Malaria in Eswatini, 2012–2019: a case study of the elimination effort

Abstract Eswatini was the first country in sub-Saharan Africa to pass a National Malaria Elimination Policy 2011, and later set target for elimination by year 2020. This case study aimed review malaria surveillance data of collected over 8 years between 2012 2019 evaluate country’s efforts that targeted Coverage indoor residual spraying (IRS) vector control on cases were provided Programme (NMP) Eswatini. The included all treated health facilities. analysed descriptively. Over years, total 5511 patients reported facilities with symptoms. investigation rate through routine system increased from 50% 84% 2019. Incidence per 1000 population at risk fluctuated but general 0.70 1.65 2019, highest incidence 3.19 2017. IRS showed inconsistency years. Most diagnosed rapid diagnostic test (RDT) kits government (87.6%), mission (89.1%), private (87%) company/industry-owned (84.3%), either singly or combination microscopy. has fallen short achieving are still consistently reported, albeit low rates, occasional localized outbreaks. To achieve elimination, it is critical optimize timely well-targeted consider rational expansion tools an integrated approach including such as larval source management, long-lasting insecticidal nets (LLINs), screening mosquito house entry points, chemoprophylaxis. establishment rigorous entomological should also be prioritized determine local vectors’ ecology, potential species diversity, role secondary vectors insecticide resistance.