In the struggle to control malaria, researchers at the University of Pretoria Institute for Sustainable Malaria Control  (UP ISMC) have turned to satellite data to get a heads-up on malaria outbreaks and smartphone apps to control and monitor the disease.  

Technology implemented in the air and on the ground form part of a transdisciplinary solution to the prevalence of malaria in South Africa.  

Satellites to map at-risk areas and predict outbreaks

Up in the air, satellites are being used to predict malaria outbreaks using geographic information systems (GIS) and advanced satellite imaging to identify the environmental factors that allow malaria-spreading mosquitos to breed and thrive.   And armed with this information, outbreaks can be predicted with incredible accuracy. “Using remote sensing as part of an early-warning system for outbreaks, we can forecast malaria occurrences from three to six months in the future,” adds UP ISMC doctorate student Abiodun Morakinyo Adeola. “Our predictions using his model have been correct nine out of 10 times in all five Mpumalanga communities which formed part of the study.” This level of accuracy is on par with the World Health Organisation’s standards. Find out more here.  

Apps to control and monitor malaria

mSpray focusses on malaria control data management for the annual indoor residual spraying (IRS) programme. And was developed at the University of California Berkeley (UCB) with input from researchers at the UP ISMC; specifically Prof Riana Bornman,.  

And the Malaria Buddy app provides information on malaria risk, prevention and symptoms for travellers in malaria endemic areas.  

The indoor residual spraying (IRS) programme is the current preferred method for malaria control in at-risk areas. And, until recently there was no centralised digital database to ensure that spraying was effective, regular and safe. “Previously, the spray workers would go into homes, spray the walls and fill in cards,” says Prof Tiaan de Jager, director of the UP ISMC. “Come the next malaria season, they would go back and spray, but there was no clear database recording what substance was use, where was sprayed or when.”  

mSpray works by allowing spray workers to record information about pesticides sprayed, the number of structures sprayed, concentrations and application procedures - all on their cell phone. This technology reduces the time needed to record or access data and ensures a safer and more effi cient IRS programme.    

Launched in early 2016, Malaria Buddy made in collaboration with Travel With Flair is available for Android and iOS and assists travellers to malaria-endemic areas with information on risk, prevention and symptoms. The UP ISMC team and Travel with Flair are currently designing an updated version to include GPS technology to direct users to the nearest healthcare centre if symptoms are detected.   Prof de Jager is enthusiastic about using mobile technology to combat malaria saying, "We should continue to use cell phone technology as it is much more efficient than manual means to control malaria." 

Research by the University of Pretoria Institute for Sustainable Malaria Control  (UP ISMC) has discovered that conventional methods for controlling malaria (DDT and other common insecticides) leads to endocrine disruption, which means that it interferes with hormones in the human body.  

Worldwide, the use of dichlorodiphenyltrichloroethane, of DDT is controversial. “DDT is known to potentially cause health problems, but the exact effects of indoor residual spraying (IRS) were previously unknown,” explains director of the UP ISMC, Prof Tiaan de Jager. IRS is a programme to spray homes in South African malaria hotspots with insecticides to limit the transmission of the disease.  

An important focus area for the UP ISMC was to understand the developmental effects of constant exposure to insecticides. Its most recent research focused on 750 mothers and babies in Vhembe, Limpopo. The purpose of this study is to understand the effects of DDT exposure on children including birth difficulties, thyroid levels, and neurodevelopment during the first two years of life.    

“There have been reports of poor reproductive health in the Vhembe area, which is why we chose this region and its community for our research," adds Prof de Jager. In other similar research on new mothers and their babies, researchers found that DDT exposure leads to endocrine disruption. "This means DDT chemicals interfere with human hormones. And as a result, individuals experience a decrease in retinol binding protein, limiting vitamin A uptake with an effect on nutritional status," advises Prof de Jager.  

In addition to these effects, research uncovered that high concentrations of environmental DDT impacts semen quality in young men, reducing fertility and leading to congenital disabilities. “Our researchers found that boys whose mothers were exposed to DDT spraying, showed a high rate of defects of the reproductive system,” adds Prof de Jager.  

Another significant finding from yet another study in the area is that DDT and dichlorodiphenyldichloroethylene (DDE, a DDT breakdown product) levels in dust are an accurate measure of insecticide exposure in people who live in IRS areas. This knowledge will make future studies of DDT exposure simpler.   

“We acknowledge that we are still dependent on the use of DDT and other pesticides, but we need to communicate, educate and make people aware of the potential risk,” advises Prof de Jager. “The use of DDT and other insecticides has contributed immensely to controlling malaria in South Africa. And after an alarmingly sharp rise in 2000, the incidence of malaria has significantly decreased due to a more efficient use of DDT and better access to anti-malarial drugs.”  

Advice People living in malaria regions where an IRS programme is used should allow spray workers to do their job. However, we recommend people ensure all food is covered safely or removed, close open water containers, pack clothing away and wait outside while spraying occurs.  Post-spraying, try and ventilate the home. 

Video: https://youtu.be/L3M04umMzd8  

Infographic: http://www.researchmatters.up.ac.za/cake-gallery/img/uploads/1477719189_294799.png