Malaria

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Situational analysis

World Malaria Day Moz2013In Mozambique, malaria is a major cause of morbidity and mortality especially among children. The disease represents around 45% of all cases in outpatient visits, approximately 56% of inpatient at paediatric clinics and around 26% of all hospital deaths. .According to the Demographic Health Survey 2011, the prevalence of malaria among children under five years is 46.3% in rural areas compared to 16.8% in urban areas. The relatively high prevalence in many parts of the country puts the entire population at risk and poses a challenge for malaria elimination efforts nationally and in neighboring countries.      

Malaria is endemic throughout Mozambique with seasonal peaks during and after the rainy season, which is between November and December. The seasonal intensity of transmission varies depending on the amount of rain and air temperature. The tropical climate combined with the presence of some of the most efficient vectors for malaria transmission (namely Anopheles gambiae s.s., An. Arabiensis from the Gambiae complex and An. Funestus) facilitate malaria transmission throughout the entire calendar year.

Plasmodium falciparum is the most common parasite, responsible for more than 9 out of 10 of all infections. Plasmodium malariae accounts for approximately 6% of infections, with the rest being mixed infections from these two species. Infections caused by plasmodium ovale are relatively rare.

Main prevention methods include long-lasting insecticidal nets (LLIN), indoor residual spraying and intermittent preventive treatment for pregnant women (IPTp).

Mozambique faces a number of specific challenges in combatting malaria:

·         The Health Information System (HIS) does not collect data on most malaria indicators;

·         Limited available data from laboratories on rapid diagnostic tests and microscopy;

·         Inadequate health infrastructure affecting the distribution and availability of treatment (artemisinin-combination therapies – ACT);

·         Scarce human resources for health impairing the quality of care provided at health facilities;

·         Limited use and logistical capacity in the distribution of long-lasting insecticidal nets;

·         Limited funds for campaigns for indoor residual spraying, and

·         Finalization of the Integrated Vector Management (IVM) Guidelines

In October 2010, the Ministry of Health decided to undertake an in-depth review of the National Malaria Control Program (NMCP). In response to the recommendations of the Malaria Program Review 2010, the NMCP developed and finalized the Malaria Policy and Strategic Plan (MSP) 2012-2016. In line with the Global Malaria Program, the MSP includes a monitoring and evaluation plan to measure to aim of scaling up malaria control interventions to achieve universal health coverage by 2015 according to the Millennium Development Goals.

The overall objective of the MSP 2012-2016 is to halve malaria morbidity and mortality rates relative to the rates observed in 2009.

Specific Objectives of the MSP 2012-2016 include:

  1. By 2014, all districts should have the capacity to manage malaria control activities.
  2. By 2014, the entire population should have access to at least one malaria prevention method.
  3. By 2014, all suspected malaria cases presenting to health and community health workers (CHWs) should receive a malaria diagnostic test and receive treatment according to the national guidelines.
  4. By 2014, surveillance, monitoring, and evaluation systems should be strengthened so that districts are able to report routinely on key malaria indicators.
  5. By 2016, all of the population should have received information on malaria prevention and treatment.

Achievements

Some of the main achievements include the development of a number of technical guidelines on how to reduce morbidity and mortality caused by malaria in Mozambique:

  • Malaria Treatment Guidelines updated
  • National supervision guidelines developed  in 2011
  • Laboratory guidelines developed  in 2011
  • Integrated Vector Management Guidelines under development
  • Annual distribution of LLIN to reach universal access:
    • 2010: 1.525.979
    • 2011: 3.311.246
    • 2012: 2.601.953
    • According to the plan of the MoH, 6,229,492 LLIN are expected to be distributed in 2013.
  • Raising awareness of malaria on World Malaria Day 2013 during an event in Ndlavela .

Key Resources

Mozambique