DYNAMICS IN MALARIA TRANSMISSION IN THE CROSS-BORDER AREAS OF MOZAMBIQUE, SOUTH AFRICA AND ESWATINI (MOSASWA), MARCH 2017 TO MARCH 2019

Abstract

Introduction: malaria is considered a major public health issue for humans worldwide, and it is estimated that more than 1/3 of the population is in circumstantial equality of acquiring it. Sharing borders between several countries with different malaria prevalence and strategies further delays elimination goals. Aim: to analyze malaria transmission dynamics in the crossborder areas of Mozambique, South Africa and ESwatini from March 2017 to March 2019. Methodology: a malaria database (secondary source) was queried, from which ratio comparison tests were performed and then logistic regression model estimation was done. The sample consisted of 250563 migrants and residents in MOSASWA cross-border areas tested for malaria between March 2017 to March 2019, whose in-depth analyses focused on all positive cases (5253), diagnosed in the same period. Descriptive statistics were used to describe the main indicators, in addition to testing hypotheses of association at 5% significance level. Data were analyzed using SPSS 22.0. Results: 250563 people were tested, out of which, 93035 (37.13%) were migrant populations and 157528 (62.87%) were residents of the surrounding areas. Regarding gender and occupation, 50.1% were male and 76% had informal occupation. The positivity of those tested was 2.1% (5253), out of which, 33.3% (1751) were mobile and migrant populations. 39.18% (686) and 28.44% (498) of the positive travelers were using the Macuacua and Ressano Garcia borders on their way to South Africa respectively. 45.9% of the total cases were asymptomatic carriers. 66.7% of the positives cases were surrounding populations, out of which 20.5% and 20.6% crossed the borders three to four times a week. The predictive power of having malaria increased 5.090 and 3.540 times more if the migrant had been tested in Mozambique and if he/she was a resident in the vicinity of the borders, crossing into the borders of the same country respectively. Conclusions: A large number of the moving cases were diagnosed in Mozambique on their way to South Africa through Macuacua border.