Advances in malaria elimination in Botswana: a dramatic shift to parasitological diagnosis, 2008–2014
A retrospective study using routine national data from the integrated disease surveillance and case-based systems
Abstract
Background
Malaria elimination requires infection de- tection using quality assured diagnostics and appropriate treatment regimens. Although Botswana is moving towards malaria elimination, reports of unconfirmed cases may jeopardise this effort. This study aimed to determine the proportion of cases treated for malaria that were confirmed by rapid diagnostic testing (RDT) and/or microscopy.
Methods
This was a retrospective descriptive study using routine national data from the integrated disease surveillance and case-based surveillance systems from 2008 to 2014. The data were categorised into clinical and confirmed cases each year. An analysis of the data on cases registered in three districts that reported approximately 70% of all malaria cases was performed, stratified by year, type of reporting health facilities and diagnostic method.
Results
During 2008–2014, 50 487 cases of malaria were reported in Botswana, and the proportion of RDT and/or blood microscopy confirmed cases improved from 6% in 2008 to 89% in 2013. The total number of malaria cases decreased by 97% in the same period, then increased by 41% in 2013.
Conclusion
This study shows that malaria diagnostic tests dramatically improved malaria diagnosis and consequently reduced the malaria burden in Botswana. The study identified a need to build capacity on microscopy for species identification, parasite quantification and guiding treatment choices.
This research was supported by the UK Department for International Development’s Operational Research Capacity Building Programme led by the International Union Against TB and Lung Disease (The Union)
Citation
Moakofhi K, Edwards JK, Motlaleng M, Namboze J, Butt W, Obopile M, Mosweunyane T, Manzi M, Takarinda KC, Owiti P. Advances in malaria elimination in Botswana: a dramatic shift to parasitological diagnosis, 2008–2014. Public Health Action [Internet]. 2018 Apr 25 [cited 2018 Jun 25];8(1):34–8. Available from: http://www.ingentaconnect.com/content/10.5588/pha.17.0017