Malaria Epidemics : Prevention and Control

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Malaria Epidemics : Prevention and Control - Conférence du 3e édition du Cours international « Atelier Paludisme » - FALL Socé - Regional Office for Africa Malaria Unit, Zimbabwe - SoceF@afro.who.int

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Malaria Epidemics : Prevention and Control

  1. 1. MALARIA EPIDEMICSPrevention & Control Dr Ibrahima Socé Fall WHO AFRO Malaria Unit
  2. 2. Outlines Of The Presentation1. Rationale of malaria epidemic monitoring and control2. Situation of malaria epidemic control in Africa3. Planning for malaria epidemic control • Early warning and prevention • Early detection • Preparing to respond to malaria epidemics
  3. 3. Burden Of malaria Epidemic In Africa 1. More than 100 million people living in malaria epidemic-prone areas 2. One epidemic is expected every 4-5 year on (cyclical pattern) 3. 0.5 malaria episode per person expected during epidemic periods 4. Up to 5% of malaria episodes are severe malaria 5. CFR of severe malaria varies from 10% to 50% in epidemic situation 6. Economic lost
  4. 4. Countries At Risk Of Malaria Epidemic Countries at risk of epidemic malaria May have some districts at risk EMRO countries
  5. 5. RBM Technical StrategyEarly detection and control, forecasting and prevention of malaria epidemics are one of the technical elements the global malaria controls strategy (1993), on which RBM initiative is based (1998)
  6. 6. Abuja Targets On Malaria Epidemics1. 60% of epidemics are detected within 2 weeks of onset2. 60% of epidemics are responded to within 2 weeks of detection
  7. 7. Monitoring Abuja target for malaria epidemic control• Countries able to detect epidemic • Countries able to respond within 2 weeks of onset adequately to epidemic Able Able Not able Not able EMRO countries EMRO countries
  8. 8. Planning for malaria epidemic control
  9. 9. Guiding principlesOnly one Build on existing systems
  10. 10. Guiding principlesOnly one Build on existing systems
  11. 11. Setting up early warning system Epidemic Malaria Risk Assessment1. Identification and mapping of Epidemic risk areas – Epidemic history, environmental and epidemiological/entomological stratification2. Recognition and monitoring of epidemic risk factors – Retrospective analysis of past epidemics and risk factor data – Several indicators but few can be measured routinely (climate forecasts/weather, river level); – Others assessments when and where data are available (vector density, drug resistance, vulnerability factors)3. Develop inter-sectoral collaboration with meteorology, agriculture, etc
  12. 12. Monitoring the risk factors indicatorsTwo groups of indicators –Transmission risk indicators –Vulnerability indicatorsSelect indicators that can be measured routinely –In low land areas: rainfall (quantity and continuity) –In riverside areas subject to floods: river levels –In highlands: temperature, rainfall
  13. 13. Setting up early detection system1. Health facility to monitor weekly morbidity and mortality data2. Establish epidemic threshold to ease the interpretation of data3. Laboratory confirmation (rapid diagnostic test, smears)4. Establish reliable communication systems5. Rapid investigation of suspected epidemics
  14. 14. Preparing for epidemic control (1)1. Set up and orient the epidemic management committees2. Set up and orient the rapid response teams3. Set up malaria epidemic early warning system4. Set up malaria epidemic early detection system
  15. 15. Preparing for epidemic control (2)5. Set up a buffer stock of drugs, reagents, rapid diagnosis tests, IRS equipment, insecticides, etc.6. Develop EPR guideline7. Develop tools (capacity building, investigation guide, social mobilisation kits, SOPs)8. Capacity building9. Etc.
  16. 16. ConclusionsRemember1. When disaster strikes, the least prepared the community is, the most damage it causes2. Epidemics, as other emergencies, can reach disastrous proportions where there is poor planning and preparation, and weak or uncoordinated response…

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