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The long road to elimination: malaria mortality in a South African population cohort over 21 years
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. MRC-Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.ORCID-id: 0000-0001-5474-4361
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. MRC-Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH Network, Accra, Ghana.
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2017 (Engelska)Ingår i: Global Health, Epidemiology and Genomics, E-ISSN 2054-4200, Vol. 2, artikel-id e11Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Malaria elimination is on global agendas following successful transmission reductions. Nevertheless moving from low to zero transmission is challenging. South Africa has an elimination target of 2018, which may or may not be realised in its hypoendemic areas.

Methods: The Agincourt Health and Demographic Surveillance System has monitored population health in north-eastern South Africa since 1992. Malaria deaths were analysed against individual factors, socioeconomic status, labour migration and weather over a 21-year period, eliciting trends over time and associations with covariates.

Results: Of 13 251 registered deaths over 1.58 million person-years, 1.2% were attributed to malaria. Malaria mortality rates increased from 1992 to 2013, while mean daily maximum temperature rose by 1.5 °C. Travel to endemic Mozambique became easier, and malaria mortality increased in higher socioeconomic groups. Overall, malaria mortality was significantly associated with age, socioeconomic status, labour migration and employment, yearly rainfall and higher rainfall/temperature shortly before death.

Conclusions: Malaria persists as a small but important cause of death in this semi-rural South African population. Detailed longitudinal population data were crucial for these analyses. The findings highlight practical political, socioeconomic and environmental difficulties that may also be encountered elsewhere in moving from low-transmission scenarios to malaria elimination.

Ort, förlag, år, upplaga, sidor
Cambridge University Press, 2017. Vol. 2, artikel-id e11
Nyckelord [en]
Climate, South Africa, disease control, malaria elimination, migration
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
URN: urn:nbn:se:umu:diva-143783DOI: 10.1017/gheg.2017.7PubMedID: 29276618OAI: oai:DiVA.org:umu-143783DiVA, id: diva2:1172242
Tillgänglig från: 2018-01-09 Skapad: 2018-01-09 Senast uppdaterad: 2018-06-09Bibliografiskt granskad

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Byass, PeterCollinson, Mark A.Tollman, Stephen M.Kahn, Kathleen

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