Investigation Of The Epidemiology Of Malaria In The Engela Health District Of The Ohangwena Region In Northern Namibia

ABSTRACT

Namibia has seen a decline in reported malaria cases of up to 97.4% between 2001 and 2011. The country was nominated as one of 8 countries in Southern Africa (E8) ready to move from the control phase to the elimination phase by 2020. However, interventions that were successful in bringing down malaria cases during the control phase may no longer be appropriate now that malaria transmission patterns have changed. Gaps in knowledge about infection risk factors at low malaria transmission, such as cross border movement and the possibility of localized malaria hotspots where residual malaria may still persist create an obstacle to eliminating malaria. An effective surveillance system may contribute to zero local transmission of malaria in Namibia. Currently, passive surveillance of malaria cases is conducted; however, this can be complimented by reactive case detection (RACD) which focuses on detection of additional malaria cases within the community. An RACD study was piloted in the Engela Health District of the Ohangwena region from December 2012 to July 2014. All individuals with fever testing malaria positive by rapid diagnostic test (RDT) from the 17 clinics in the district were recruited into the study and visited at their homesteads. Consenting individuals living in the case household were screened for malaria by RDT and interviewed to ascertain the presence of possible malaria risk factors; four surrounding households were also selected and recruited into the study. For the control arm, households in the enumeration area where malaria was not reported were recruited as controls for the study and their four surrounding households were also recruited.