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. 2023 Mar 24;22(1):107.
doi: 10.1186/s12936-023-04542-1.

The effect of the COVID-19 lockdown on malaria transmission in South Africa

Rajendra Maharaj  1 , Abigail Ward  2 , Bradley Didier  2 , Ishen Seocharan  3 , Nina Firas  4 , Ryleen Balawanth  5 , Dominic Lucero  6 , Natashia Morris  3 , Mbavhalelo Shandukani  7 , Eric Raswiswi  8 , Gillian Malatjie  9 , Erik Mabunda  10 , Devanand Moonasar  11
Affiliations

The effect of the COVID-19 lockdown on malaria transmission in South Africa

Rajendra Maharaj et al. Malar J. .

Abstract

Background: For a country such as South Africa which is targeting malaria elimination, mobile and migrant populations pose a substantial risk to importation of malaria parasites. It has been hypothesized that halting cross-border movement of mobile and migrant populations will decrease the importation of malaria, however this option is not a politically, operationally, and financially viable prospect. It has social impacts as well, since families live on either side of the border and preventing travel will challenge family ties. Due to the COVID-19 pandemic and closure of ports of entry (land and air) for non-essential travel into South Africa, a unique opportunity arose to test the hypothesis.

Methodology: An interrupted time series analysis was done to assess whether the post-lockdown trends (April-December 2020) in monthly reported imported and local cases differed from the pre-lockdown trends (January 2015-March 2020). The analysis was conducted separately for KwaZulu-Natal, Mpumalanga, and Limpopo provinces.

Results: On average, imported cases were lower in the post-intervention period in all three provinces, and local cases were lower in Mpumalanga and Limpopo, though no results were statistically significant.

Conclusion: Since population movement continued after the travel restrictions were lifted, border screening with testing and treating should be considered for reducing parasite movement. Another option is reducing malaria cases at the source in neighbouring countries by implementing proven, effective vector and parasite control strategies and through a downstream effect reduce malaria entering South Africa.

Keywords: COVID-19; Imported malaria; Malaria elimination; Population movement.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Malaria and COVID-19 cases for 2020 at the different lockdown levels (Level 1 (L1)–Level 5 (L5))
Fig. 2
Fig. 2
Imported malaria cases into the three endemic provinces (2015–2020)
Fig. 3
Fig. 3
Local malaria cases in the three endemic provinces (2015–2020)
See this image and copyright information in PMC

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