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

1. MALARIA EPIDEMICS
Prevention & Control
Dr Ibrahima Socé Fall
WHO AFRO
Malaria Unit

2. Outlines Of The Presentation
1. Rationale of malaria epidemic monitoring and
control
2. Situation of malaria epidemic control in Africa
3. Planning for malaria epidemic control
• Early warning and prevention
• Early detection
• Preparing to respond to malaria epidemics

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

5. Countries At Risk Of Malaria Epidemic
Countries at risk of
epidemic malaria
May have some
districts at risk
EMRO countries

6. RBM Technical Strategy
Early 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)

7. Abuja Targets On Malaria Epidemics
1. 60% of epidemics are detected within 2 weeks
of onset
2. 60% of epidemics are responded to within 2
weeks of detection

9. 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

10. Planning for malaria epidemic
control

11. Guiding principles
Only one
Build on existing systems

12. Guiding principles
Only one
Build on existing systems

13. Setting up early warning system
Epidemic Malaria Risk Assessment
1. Identification and mapping of Epidemic risk areas
– Epidemic history, environmental and epidemiological/entomological
stratification
2. 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

14. Monitoring the risk factors indicators
Two groups of indicators
–Transmission risk indicators
–Vulnerability indicators
Select 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

15. Setting up early detection system
1. Health facility to monitor weekly morbidity and
mortality data
2. Establish epidemic threshold to ease the
interpretation of data
3. Laboratory confirmation (rapid diagnostic test,
smears)
4. Establish reliable communication systems
5. Rapid investigation of suspected epidemics

16. Preparing for epidemic control (1)
1. Set up and orient the epidemic management
committees
2. Set up and orient the rapid response teams
3. Set up malaria epidemic early warning system
4. Set up malaria epidemic early detection system

17. Preparing for epidemic control (2)
5. Set up a buffer stock of drugs, reagents, rapid
diagnosis tests, IRS equipment, insecticides, etc.
6. Develop EPR guideline
7. Develop tools (capacity building, investigation guide,
social mobilisation kits, SOPs)
8. Capacity building
9. Etc.

18. Conclusions
Remember
1. When disaster strikes, the least prepared the
community is, the most damage it causes
2. Epidemics, as other emergencies, can reach
disastrous proportions where there is poor planning
and preparation, and weak or uncoordinated
response…