No control measures are in place in the Mozambique sector. The areas are contiguous and can be considered one system in regard to the broad ecological and climatological factors driving malaria transmission. People cross national borders for various reasons including health care seeking, employment, family ties, tourism etc. All three countries undertake population census monitoring and a Malaria Information System is in place in the three malarious provinces of South Africa, is under development for Swaziland and will be extended to the Mozambique sector as outlined in the GIS section of this proposal. The incidence of malaria at district level is shown in Figure 1 and the annual case total for the respective provinces and Swaziland are included.
Malaria is distinctly seasonal in the region.
Health information systems are vital to structure malaria control such as drug distribution, house spraying, etc. This combined system has proved invaluable in research design with regard to selection of study sites, randomisation of sampling, patient follow up, spatial analysis of data and intervention assessment. In vivo studies began in KwaZulu and Mpumalanga in January 2000 to evaluate the baseline clinical and parasitological failure of SP montherapy in these sites. The distribution of health care facilities is illustrated in Figure 5 . National malaria treatment policy in South Africa stipulates SP as first-line therapy, with quinine recommended for patients requiring hospital admission.