable Health authorities to respond timeously to such epidemics, thereby
offsetting the "exponential" pressure they exert on the health system
and its logistical ability to cope (le Sueur & Sharp, 1996).
South African Country
Study on Climate Change
The link between
climate variables such as temperature and rainfall, and the distribution of
malaria and schistosomiasis (bilharzia) has been established.
This study is a collaboration
between the Medical Research Council; University of Natal, School of Bioresources
Engineering and Environmental Hydrology; and University of Natal, School of
Life and Environmental Sciences
Its aims are fourfold:
- to use a GIS approach
to map the distribution of malaria and schistosomiasis in South Africa;
- to establish a model
describing the relationship between disease data and current climate variables;
- to assess the population
at risk; and
- to analyse the models
based on future predictions for climate.
Towards a Rural Spatial
Information System
This report overviews the vector-based GIS activities of the Malaria Research
Unit (MRU) and its collaborators, and is divided into the following three
categories:
- Vector-based GIS and
malaria in South Africa. This section highlights the spatial heterogeneity
of malaria transmission and the implications of this uneven distribution
for research and control activities.
- Facility placement
and utilisation. This section highlights the inter-sectoral applicability
of such a spatial rural database, using existing health service (malaria
control) activities.
- Using community-based
field teams to create a village level spatial database.This section reports
on the integration of demographic and health information collected by community
workers into a digital, spatial platform.
For more information
please visit: http://www.malaria.org.za/Research/RSIS/rsis.html
Technical Support to
UN Agencies and other NGOs
On a number
of occasions, the MRU has been requested to provide technical support by way
of training and advice to Malaria Control Programmes in Africa. Most requests
have been made by the World Health Organization (WHO), Africa region and the
United Nations High Commissioner for Refugees (UNHCR). The following are some
of the activities carried out under such requests:
- Training workshops
for WHO in Arusha, Tanzania, Bouake in Cote D'Ivoire and Abuja in Nigeria;
- Provision of advice
to Ministries of Health in Zanzibar, Namibia, Kenya, Malawi and Mozambique
for WHO.
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