Elimination Target Year

Country Overview


At a Glance

  • Swaziland achieved 92% malaria case reduction from the year 2002 and 2016 and aims to eliminate malaria by 2020
  • An estimated 30% of the population, live in areas considered receptive to malaria transmission (Total population 1.287 million)


Swaziland is pursuing a vision of a Kingdom free from malaria, elaborated in the National Malaria Elimination Strategic Plan 2015 – 2020. Four intervention areas underpin this pursuit: (i) definitive diagnosis and standardized case management, (ii) evidence-based vector control, particularly targeted indoor residual spraying, (iii) epidemiological (including entomological) surveillance, and (iv) behaviour change communications.

Focus on the End Game

Malaria transmission in Swaziland is unstable and heavily dependent on the level of rainfall and parasite importation, both of which vary considerably throughout the year. The bulk of confirmed cases occur between November and May coinciding with the rainy season, with a significant peak of imported cases in January/February. Local malaria transmission occurs primarily in the Lowveld climatic region, approximately 250 meters above sea level in the east of the country. The key drivers of local transmission are rainfall, temperature and relative humidity in these areas and, coupled with the occasional influx of parasites, leading to local transmission. Confirmed cases decreased from 4004 in the year 2000 to 317 in 2016. Although the goal of Swaziland is to have no (zero) people die of malaria, there have been five and three deaths in 2014/2015 and 2015/2016, respectively, with two deaths so far in 2016/2017 owing to late treatment seeking behaviour. IRS coverage has improved from 87% to 96% over the same time period. These measures suggest Swaziland is progressing towards malaria elimination.

While the country has undergone strategic plan review, successes thus far can be attributed to key interventions such malaria case-based surveillance, optimised entomological surveillance and vector management. Towards the achieving elimination, the country will intensify malaria case-based surveillance, strengthen Integrated Vector Control Management, enhance and optimise entomological surveillance systems and vector control. Furthermore, community engagement in active foci and malaria At-Risk areas will be intensified coupled with an increase in malaria awareness to mobile populations.

Key Challenges

  • Cross-border migration resulting in high importation of parasite reservoirs into local receptive areas.
  • Low usage of preventive measures such LLIN usage, low uptake of prophylactic medication for travelers
  • Pockets of sporadic local transmission

Key Statistics

Recorded Malaria Cases

Recorded Malaria Deaths

Malaria Incidence Rate

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