a) Malaria is a seasonal disease, transmission increases during the summer months, and is exacerbated when there is higher rainfall. The COVID-19 pandemic started in March and peaked in July this year- when the malaria transmission period was waning.
There was a timely start of the Indoor Residual Spraying (IRS) programme this year despite the COVID-19 pandemic. Spraying started as planned in September 2020 in each of the malaria-endemic provinces. As 18 November 2020, a total of 1,112,637 structures (624,365 structures in Limpopo; 410974 in Mpumalanga and 77298 in KwaZulu-Natal) have been sprayed of the targeted 2 059 979 structures for the 2020/2021 financial year. The current national spray coverage is 54% (51.94%, 54.29% and 76.53% in Limpopo, Mpumalanga and KZN provinces respectively), noting that spraying will continue into the early part of the new year.
Community testing and treatment was adopted as part of the malaria elimination strategy for South Africa and cross-border collaboration with eight malaria eliminating countries (E8) that form the SADC Elimination 8 countries. It mostly targets the border districts to prevent secondary transmission from malaria cases imported from the high malaria-endemic countries bordering the Republic of South Africa. The screening process was slow with only a few cases reported during the initial days of the COVID-19 pandemic due to level 5 Lockdown and border closures when travel was limited. The screening gradually improved and will continue in the border areas over the festive period. During the 2020/2021 financial year a total of 66 162 people suspected to have malaria have been tested in the community and a total of 517 have been found to be positive through active case detection. All the positive cases were treated with the recommended treatment for malaria.
b) The holiday season (Christmas and New Year) coincides with the malaria transmission season hence the Malaria programmes embark on spraying in September 2020 to protect the communities at risk in the three malaria-endemic provinces of Limpopo, Mpumalanga and KwaZulu-Natal. The provincial Malaria Programmes have updated their Epidemic Preparedness Plans to ensure that there are adequate stocks of diagnostics, treatment and insecticides.
In addition, health promotion and awareness campaigns are essential interventions for the prevention of malaria morbidity and mortality and were enhanced during the first week of November 2020 when the SADC Malaria Day was event was commemorated in the endemic provinces. These interventions will continue during the peak season covering December to April.