ABSTRACT
OBJECTIVE: Nkomazi local municipality of South Africa is a high-risk malaria region with an incidence rate of about 500 cases per 100 000. We examined the influence of environmental factors on population (age group) at risk of malaria. METHODS: r software was used to statistically analyse data. Using remote sensing technology, a Landsat 8 image of 4th October 2015 was classified using object-based classification and a 5-m resolution. Spot height data were used to generate a digital elevation model of the area. RESULTS: A total of 60 718 malaria cases were notified across 48 health facilities in Nkomazi municipality between January 1997 and August 2015. Malaria incidence was highly associated with irrigated land (P = 0.001), water body (P = 0.011) and altitude ≤400 m (P = 0.001). The multivariate model showed that with 10% increase in the extent of irrigated areas, malaria risk increased by almost 39% in the entire study area and by almost 44% in the 2-km buffer zone of selected villages. Malaria incidence is more pronounced in the economically active population aged 15-64 and in males. Both incidence and case fatality rate drastically declined over the study period. CONCLUSION: A predictive model based on environmental factors would be useful in the effort towards malaria elimination by fostering appropriate targeting of control measures and allocating of resources.
