One year after starting interventions in the field, the Mozambican Alliance Towards Elimination of Malaria (MALTEM) has made significant progress towards its goal of interrupting the transmission of malaria in the district of Magude, located in southern Mozambique. The preliminary results of this project, made possible by the support of the “la Caixa” Foundation and the Bill & Melinda Gates Foundation, show that the number of cases of malaria diagnosed in all of the health care centres within the Magude district during the first three months of this year represents a decline of 92% over the same period in 2015. Compared to the 3,620 confirmed cases recorded from January to March 2015, this year’s total is only 286 cases.
“The result is preliminary because the epidemiologic data collected in the field are still being reviewed, but the outlook is undoubtedly excellent” says Francisco Saúte, Director of MALTEM.
MALTEM is an alliance of national and international institutions that have joined forces to fight malaria in Mozambique. The aim of the alliance is to pioneer new scientific methods that can be used to eliminate malaria in regions where the disease is highly endemic. The activities of the Alliance are directed and supervised by the Mozambican Ministry of Health through the country’s National Malaria Control Programme. The pilot phase was coordinated by the Barcelona Institute for Global Health (ISGlobal) and implemented by the Manhiça Health Research Centre (CISM) in close collaboration with the Maputo Province Health Department, among other partners.
In this initial phase, efforts have been focussed on Magude, a district in the province of Maputo, where the programme has deployed all of the tools currently used to combat malaria in an effort to completely eliminate the disease from the area, which is home to more than 50,000 people.
The main interventions undertaken during the first year of the project were as follows:
- A campaign to raise awareness in the population, informing people about the project and working to gain community acceptance for the interventions
- A population census that registered all the people and houses in the district
- A series of direct interventions, including domiciliary fumigation with the most effective insecticides available and mass administration of antimalarial drugs to the whole population.
The trend indicated by the number of cases reported in the first quarter is consistent with preliminary estimates made by MALTEM on the basis of epidemiologic data, which predicted an 80% reduction in disease prevalence before the second mass administration of antimalarial agents, which was started in January 2016.
Drought: An Ally Adding Complexity
The project’s interventions have coincided with an unusually severe period of drought, which has contributed to the reduction in the population of the mosquitoes that transmit the malaria parasite. “The drought has been an unexpected ally in the effort to interrupt malaria transmission” explains Regina Rabinovich, the Director of ISGlobal’s Malaria Elimination Initiative. “In Africa, changes in climatic conditions always make it difficult to analyse data” she added.
Once the first year of interventions had been completed, the project leaders drew up a roadmap for the next phase. The plan for the coming year includes sustaining the pressure on mosquito and parasite populations with all available tools, focussing particularly on the areas where intervention is most needed.