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Abstract：
Eswatini was the first country in sub-Saharan Africa to pass a National Malaria Elimination Policy in 2011, and later set a target for elimination by the year 2020. This case study aimed to review the malaria surveillance data of Eswatini collected over 8 years between 2012 and 2019 to evaluate the country\'s efforts that targeted malaria elimination by 2020. Coverage of indoor residual spraying (IRS) for vector control and data on malaria cases were provided by the National Malaria Programme (NMP) of Eswatini. The data included all cases treated for malaria in all health facilities. The data was analysed descriptively. Over the 8 years, a total of 5511 patients reported to the health facilities with malaria symptoms. The case investigation rate through the routine surveillance system increased from 50% in 2012 to 84% in 2019. Incidence per 1000 population at risk fluctuated over the years, but in general increased from 0.70 in 2012 to 1.65 in 2019, with the highest incidence of 3.19 reported in 2017. IRS data showed inconsistency in spraying over the 8 years. Most of the cases were diagnosed by rapid diagnostic test (RDT) kits in government (87.6%), mission (89.1%), private (87%) and company/industry-owned facilities (84.3%), either singly or in combination with microscopy. Eswatini has fallen short of achieving malaria elimination by 2020. Malaria cases are still consistently reported, albeit at low rates, with occasional localized outbreaks. To achieve elimination, it is critical to optimize timely and well-targeted IRS and to consider rational expansion of tools for an integrated malaria control approach in Eswatini by including tools such as larval source management, long-lasting insecticidal nets (LLINs), screening of mosquito house entry points, and chemoprophylaxis. The establishment of rigorous routine entomological surveillance should also be prioritized to determine the local malaria vectors\' ecology, potential species diversity, the role of secondary vectors and insecticide resistance.
摘要：
埃斯瓦蒂尼是撒哈拉以南非洲第一个在2011年通过国家消除疟疾政策的国家，后来设定了到2020年消除疟疾的目标。本案例研究旨在回顾2012年至2019年8年间收集的Eswatini疟疾监测数据，以评估该国在2020年前消除疟疾的目标。埃斯瓦蒂尼国家疟疾方案（NMP）提供了用于病媒控制的室内残留喷洒（IRS）的覆盖率和疟疾病例数据。数据包括在所有卫生机构接受治疗的所有疟疾病例。对数据进行了描述性分析。八年来,共有5511名患者向医疗机构报告了疟疾症状。通过常规监测系统的病例调查率从2012年的50％增加到2019年的84％。每1000名风险人群的发病率多年来一直在波动，但总体上从2012年的0.70上升至2019年的1.65,2017年报告的最高发病率为3.19.IRS数据显示8年来的喷雾不一致。大多数病例是通过政府的快速诊断测试（RDT）试剂盒诊断的（87.6％），任务(89.1%)，私营(87%)和公司/工业拥有的设施(84.3%)，无论是单独或结合显微镜。埃斯瓦蒂尼还没有到2020年实现消除疟疾。疟疾病例仍然不断报告，尽管利率很低，偶尔有局部爆发。为了实现消除，至关重要的是，及时优化针对性强的IRS，并考虑通过包括幼虫来源管理等工具来合理扩展Eswatini的综合疟疾控制方法的工具，长效杀虫网(LLINs)，蚊子屋入口点的筛查，和化学预防。建立严格的常规昆虫学监测也应优先确定当地的疟疾病媒生态，潜在的物种多样性，次级载体和杀虫剂抗性的作用。
