Risk factors and characteristics of patients with acute Plasmodium falciparum malaria presenting to a private hospital network in South Africa

Abstract

Malaria is endemic in much of southern Africa. Every year, large numbers of South Africans are infected, either in the malaria-endemic border regions in the north-east of the country or during visits to neighboring countries. In 2000, 61,934 cases of malaria and 423 deaths were notified to the Department of Health in South Africa. The South African population can be divided into two distinct socioeconomic groups,and consequently two very distinct populations at risk of malaria;a predominantly impoverished rural community who almost exclusively use government medical facilities, and a more affluent urban community who utilize private, often state-of-the-art, medical care. Most of the population living permanently in the malaria-endemic area of the country belong to the former category. Whereas malaria prophylactic medication is seldom financially affordable for rural South Africans, wealthier urban dwellers usually have the means to obtain advice, preventive medication and sophisticated therapy. Most studies of malaria in South Africa have focused on the epidemiology and clinical presentation of malaria in the socioeconomically deprived group.