Tourism is the world's largest earner of foreign currency. It brings an estimated R20 billion a year into the South African economy, second only to the manufacturing and mining industry in its contribution to the Gross Domestic Product (GDP). An estimated 1.7 million overseas and African tourists visited South Africa in 1999. Of the 1.7 million approximately 500 000 or 30% of these tourists visited KwazuluNatal. Forty seven percent of the foreign tourists visited the Zululand and Maputaland area, which falls within a malaria transmission zone. An estimated 8 million domestic tourists from outside or within this province travelled to one or more destinations within KwaZulu-Natal on an annual basis. The Lubombo Spatial Development Initiative is a tri-Iateral initiative between the governments of Swaziland, Mozambique and South Africa to develop the Lubombo region into a globally competitive economic zone. The geographical area targeted by this initiative is broadly defined as eastem Swaziland, southem Mozambique and north-eastem KwaZulu-Natal. Accelerated development with regards to agriculture and tourism is the main objective of the Lubombo Spatial Development Initiative (LSD!). The Lubombo corridor has the potential to develop into an intemational tourist destination but malaria is hampering the growth and development of the region. Perceived malaria risk by tourists is believed to be an important factor that has a negative influence on the tourism industry in the study area. The risk factor, as defined in this study, is the possibility of contracting malaria whilst visiting a tourism facility in the area. It is therefore essential to understand perceptions relating to malaria and malaria risk in the LSDI area. Malaria control plays a pivotal role in the Lubombo Spatial Development Initiative (LSD!). The objective of the malaria control component of the LSDI is to put in place a malaria control programme that will protect the economic interest of the Lubombo Spatial Development Initiative (LSD!) and stimulate development. Malaria control activities have been taking place in the three countries since 1999. Residual house spraying is the method used to control malaria in the Lubombo corridor. Major reductions in both malaria cases and parasite prevalence have been recorded. Swaziland's malaria incidence reduced by 64%, South Africa's malaria incidence plummeted by a staggering 76% and Mozambique saw a parasite prevalence reduction of40% in the first year of residual house spraying in 1999. This study focuses on the scientific study of malaria incidence and distribution as well as on both tourists and tourism operator's perceptions of malaria risk. It considers the factors that drive people's perceptions of risk and investigates how tourists and tourism operators respond to malaria risk. It draws conclusions about how malaria impacts on tourism in the LSDI and recommends how malaria control can play a positive role in tourism development in the area. / Thesis (M.Sc.)-University of Natal, Durban, 2003.

This study aimed at investigating the knowledge, perceptions and attitudes of both the community and traditional healers with regard to the diagnosis and treatment of malaria in KwaZulu Natal with special reference to Ndumu in the magisterial district of Ingwavuma. Ingwavuma is one of the two northern magisterial district of KwaZulu Natal Province which is regarded as the highest malaria risk district in South Africa as a whole. The area has a warm temperature, 27-32°C, which is favourable for the development of the Anopheles mosquito. The factors predisposing the community to malaria infections were the socio-economic status of the area which is characterised by poverty. unemployment, poor housing and illiteracy, cross border migration, drug resistance, the agricultural development and irrigation scheme. Efficient control measures like house spraying a residual insecticide to control malaria vector mosquitoes, passive surveillance and active case detection with definitive diagnosis and treatment in place to prevent and control the upsurge of the disease The objectives of the study were to ascertain the knowledge. attitudes and perceptions of traditional healers in regard to malaria diagnosis and treatment and that of the community in relation to malaria treatment and diagnosis by traditional healers. The ultimate objective was to identify possible forms of collaboration between the traditional and the modern health services. The study was conducted from sections 2 - 10 of Ndumu where the population was 13 047 and 1300 households. A random sample of 173 respondents from the community and 70 traditional healers were selected for interview. Qualitative and quantitative methodologies were used in order to collect numerical and descriptive information. Data was collected using semi- structured questions and two sets were made: for traditional healers and the community. The study showed that the community was well aware of the signs of malaria but their knowledge was not supported by definitive testing and diagnosis of the condition. It came out that there are forms of health services available at grass root levels for example. self - help. where an individual tried on his own to combat he offending symptoms of the disease, family support systems, where family members especially the elder member gave support and assisted during the times of ill-health, the use of traditional healers, the malaria control camp, clinics and the hospital. The community supported the idea of collaboration between healers and the malaria control team and expressed their willingness to attend the services of a trained healer. Traditional healers confirmed the fact that some community members utilize traditional healers services and also expressed their wish to see the two forms of health services working together to control malaria. / Thesis (M.Sc.)-University of Natal, Durban, 2000.