Since 2000, the burden of malaria morbidity and mortality has been reduced substantially. Implementing more effective treatments for uncomplicated malaria (artemether-lumefantrine) and severe malaria (intravenous artesunate), as well as strengthening of mosquito vector control and malaria information systems, were among the measures that contributed to improved malaria control. These advances paved the way toward the South African Department of Health refocusing its efforts to work towards malaria elimination.
South Africa has played a leading role in the control of malaria for almost a century and has dramatically reduced its burden of malaria since 2000. This has paved the way for our commitment to eliminate malaria. However, climatic conditions favourable for malaria transmission, budget constraints and a high burden of malaria in some of our neighbouring countries make it essential that malaria control is maintained while moving the elimination agenda forward.
However, this success brings its own challenges, including the fact that a significant number of malaria cases in South Africa are now imported (i.e. not locally transmitted). Late presentation especially to health facilities in malaria-free areas is problematic. Thus, health professionals throughout South Africa, in both the malaria-endemic and malaria-free areas, all need to develop and maintain their knowledge and skills in malaria diagnosis and treatment.
These guidelines are based on the 3rd Edition of the WHO Guidelines (Published 2015) World Health Organization’s Guidelines for the treatment of malaria. Additional literature surveys have been undertaken. Factors that were considered in the choice of therapeutic options included effectiveness, safety, and impact on malaria transmission and on the emergence and spread of antimalarial drug resistance. On-going surveillance is critical given the spread of artemisinin resistance in Southeast Asia, although not yet confirmed anywhere in Africa. The guidelines on the treatment of malaria in South Africa aim to facilitate effective, appropriate and timeous treatment of malaria, thereby reducing the burden of this disease in our communities. This is essential to further reduce the malaria case fatality rates currently recorded in South Africa, to decrease malaria transmission and to limit resistance to antimalarial drugs.
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