Preventing disease and saving lives: the malaria season is upon us.

December 2011, Vol. 101, No. 12 SAMJ The burden of malaria In South Africa, malaria is endemic in three provinces – Limpopo, Mpumalanga and KwaZulu-Natal (Fig. 1) – and transmission occurs predominantly between September and May.1 Over the past decade, the National Department of Health (DoH) has focused intense efforts on preventing the local transmission of malaria, and on ensuring the prompt and effective management of cases, especially in the endemic provinces. The DoH has recorded significant success in reducing the burden of malaria through the implementation of its key interventions: Vector Control, Case Management, Surveillance, Health Promotion, and Epidemic Preparedness and Response. Notified malaria cases in the aforementioned provinces have decreased by 88% over the past decade, from 64 622 cases in 2000 to 7 626 in 2010. In the same period, malariarelated deaths have been reduced by 81%, from 458 to 87 deaths.2 Malaria has been a notifiable disease in South Africa since 1956 (Government notice No. 2 081 of 1956). One of the key challenges that the DoH has historically faced is the irregularity of routine notifications, particularly from the private sector and public health facilities in non-endemic areas. In recent years, reporting appears to be gaining in efficiency, with an increase in malaria notifications from the non-endemic areas, especially Gauteng (Fig. 2). In this province, trends for malaria cases and related deaths show an increase over the past 2 years, with a peak in January. This seasonality is related to travellers returning from malaria-endemic areas, particularly Mozambique (Fig. 3).3