The impact of malaria control on perceptions of tourists and tourism operators concerning malaria prevalence in KwaZulu-Natal, 1999/2000 versus 2002/2003

Background. Although the regional approach to malaria control between South Africa, Swaziland, and Mozambique has significantly decreased malaria risk in the Lubombo corridor, many facility owners' and tourists' malaria risk perception has remained unchanged. A large percentage are still unaware of the extensive malaria control efforts in the region and subsequent malaria reductions in the Lubombo corridor. Methods. A questionnaire-based follow-up survey was carried out in northern KwaZulu-Natal in the 1999/2000 and 2002/2003 malaria seasons. Tourists and tourist facility owners/managers were interviewed on their perceptions pertaining to malaria risk. Results. In the 1999/2000 malaria season, 18% of tourist facilities in northern KwaZulu-Natal were in areas where 5 to 25 malaria cases per 1,000 population were recorded, and 68% were in areas where <5 malaria cases per 1,000 population were recorded. A major reduction in malaria cases was achieved by the end of the 2002/2003 malaria season. None (0%) of the tourist facilities were in areas where 5 to 25 malaria cases per 1,000 population were recorded, and 98% were in areas where malaria cases were lower than five cases per 1,000 population. Conclusion. The survey of local and international tourists and tourist facility operators in northern KwaZulu-Natal revealed that there was a discrepancy between perceived and actual malaria risk. The perceived malaria risk among both local and international tourists and facility operators needs to be addressed by distributing updated malaria risk information on an annual basis. © 2007 International Society of Travel Medicine.