NRF-SAASTA hosts webinar examining causes of Gauteng's malaria spike

Travel to malaria-endemic areas, delayed diagnosis and changing environmental conditions are among the factors contributing to malaria cases reported in Gauteng, according to Professor Tiaan de Jager, a public health and environmental health researcher at the University of Pretoria (UP).

Professor de Jager shared these insights during a webinar hosted by NRF-SAASTA, in collaboration with the Department of Science, Technology and Innovation (DSTI), on 21 October 2026.

The webinar examined the increase in malaria cases in Gauteng and highlighted the importance of public awareness, early diagnosis and preparedness for outbreaks associated with extreme weather events.

According to the Department of Health, Gauteng recorded 414 malaria cases and 11 deaths between January and March 2026. Professor de Jager explained that most cases were imported, meaning the infections were acquired in malaria-endemic areas before individuals returned to Gauteng, where they subsequently developed symptoms or received a diagnosis.

Travel to malaria-risk areas in Limpopo, Mpumalanga and parts of KwaZulu-Natal, as well as neighbouring countries such as Mozambique, Zimbabwe, Malawi and the Democratic Republic of Congo, can expose travellers to the disease. Symptoms may develop after they return home, increasing the risk of delayed diagnosis if their recent travel history is not considered.

Malaria remains a significant global public health challenge. An estimated 282 million cases and 610,000 deaths were recorded worldwide in 2024, with the World Health Organization’s African Region accounting for approximately 94% of cases and 95% of deaths. Despite being preventable and treatable, the disease continues to pose a serious threat, particularly to young children and other vulnerable groups.

Professor de Jager noted that people returning from malaria-risk areas may mistake early symptoms for other illnesses or fail to inform healthcare professionals about their recent travel. Such delays can allow the disease to progress, increasing the risk of severe complications and death. Early diagnosis and prompt treatment are therefore critical.

Established malaria-control measures include indoor residual spraying, insecticide-treated mosquito nets and larviciding, which targets mosquito larvae before they develop into adults. However, resistance to antimalarial medicines and insecticides, changes in mosquito-biting behaviour, climate-related changes and increased population movement are complicating efforts to control the disease.

During the question-and-answer session, participants raised concerns about whether malaria transmission had become established in Gauteng and whether rising temperatures could allow malaria-carrying mosquitoes to survive in areas previously considered low-risk.

In response, Professor de Jager referred to data from the National Institute for Communicable Diseases (NICD), indicating that the cases investigated were not endemic to Gauteng. He

cautioned, however, that changing temperatures and more favourable mosquito-breeding conditions reinforce the need for continued surveillance and effective early-warning systems.

He also addressed questions about natural immunity, explaining that people living in areas with consistently high malaria transmission may develop some immunity through repeated exposure. However, this does not provide complete or permanent protection. Pregnant women and children under five remain particularly vulnerable and require appropriate preventive measures and timely access to healthcare.

The discussion also stressed the importance of prevention among travellers. According to information presented during the webinar, a review of the 11 deaths recorded in Gauteng found that only one individual had reportedly taken preventive antimalarial medication. The finding highlighted the need for travellers to seek medical advice before visiting malaria-endemic areas and to follow prescribed preventive medication regimens.

“Adherence to the prescribed regimen is non-negotiable if we want to reduce the risk of severe malaria,” Professor de Jager said.

He emphasised that effective malaria control requires a combination of interventions targeting the parasite, mosquito populations and human exposure. Public education, health promotion and accessible healthcare services are equally important in helping people understand the risks and recognise when to seek medical attention.

“Early diagnosis and immediate diagnostic testing save lives, especially when returning from high-risk zones,” he said.

Professor de Jager warned that sustained efforts in public awareness, prevention, surveillance, testing and treatment are essential to controlling malaria. A slowdown in these interventions could undermine progress and increase the risk of renewed transmission.

“In the fight against malaria, standing still is not neutral. It is regressive … When efforts slow down, the disease returns,” he said.

The webinar concluded with a call for stronger collaboration, improved disease surveillance and clearer public communication. Professor de Jager stressed that malaria does not respect provincial or national borders, making regional cooperation and effective early-warning systems essential to South Africa’s efforts to eliminate the disease.