Investigation Into The Risk Factors For Malaria Transmission In The Omusati Region

ABSTRACT

Namibia has achieved great success in the reduction of malaria case numbers from over 500 per 1000 population in 2000 to between 1 -2 per 1000 population in 2013 (MoHSS-NVDCP, 2009). The gains in the reduction of malaria case numbers have seen the country transitioning from the control phase of malaria epidemiology to the pre-elimination phase, and has subsequently adopted the goal of malaria elimination by 2020 (MoHSS-NVDCP, 2010; Pindolia et al., 2012). Since the year 2008, there were no significant reductions in cases per annum, despite continued interventions (such as Indoor Residual spraying, Insecticide treated nets and larviciding) geared towards vector and parasite control. These interventions are aimed at the realization of malaria elimination. These uninformed and untargeted interventions leave certain groups or individuals at an increased risk of infection. Furthermore in a low transmission setting, parasite density decreases and a considerable number of people harboring Plasmodium parasites are asymptomatic. As a consequence, untargeted at risk populations continue to harbor parasites, which continues to fuel transmission and thus poses as a challenge to elimination. This highlights the need for establishing the unknown risk factors and detection of low parasite density asymptomatic infections with more sensitive molecular diagnostics since the current Point of Care (P.O.C) diagnostics, the Rapid Diagnostic Tests (RDTs) do not detect some of these low density infections. These will ultimately allow for evidence-based targeting of interventions, for the final drive to eliminate malaria.