transmission), excluding the population living in malaria-free ..... tions/world_malaria_report_2012/en/index.html, acce
Country profiles Afghanistan Algeria Angola Argentina Azerbaijan Bangladesh Belize Benin Bhutan Bolivia (Plurinational State of ) Botswana Brazil Burkina Faso Burundi Cambodia Cameroon Cabo Verde Central African Republic Chad China Colombia Comoros Congo Costa Rica Côte d’Ivoire Democratic People’s Republic of Korea Democratic Republic of the Congo Djibouti Dominican Republic Ecuador El Salvador Equatorial Guinea Eritrea Ethiopia French Guiana, France Gabon Gambia Ghana Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras India Indonesia Iran (Islamic Republic of ) Kenya Kyrgyzstan Lao People’s Democratic Republic
99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 134 135 136 137 138 139 140 141 142 143
Liberia Madagascar Malawi Malaysia Mali Mauritania Mayotte Mexico Mozambique Myanmar Namibia Nepal Nicaragua Niger Nigeria Pakistan Panama Papua New Guinea Paraguay Peru Philippines Republic of Korea Rwanda Sao Tome and Principe Saudi Arabia Senegal Sierra Leone Solomon Islands Somalia South Africa Sri Lanka South Sudan Sudan Suriname Swaziland Tajikistan Thailand Democratic Republic of Timor-Leste Togo Turkey Uganda United Republic of Tanzania (Mainland) United Republic of Tanzania (Zanzibar) Uzbekistan Vanuatu Venezuela (Bolivarian Republic of ) Viet Nam Yemen Zambia Zimbabwe
144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193
WORLD MALARIA REPORT 2013 | 91
C.1 Methods for preparing country profiles This section describes the methods used for preparing country profiles. These methods also apply to other sections of the report.
C.1.1 Maps Confirmed cases per 1000 population The epidemiological maps for each country shown in the country profiles are based on the number of confirmed cases per 1000 population in 2012 (the working definition of a case of malaria is considered to be “fever with parasites”). Incidence rates are corrected for reporting completeness by dividing by the proportion of health-facility reports received in 2012. Seven levels of endemicity are shown: ■
>100 cases per 1000 population per year
■
50 cases per 1000 population per year and 10 cases per 1000 population per year but 1 cases per 1000 population per year but 0.1 cases per 1000 population per year but 0 cases per 1000 population per year but 1 per 1000 population per year in 2012. 2 Areas of low transmission, where the reported malaria case incidence from all species was ≤1 per 1000 population per year in 2011, but >0. Transmission in these areas is generally highly seasonal, with or without epidemic peaks.
The maps for countries in sub-Saharan Africa display a combination of: (i) cases per 1000 per year and, (ii) parasite prevalence in areas with >10 cases per 1000 population per year. To obtain a measure of combined parasite prevalence for both Plasmodium falciparum and P. vivax, the sum of the two independent parasite rates (1, 2) was calculated at each point (~5 km2). Data on environmental suitability for malaria transmission were used to identify areas
3 Malaria-free areas, where there is no continuing local mosquito-borne malaria transmission, and all reported malaria cases are imported. An area is designated “malaria free” when no cases have occurred for several years. Areas may be naturally malaria free due to altitude or other environmental factors that are unfavourable for malaria transmission, or they may become malaria free as a result of effective control efforts. In practice, malaria-free areas can be accurately designated by national programmes only after taking into account the local epidemiological situation and the results of entomological and biomarker investigations. If cases where a national programme did not provide the number of people living in high- and low-risk areas, the numbers were inferred from subnational case incidence data provided by the programme. The population at risk is the total population living in areas where malaria is endemic (low and high transmission), excluding the population living in malaria-free areas. The population at risk is used as the denominator in calculating the coverage of malaria interventions; hence, it is used in assessing current and future needs for malaria control interventions, taking into account the population already covered. For countries in the pre-elimination and elimination stages, “population at risk” is defined by the countries, based on the resident populations in foci where active malaria transmission occurs.
that would be free of malaria.
Parasites and vectors
Proportion of cases due to P. falciparum
The species of mosquito responsible for malaria transmission in a country, and the species of Plasmodium involved, are listed according to information provided by WHO regional offices. The proportion of malaria cases due to P. falciparum is estimated from the number of P. falciparum and mixed infections detected by microscopy, divided by the total number of microscopically confirmed malaria cases.
The first four categories correspond to the high-transmission category defined below. Case incidence rates for 2012 do not necessarily reflect the endemicity of areas in previous years. If subnational data on population or malaria cases were lacking, an administrative unit was labelled “no data” on the map. In some cases, the subnational data provided by a malaria control programme did not correspond to a mapping area known to WHO, either because of modifications to administrative boundaries, or the use of names not verifiable by WHO.
This map is based on the proportion of P. falciparum in 2012: total number of cases due to P. falciparum divided by the total number of positive cases. Five levels of endemicity are shown: ■
80% P. falciparum
■
50% to 75% decrease in incidence 2000–2015
104 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
6 000 5 000 4 000 3 000 2 000 1 000 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
700 600 500 400 300 200 100 0
Deaths
2000
At high risk protected with ITNs Households with at least one ITN
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
Belize
Region of the Americas Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
0 224 000 100 000 324 000
0 69 31
Major plasmodium species: Major anopheles species:
P. falciparum (3%), P. vivax (97%) An. albimanus, darlingi
Programme phase: Control (Pre-elimination as of December 2013)
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2009 2009
IRS
IRS is recommended DDT is used for IRS
Yes No
– –
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
– –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes – Yes
2010 – –
Yes No Yes No
– – – –
Contribution (US$m)
III. Financing 0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes No Yes No No
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – – – –
Year adopted
Medicine
– – CQ+PQ – – – QN – CQ+PQ(14d) – 0.25 mg/kg (14 days) –
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine
Year
Min
Sources of financing
2002
Government
Intervention
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, PMI/ USAID
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20
40
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
16 14 12 10 8 6 4 2 0 2012
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
Cases per 1000
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2000
2005
100
Confirmed cases (per 1000) 7 6 5 4 3 2 1 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. vivax cases potentially treated with primaquine
100
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
2008
Cases (P. vivax)
2009
2010
2011
2012
18 16 14 12 10 8 6 4 2 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
5 4 3 2 1 0
Deaths
2000
At high risk protected with ITNs Households with at least one ITN
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
Admissions (P. vivax) Deaths (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 105
Benin
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
10 100 000 0 0 10 100 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae, funestus, melas
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes No
2007 –
IRS
IRS is recommended DDT is used for IRS
Yes No
2006 –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
Yes
2005
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2011 2008
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
No Yes No
– 2008 –
45 40 35 30 25 20 15 10 5 0
2000
2001
2003
2004
Global Fund
2005
2006
World Bank
IV. Coverage
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– No No Yes No
Antimalaria treatment policy
– – – 2005
2007
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Medicine AL
2012
2004 2004 2004 2004 –
Year
Min
Median
Max
0
0.75
6.5
Follow-up No. of studies Species 28 days
P. f
4
No data reported for 2012
Cases tested and potentially treated (public sector) 100
Source: DHS 2006
Cases (%)
80
40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
12 10 8 6 4 2 0 2012
2002
2003
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2001
2005
100
Confirmed cases (per 1000)
2000
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
Cases due to P. vivax (%)
2000
With access to an ITN (model) With access to an ITN (survey)
Cases per 1000
– – – QN –
–
2005–2009
Coverage of ITNs and IRS
60
120 100 80 60 40 20 0
Year adopted
Therapeutic efficacy tests (clinical and parasitological failure, %)
Others
80
0
– – – – –
Medicine
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
ABER (%)
Population (%)
Surveillance
Expenditure by intervention in 2012
100
Positivity rate (%)
Yes/ Year No adopted
Sources of financing
2002
Government
Policies/strategies
2008
Cases (P. vivax)
Impact: Insufficiently consistent data to assess trends
106 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
900 800 700 600 500 400 300 200 100 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
25 20 15 10 5 0
Deaths
Contribution (US$m)
III. Financing
No – No Yes
Intervention
Bhutan
South-East Asia Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40 40–60 60–80 80–100
I. Epidemiological profile Population (UN Population Division) Number of active foci Number of people living within active foci Number of people living in malaria-free areas Total
2012
%
– 518 000 729 000 1 247 000
42 58
Parasites and vectors P. falciparum (43%), P. vivax (57%) An.maculatus, culicifacies, philippiensis, annularis
Major plasmodium species: Major anopheles species:
Programme phase: Pre-elimination
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2006 2006
IRS
IRS is recommended DDT is used for IRS
Yes No
1964 –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
No
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
1964 1964
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes Yes
2006 – 2012
Yes No No Yes
– – – –
Contribution (US$m)
III. Financing 2.0 1.6 1.2 0.8 0.4 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted Foci and case investigation undertaken Case reporting from private sector is mandatory
No No Yes Yes No Yes Yes
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – 2011 – – 2012 2012
Year adopted
Medicine
– – – N2006 – 2006 AM; QN 2006 CQ+PQ(14d) 2006 0.25 mg/kg (14 days)
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine AL
Year
Min
Median
Max
2005–2011
0
0
0
Sources of financing
2002
Government
Intervention
Follow-up No. of studies Species 28 days
P. f
23
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, WHO, Other
Coverage of ITNs and IRS
80
80 Cases (%)
100
60 40 20
60 40 20
2000
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
8
16
6
12
4
8
2
4 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
0 2012
2001
2002
Total cases
2003
2004
2005
2006
2007
2008
Imported cases
Confirmed cases
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
Slide positivity rate
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Among total cases
Among indigenous cases
Indigenous malaria cases by species Confirmed cases
2000
2005
100
Malaria cases by source 7 000 6 000 5 000 4 000 3 000 2 000 1 000 0
2004
Proportion of malaria cases due to P. vivax 20
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
10
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
Cases due to P. vivax (%)
0
Positivity rate (%)
Cases tested and potentially treated (public sector)
100
ABER (%)
Population (%)
IV. Coverage
2009
2010
2011
2012
7 000 6 000 5 000 4 000 3 000 2 000 1 000 0 2000
2001
2002
2003
2004
Indigenous cases (all species)
2005
2006
2007
2008
2009
2010
2011
2012
Indigenous cases (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 107
Bolivia (Plurinational State of )
Region of the Americas Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
504 000 3 200 000 6 790 000 10 494 000
5 30 65
Major plasmodium species: Major anopheles species:
P. falciparum (5%), P. vivax (95%) An. darlingi, pseudopunctipennis
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2008 2005
IRS
IRS is recommended DDT is used for IRS
Yes No
1959 –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2000 1996
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes No Yes
2003 – –
Yes No No No
1998 – – –
Contribution (US$m)
III. Financing 5 4 3 2 1 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes No Yes No No
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
– – 1998 – –
Year adopted
Medicine
– – AS+MQ+PQ 2001 QN+CL – QN 2001 CQ+PQ(14d) 2001 0.25mg/Kg (14 days) P.f + P.v specific (Combo)
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine
Year
Min
Sources of financing
2002
Government
Intervention
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, PMI/ USAID
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20
40
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
7 6 5 4 3 2 1 0 2012
2002
2003
Cases (all species)
2004
2005
2006
2007
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Malaria admissions and deaths
Admissions 2001
2006
Slide positivity rate
Total cases
2000
2005
100
Confirmed cases 35 000 30 000 25 000 20 000 15 000 10 000 5 000 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. vivax cases potentially treated with primaquine
100
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
2008
Cases (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
108 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
300 250 200 150 100 50 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
12 10 8 6 4 2 0
Deaths
2000
At high risk protected with ITNs Households with at least one ITN
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
Botswana
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
361 000 942 000 701 000 2 004 000
18 47 35
Major plasmodium species: Major anopheles species:
P. falciparum (100%), P. vivax (0%) An. arabiensis, gambiae
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2009 1997
IRS
IRS is recommended DDT is used for IRS
Yes Yes
1950 1950
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
No
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2010 1995
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2007 – –
III. Financing
No No No Yes
Intervention
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes Yes No No No
Antimalaria treatment policy
– – – –
Medicine
Year
2002
2003
2004
Global Fund
2005
2008
2009
2010
2011
WHO/UNICEF
2012
Others
Coverage of ITNs and IRS 80 Cases (%)
80 60 40 20
Follow-up No. of studies Species
No data reported for 2012
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
80
2.0
60
1.5
40
1.0
20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
0 2012
2002
2003
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2001
2005
100
Confirmed cases (per 1000)
2000
2004
Proportion of malaria cases due to P. vivax 2.5 Cases due to P. vivax (%)
Malaria test positivity rate and ABER
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
ABER (%)
2000
With access to an ITN (model) With access to an ITN (survey)
Cases per 1000
Max
Cases tested and potentially treated (public sector) 100
9 000 8 000 7 000 6 000 5 000 4 000 3 000 2 000 1 000 0
Median
Expenditure by intervention in 2012
100
0
Positivity rate (%)
2007
USAID/PMI
2007 2007 2007 2007 –
2008
2009
Cases (P. vivax)
2010
2011
2012
1 200 1 000 800 600 400 200 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
45 40 35 30 25 20 15 10 5 0
Deaths
Contribution (US$m)
IV. Coverage Population (%)
2006
World Bank
AL AL QN QN –
–
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
0.5 2001
Min
Sources of financing
1.0
2000
Year adopted
Therapeutic efficacy tests (clinical and parasitological failure, %)
1.5
0
Medicine
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2.0
Government
2012 2012 – – –
Admissions (P. vivax) Deaths (P. vivax)
Impact: Impact: On track for >75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 109
Brazil
Region of the Americas Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
4 570 000 35 800 000 158 000 000 198 370 000
2 18 80
Major plasmodium species: Major anopheles species:
P. falciparum (15%), P. vivax (85%) An. darlingi, albitarsis, aquasalis
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2007 2007
IRS
IRS is recommended DDT is used for IRS
Yes No
1945 –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
1972 1972
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes Yes
2006 2010 2011
Contribution (US$m)
III. Financing 120 100 80 60 40 20 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes Yes Yes Yes Yes
Antimalaria treatment policy
1972 – – –
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – – – –
Year adopted
Medicine
– – AL+PQ(1d); AS+MQ+PQ(1d) 2012 – – AM+CL; AS+CL 2012 CQ+PQ(7d);CQ+PQ(14d) 2006 0.5 mg/kg (7 days)
Type of RDT used
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine AS+MQ AL
Year
Min
Median
Max
2005–2007 2005–2007
0 0
0 0
0 0
Sources of financing
2002
Government
Yes No No No
Intervention
Follow-up No. of studies Species 42 days 28 days
P. f P. f
3 2
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): PMI/ USAID
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20
40
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
9 8 7 6 5 4 3 2 1 0 2012
2001
2002
2003
Total cases per 1000
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2000
2005
100
Confirmed cases (per 1000) 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. vivax cases potentially treated with primaquine
100
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
2008
Cases (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
110 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
16 000 14 000 12 000 10 000 8 000 6 000 4 000 2 000 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
250 200 150 100 50 0
Deaths
2000
At high risk protected with ITNs With access to an ITN in household
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
Burkina Faso
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
16 500 000 0 0 16 500 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae, funestus, arabiensis
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2007 1998
IRS
IRS is recommended DDT is used for IRS
Yes No
2006 –
Larval control Use of larval control
Yes
2012
IPT
IPT used to prevent malaria during pregnancy
Yes
2005
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2009 2009
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
No Yes No
– 2009 –
Contribution (US$m)
III. Financing 80 70 60 50 40 30 20 10 0
2000
2001
– – – 2009
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– No No Yes No
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – – – –
Medicine
Year adopted
AL; AS+AQ AL; AS+AQ QN QN –
2005 2005 – – –
Antimalaria treatment policy
P.f only
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine AL AS+AQ
Year
Min
Median
Max
2005–2009 2006–2009
1.9 3.2
7 15.3
12.5 21.5
Sources of financing
2002
Government
No No No Yes
Intervention
Follow-up No. of studies Species 28 days 28 days
P. f P. f
6 3
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, PMI/ USAID, Other Bilaterals
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
35 30 25 20 15 10 5 0 2012
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
Cases per 1000
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2000
2005
100
Confirmed cases (per 1000) 250 200 150 100 50 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
2009
2010
2011
2012
3 000 2 500 2 000 1 500 1 000 500 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
70 60 50 40 30 20 10 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: DHS 2003, MICS 2006, DHS 2010
ABER (%)
Population (%)
100
Admissions (P. vivax) Deaths (P. vivax)
Impact: Insufficiently consistent data to assess trends
WORLD MALARIA REPORT 2013 | 111
Burundi
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
2 360 000 5 320 000 2 170 000 9 850 000
24 54 22
Major plasmodium species: Major anopheles species:
P. falciparum (100%), P. vivax (0%) An. gambiae, funestus, arabiensis
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes No
2004 –
IRS
IRS is recommended DDT is used for IRS
Yes –
2009 –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
No
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes No
2012 –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes No No
2009 –
25 20 15 10 5 0
2000
2001
2003
2004
Global Fund
2005
2006
World Bank
IV. IV.Coverage Coverage
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– No No No No
2007
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Antimalaria treatment policy
Medicine
Year adopted
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
AS+AQ AS+AQ QN QN –
2003 2003 2003 2003 –
Medicine AS+AQ
2012
Year
Min
Median
Max
2005–2006
2.9
5.2
7.5
Coverage of ITNs and IRS
28 days
P. f
2
No data reported for 2012
Cases tested and potentially treated (public sector)
Cases (%)
80
40 20
60 40 20
2001
2002
2003
2004
2005
2006
V.V.Impact Impact
2007
2008
2009
2010
2011
2000
2001
2002
2003
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2005
2006
2007
2008
2009
2010
2011
2010
2011
60 50 40 30 20 10 0 2012
100 80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Malaria admissions and deaths (100 000)
Admissions
1600
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
2012
Slide positivity rate
Confirmed cases (per 1000)
2000
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
Proportion of malaria cases due to P. vivax
80
2001
2004
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
Cases due to P. vivax (%)
2000
With access to an ITN (model) With access to an ITN (survey)
Cases per 1000
Follow-up No. of studies Species
100
Source: DHS 2010
60
250 200 150 100 50 0
–
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
Others
80
0
– – – – –
Therapeutic efficacy tests (clinical and parasitological failure, %)
ABER (%)
Population (%)
Surveillance
Expenditure by intervention in 2012
100
Positivity rate (%)
Yes/ Year No adopted
Sources of financing
2002
Government
Policies/strategies
2008
Cases (P. vivax)
Impact: Insufficiently consistent data to assess trends
112 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
1200 800 400 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
35 30 25 20 15 10 5 0
Deaths
Contribution (US$m)
III. III.Financing Financing
No No No No
– – – – –
Intervention
Cambodia
Western Pacific Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
6 540 000 1 340 000 6 990 000 14 870 000
44 9 47
Major plasmodium species: Major anopheles species:
P. falciparum (56%), P. vivax (44%) An. dirus, minimus, maculatus, sundaicus
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2000 2000
IRS
IRS is recommended DDT is used for IRS
No No
– –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2000 2000
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2000 2000 –
No Yes No Yes
– 2012 – 2010
Contribution (US$m)
III. Financing 50 40 30 20 10 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
No No No No No
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – – – –
Medicine
Year adopted
– AS+MQ; DHA-PPQ+PQ QN+T AM; QN DHA-PPQ
– – – – –
Antimalaria treatment policy
– P.f + P.v specific (Combo)
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine
Year
Min
Median
Max
DHA-PPQ DHA-PPQ
2008–2013 2010–2011
0 0
3.6 0
30.8 0
Sources of financing
2002
Government
Intervention
Follow-up No. of studies Species 42 days 28 days
P. f P. v
15 3
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, PMI/ USAID, Other Bilaterals, WHO
Coverage of ITNs and IRS
80
80 Cases (%)
100
60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact 100 80 60 40 20 10 0 2000
2007
2008
2009
2010
2011
0
2012
2000
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
2001
2002
Malaria test positivity rate and ABER
2001
2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2003
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
Cases per 1000
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
2010
2011
100 80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2000
2005
Proportion of malaria cases due to P. vivax 3.0 2.5 2.0 1.5 1.0 0.5 0 2012
Confirmed cases (per 1000) 7 6 5 4 3 2 1 0
2004
Suspected cases tested P. falciparum cases potentially treated with ACT
2008
Cases (P. vivax)
2009
2010
2011
2012
18 000 16 000 14 000 12 000 10 000 8 000 6 000 4 000 2 000 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
700 600 500 400 300 200 100 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
Cases tested and potentially treated (public sector)
100
ABER (%)
Population (%)
IV. Coverage
Admissions (P. vivax) Deaths (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 113
Cameroon
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
15 400 000 6 290 000 0 21 690 000
71 29 0
Major plasmodium species: Major anopheles species:
P. falciparum (100%), P. vivax (0%) An. gambiae, arabiensis, funestus, moucheti, nili
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
No No
– –
IRS
IRS is recommended DDT is used for IRS
Yes No
2007 –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
N/A
2004
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2011 2012
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
No Yes No
– 2006 –
Contribution (US$m)
III. Financing 70 60 50 40 30 20 10 0
2000
2001
– – – 2004
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– No No Yes No
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – – – –
Antimalaria treatment policy
Medicine
Year adopted
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
AS+AQ AS+AQ QN AM; QN –
2004 2004 2004 2004 – –
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine
Year
Min
Sources of financing
2002
Government
No – – Yes
Intervention
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): WHO
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
Source: DHS 2004, MICS 2006
80
80 Cases (%)
60 40 20 0
60 40 20
2000
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
0
2012
2001
2002
Malaria test positivity rate and ABER
2002
2003
2004
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
Cases due to P. vivax (%)
5.75 2012
ABER (%)
Positivity rate (%)
5.80
ABER (Micr. & RDT)
2001
2002
2003
Cases per 1000
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2000
2005
100
Confirmed cases (per 1000) 18 16 14 12 10 8 6 4 2 0
2004
Proportion of malaria cases due to P. vivax
5.85
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT 5.90
2000
2000
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
Impact: Insufficiently consistent data to assess trends
114 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
2 500 2 000 1 500 1 000 500 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
45 40 35 30 25 20 15 10 5 0
Deaths
Population (%)
100
Cabo Verde
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40 40–60 60–80 80–100
I. Epidemiological profile Population (UN Population Division) Number of active foci Number of people living within active foci Number of people living in malaria-free areas Total
2012
%
– 283 000 211 000 494 000
57 43
Parasites and vectors P. falciparum (100%), P. vivax (0%) An.arabiensis
Major plasmodium species: Major anopheles species:
Programme phase: Pre-elimination
II. Intervention policies and strategies Yes/ Year No adopted
Intervention
Policies/strategies
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
IRS
– –
– –
IRS is recommended DDT is used for IRS
Yes No
1998 –
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
No
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
1998 1975
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes No Yes
2008 – –
Yes – Yes No
– – – –
Contribution (US$m)
III. Financing 30 25 20 15 10 5 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted Foci and case investigation undertaken Case reporting from private sector is mandatory
Yes Yes No Yes – Yes Yes
Antimalaria treatment policy
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – – – – – –
Medicine
Year adopted
AL AL QN QN –
– – – – –
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
–
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine
Year
Min
Sources of financing
2002
Government
Intervention
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund
Coverage of ITNs and IRS
80
80 Cases (%)
100
60 40 20
60 40 20
2000
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
4
20
3
15
2
10
1
5 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
0 2012
2001
2002
Total cases
2003
2004
2005
2006
2007
2008
Imported cases
Confirmed cases
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
Slide positivity rate
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Among total cases
Among indigenous cases
Indigenous malaria cases by species Confirmed cases
2000
2005
100
Malaria cases by source 160 140 120 100 80 60 40 20 0
2004
Proportion of malaria cases due to P. vivax 25
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
5
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs With access to an ITN in household
Cases due to P. vivax (%)
0
Positivity rate (%)
Cases tested and potentially treated (public sector)
100
ABER (%)
Population (%)
IV. Coverage
2009
2010
2011
2012
140 120 100 80 60 40 20 0 2000
2001
2002
2003
2004
Indigenous cases (all species)
2005
2006
2007
2008
2009
2010
2011
2012
Indigenous cases (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 115
Central African Republic
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
4 530 000 0 0 4 530 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae, funestus, arabiensis
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes No
2006 –
IRS
IRS is recommended DDT is used for IRS
Yes No
– –
Larval control Use of larval control
–
–
IPT
IPT used to prevent malaria during pregnancy
Yes
2004
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes No
– –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
No Yes No
2010 2010 –
Contribution (US$m)
III. Financing 8 7 6 5 4 3 2 1 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– No No – –
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – – – –
Antimalaria treatment policy
Medicine
Year adopted
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
AL AL QN AM; QN –
2005 – – 2005 – –
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine
Year
Min
Sources of financing
2002
Government
No No No No
Intervention
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20
40
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
1.4 1.2 1.0 0.8 0.6 0.4 0.2 0 2012
2001
2002
2003
Cases per 1000
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2000
2005
100
Confirmed cases (per 1000) 12 10 8 6 4 2 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
2008
Cases (P. vivax)
Impact: Insufficiently consistent data to assess trends
116 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
1 800 1 600 1 400 1 200 1 000 800 600 400 200 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
35 30 25 20 15 10 5 0
Deaths
2000
With access to an ITN (model) With access to an ITN (survey)
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
Chad
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
9 960 000 2 370 000 124 000 12 454 000
80 19 1
Major plasmodium species: Major anopheles species:
P. falciparum (100%), P. vivax (0%) An. arabiensis, funestus, pharoensis, nili
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes No
2003 –
IRS
IRS is recommended DDT is used for IRS
Yes No
– –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
Yes
2004
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
– –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
No Yes No
– – –
1 200 1 000 800 600 400 200 0
2000
2001
2003
2004
Global Fund
2005
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– No – Yes –
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2007
2008
USAID/PMI
– – – –
Medicine AS+AQ
Year
Min
Median
Max
2009–2009
0
0
0
– – – – –
Follow-up No. of studies Species 28 days
P. f
2
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
2012
Others
Coverage of ITNs and IRS
No data reported for 2012
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
4.5 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0 2012
2002
2003
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2001
2005
100
Confirmed cases (per 1000)
2000
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
Cases due to P. vivax (%)
2000
With access to an ITN (model) With access to an ITN (survey)
Cases per 1000
AL; AS+AQ AL; AS+AQ QN AM; QN –
–
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
100
18 16 14 12 10 8 6 4 2 0
Year adopted
Therapeutic efficacy tests (clinical and parasitological failure, %)
100
0
– – – – –
Medicine
Antimalaria treatment policy
ABER (%)
Population (%)
2006
World Bank
IV. Coverage
Positivity rate (%)
Yes/ Year No adopted
Sources of financing
2002
Government
Policies/strategies
2008
Cases (P. vivax)
2009
2010
2011
2012
400 350 300 250 200 150 100 50 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
12 10 8 6 4 2 0
Deaths
Contribution (US$m)
III. Financing
No No No No
Intervention
Admissions (P. vivax) Deaths (P. vivax)
Impact: Insufficiently consistent data to assess trends
WORLD MALARIA REPORT 2013 | 117
China
Western Pacific Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
196 000 576 000 000 801 000 000 1 377 196 000
0 42 58
Major plasmodium species: Major anopheles species:
P. falciparum (58%), P. vivax (42%) An. sinensis, anthropophagus, dirus, minimus
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes Yes Yes No No
Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2003 2000
IRS
IRS is recommended DDT is used for IRS
Yes No
2000 –
Larval control Use of larval control
No
–
Antimalaria treatment policy
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes No
2000 –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2006 2006 –
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
Yes No Yes Yes
1970 – 1970 1970
60 50 40 30 20 10 0
2000
2001
2003
2004
Global Fund
IV. Coverage
2006
2008
Year
Min
Median
Max
CQ+PQ CQ DHA-PPQ
2008–2009 2009–2013 2012–2012
0 0 0
0 0 1.15
0 4.3 2.3
Follow-up No. of studies Species 28 days 28 days 42 days
P. v P. v P. f
1 5 2
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
2012
Others
Coverage of ITNs and IRS
No data reported for 2012
Cases tested and potentially treated (public sector)
80
80 Cases (%)
100
60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact 100 80 60 40 20 10 0 2000
2007
2008
2009
2010
2011
0
2012
2000
At high risk protected with IRS All ages who slept under an ITN
2001
2002
Malaria test positivity rate and ABER
2001
2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2003
2010
2011
2003
2004
2005
2006
2007
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
100 80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Malaria admissions and deaths
Admissions 2002
Cases (all species)
2006
Slide positivity rate
Cases per 1000
2001
2005
Proportion of malaria cases due to P. vivax 1.8 1.6 1.4 1.2 1.0 0.8 0.6 0.4 0.2 0 2012
Confirmed cases (per 1000)
2000
2004
Suspected cases tested P. falciparum cases potentially treated with ACT
Cases due to P. vivax (%)
2000
At high risk protected with ITNs Households with at least one ITN
35 000 30 000 25 000 20 000 15 000 10 000 5 000 0
– 2009 – 2009 2006 – –
Medicine
100
0
Positivity rate (%)
2007
USAID/PMI
– ART+NQ; ART-PPQ; AS+AQ; DHA-PPQ – AM; AS; PYR CQ+PQ(8d)
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
ABER (%)
Population (%)
2005
World Bank
Year adopted
Therapeutic efficacy tests (clinical and parasitological failure, %)
Sources of financing
2002
Government
Medicine
2008
Cases (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
118 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
1.2 1.0 0.8 0.6 0.4 0.2 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
60 50 40 30 20 10 0
Deaths
Contribution (US$m)
III. Financing
2000 2000 1970 – –
Colombia
Region of the Americas Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
7 060 000 3 670 000 37 000 000 47 730 000
15 8 78
Major plasmodium species: P. falciparum (27%), P. vivax (73%) Major anopheles species: An. darlingi, albimanus, nunestovari, neivai, punctimacula, pseudopunctipennis
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2005 2005
IRS
IRS is recommended DDT is used for IRS
Yes No
1958 –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
1984 1958
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes No No
2008 – –
Contribution (US$m)
III. Financing 35 30 25 20 15 20 15 10 5 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes No No No No
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
1998 – – – –
Year adopted
Medicine
– – AL 2006 QN(3d)+CL(5d) 2004 AS 2004 CQ+PQ(14d) 1960s 0.25 mg/kg (14 days)
P.f + P.v specific (Combo)
Type of RDT used
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine AL
Year
Min
Median
Max
2007–2010
0
0
1.3
Sources of financing
2002
Government
Yes No No Yes
Intervention
Follow-up No. of studies Species 28 days
P. f
3
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, PMI/ USAID
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
9 8 7 6 5 4 3 2 1 0 2012
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
Total cases per 1000
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2000
2005
100
Confirmed cases (per 1000) 6 5 4 3 2 1 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. vivax cases potentially treated with primaquine
100
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
2008
Cases (P. vivax)
2009
2010
2011
2012
700 600 500 400 300 200 100 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
70 60 50 40 30 20 10 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: DHS 2000, Other Nat.
ABER (%)
Population (%)
100
Admissions (P. vivax) Deaths (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 119
Comoros
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
674 000 43 100 0 717 100
94 6 0
Major plasmodium species: Major anopheles species:
P. falciparum (96%), P. vivax (1%) An. gambiae, funestus
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2005 2010
IRS
IRS is recommended DDT is used for IRS
Yes Yes
– –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
Yes
2004
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
1997 –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2005 – –
Contribution (US$m)
III. III.Financing Financing 5 4 3 2 1 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– No No Yes No
Antimalaria treatment policy
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
Medicine
Year adopted
AL AL QN QN –
2003 2003 2003 2003 –
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
P.f + P.v, P.o, P.m (Combo)
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine AL
Year
Min
Median
Max
2006–2011
0
0
3.2
Sources of financing
2002
Government
No No No No
Intervention
Follow-up No. of studies Species 28 days
P. f
12
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, UNICEF, WHO
Coverage of ITNs and IRS
80
80 Cases (%)
100
60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V.V.Impact Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
80
20
60
15
40
10
20
5 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
0 2012
2006
2007
2008
2009
2010
2011
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Admissions
40 20 2001
2002
2003
Cases (all species)
2004
2005
2006
2007
2012
Malaria admissions and deaths (100 000) 4 000
2000
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
100
Confirmed cases (per 1000) Cases per 1000
2005
Slide positivity rate
80
0
2004
Proportion of malaria cases due to P. vivax 25
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
Impact: Insufficiently consistent data to assess trends
120 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
3 000 2 000 1 000 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
18 16 14 12 10 8 6 4 2 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
Cases tested and potentially treated (public sector)
100
ABER (%)
Population (%)
IV. IV.Coverage Coverage
Congo
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
4 340 000 0 0 4 340 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae, funestus, nili, moucheti, hancocki
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2007 –
IRS
IRS is recommended DDT is used for IRS
Yes No
– –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
Yes
2006
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
– –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
No No No
– – –
14 12 10 8 6 4 2 0
2000
2001
2003
2004
Global Fund
2005
2006
World Bank
IV. Coverage
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– No No Yes No
2007
2008
USAID/PMI
2009
2010
2011
WHO/UNICEF
Antimalaria treatment policy
Medicine
Year adopted
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
AS+AQ AS+AQ AL QN –
– – – – –
– – – –
Medicine AS+AQ AL
2012
Year
Min
Median
Max
2005–2005 2006–2006
5.6 2.8
5.6 2.8
5.6 2.8
Coverage of ITNs and IRS
28 days 28 days
P. f P. f
1 1
No data reported for 2012
Cases tested and potentially treated (public sector) 80 Cases (%)
40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
6 5 4 3 2 1 0 2012
2002
2003
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2001
2005
100
Confirmed cases (per 1000)
2000
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
Cases due to P. vivax (%)
2000
With access to an ITN (model) With access to an ITN (survey)
Cases per 1000
Follow-up No. of studies Species
100
Source: DHS 2005
60
35 30 25 20 15 10 5 0
–
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
Others
80
0
– – – – –
Therapeutic efficacy tests (clinical and parasitological failure, %)
ABER (%)
Population (%)
Surveillance
Expenditure by intervention in 2012
100
Positivity rate (%)
Yes/ Year No adopted
Sources of financing
2002
Government
Policies/strategies
2008
Cases (P. vivax)
2009
2010
2011
2012
1 200 1 000 800 600 400 200 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
25 25 15 10 5 0
Deaths
Contribution (US$m)
III. Financing
No No No No
Intervention
Admissions (P. vivax) Deaths (P. vivax)
Impact: Insufficiently consistent data to assess trends
WORLD MALARIA REPORT 2013 | 121
Costa Rica
Region of the Americas Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
I. Epidemiological profile Population (UN Population Division)
2012
Number of active foci Number of people living within active foci Number of people living in malaria-free areas Total
%
1 2 500 4 800 000 4 802 500
Parasites and vectors P. falciparum (14%), P. vivax (57%) An.albimanus
Major plasmodium species: Major anopheles species: 100
Programme phase: Pre-elimination
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2009 2009
IRS
IRS is recommended DDT is used for IRS
Yes No
1957 –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
No Yes
– 1957
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
No – Yes
– – –
No Yes – Yes
– – – –
Contribution (US$m)
III. Financing 8 7 6 5 4 3 2 1 0
2000
2001
2003
2004
Global Fund
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted Foci and case investigation undertaken Case reporting from private sector is mandatory
Yes Yes Yes Yes Yes Yes Yes
Antimalaria treatment policy
2006
2007
Medicine
Year
Min
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
2012
Others
Coverage of ITNs and IRS
Max
Follow-up No. of studies Species
No data reported for 2012
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
5 4 3 2 1 0 2012
2002
Total cases
2003
2004
2005
2006
2007
2008
Imported cases
Impact: On track for >75% decrease in incidence 2000–2015
122 | WORLD MALARIA REPORT 2013
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial
80 60 40 20 0
2000
Slide positivity rate
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Among total cases
Among indigenous cases
Indigenous malaria cases by species Confirmed cases
2001
2005
100
Malaria cases by source
2000
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. vivax cases potentially treated with primaquine
100
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
Cases due to P. vivax (%)
2000
At high risk protected with ITNs Households with at least one ITN
Confirmed cases
Median
Expenditure by intervention in 2012
100
4 000 3 500 3 000 2 500 2 000 1 500 1 000 500 0
– – CQ+PQ(1d) – – – – – CQ+PQ(7d);CQ+PQ(14d) – 0.25 mg/kg (14 days), 0.5 mg/kg (7 days)
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
100
0
Year adopted
Medicine
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
– – – – – – –
Therapeutic efficacy tests (clinical and parasitological failure, %)
ABER (%)
Population (%)
2005
World Bank
IV. Coverage
Positivity rate (%)
Policies/strategies
Sources of financing
2002
Government
Intervention
2009
2010
2011
2012
4 000 3 500 3 000 2 500 2 000 1 500 1 000 500 0 2000
2001
2002
2003
2004
Indigenous cases (all species)
2005
2006
2007
2008
2009
Indigenous cases (P. vivax)
2010
2011
2012
Côte d’Ivoire
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
19 800 000 0 0 19 800 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae, funestus
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Yes/ Year No adopted
Intervention
Policies/strategies
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
– –
– –
IRS
IRS is recommended DDT is used for IRS
– –
– –
Larval control Use of larval control
–
–
Yes
2005
– –
– –
IPT
IPT used to prevent malaria during pregnancy
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Treatment
ACT is free for all ages in public sector – Artemisinin-based monotherapies withdrawn Yes Single dose of primaquine (0.25 mg base/kg) is used as gametocidal – medicine for P. falciparum Primaquine is used for radical treatment of P. vivax – G6PD test is a requirement before treatment with primaquine – Directly observed treatment with primaquine is undertaken – System for monitoring of adverse reaction to antimalarials exists –
70 60 50 40 30 20 10 0
2000
2001
2003
2004
Global Fund
2005
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
2007
2008
USAID/PMI
Medicine
Year adopted
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
AS+AQ AS+AQ AL QN –
2003 2003 2003 2003 –
– – – –
Medicine AL AS+AQ
Year
Min
Median
Max
2005–2009 2008–2009
0 0
2.6 0
7.4 0
Follow-up No. of studies Species 28 days 28 days
P. f P. f
5 2
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
2012
Others
Coverage of ITNs and IRS
No data reported for 2012
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
80
8
60
6
40
4
20
2 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
0 2012
2002
2003
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2001
2005
100
Confirmed cases (per 1000)
2000
2004
Proportion of malaria cases due to P. vivax 10
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
Cases due to P. vivax (%)
2000
With access to an ITN (model) With access to an ITN (survey)
Cases per 1000
–
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
100
70 60 50 40 30 20 10 0
– – – – –
Antimalaria treatment policy
100
0
– – – – –
Therapeutic efficacy tests (clinical and parasitological failure, %)
ABER (%)
Population (%)
2006
World Bank
IV. Coverage
Positivity rate (%)
Surveillance
Sources of financing
2002
Government
Policies/strategies
2008
Cases (P. vivax)
2009
2010
2011
2012
900 800 700 600 500 400 300 200 100 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
120 100 80 60 40 20 0
Deaths
Contribution (US$m)
III. Financing
– – –
Yes/ Year No adopted
Intervention
Admissions (P. vivax) Deaths (P. vivax)
Impact: Insufficiently consistent data to assess trends
WORLD MALARIA REPORT 2013 | 123
Democratic People’s Republic of Korea South-East Asia Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40 40–60 60–80 80–100
I. Epidemiological profile Population (UN Population Division) Number of active foci Number of people living within active foci Number of people living in malaria-free areas Total
2012
%
146 18 700 000 6 070 000 24 770 000
75 25
Parasites and vectors P. falciparum (0%), P. vivax (100%) An.sinensis
Major plasmodium species: Major anopheles species:
Programme phase: Pre-elimination
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2002 2002
IRS
IRS is recommended DDT is used for IRS
Yes No
2007 –
Larval control Use of larval control
Yes
2002
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
– Yes
– 1953
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
– – No
– – –
Yes No Yes Yes
2000 – 2000 2002
Contribution (US$m)
III. Financing 12 10 8 6 4 2 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted Foci and case investigation undertaken Case reporting from private sector is mandatory
Yes No No No No No Yes
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
2003
2004
Global Fund
2005
2006
World Bank
2007
1999 – – – – – 1999
Year adopted
Medicine
– – – N2006 – 2006 – 2006 CQ+PQ(14d) 2006 0.25 mg/kg (14 days)
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine
Year
Min
Sources of financing
2002
Government
Intervention
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, WHO
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20 2000
2001
2002
2003
2004
2005
2006
40
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
1.4 1.2 1.0 0.8 0.6 0.4 0.2 0 2012
2005
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
100 80 60 40 20 0
2000
Slide positivity rate
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Among total cases
Among indigenous cases
Malaria cases by source
Indigenous malaria cases by species 160 000 140 000 120 000 100 000 80 000 60 000 40 000 20 000 0 2000
Confirmed cases
Confirmed cases
160 000 140 000 120 000 100 000 80 000 60 000 40 000 20 000 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
2000
2001
2002
Total cases
2003
2004
2005
2006
2007
2008
Imported cases
Impact: On track for >75% decrease in incidence 2000–2015
124 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
2001
2002
2003
2004
Indigenous cases (all species)
2005
2006
2007
2008
2009
Indigenous cases (P. vivax)
2010
2011
2012
Democratic Republic of the Congo
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
63 700 000 1 970 000 0 65 670 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae, funestus, nili, moucheti
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2006 2008
IRS
IRS is recommended DDT is used for IRS
Yes No
2007 –
Larval control Use of larval control
Yes
1998
IPT
IPT used to prevent malaria during pregnancy
Yes
2004
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2007 2007
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2006 – –
Contribution (US$m)
III. Financing 300 250 200 150 100 50 0
2000
2001
– – – 2010
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– Yes No No No
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – – – –
Antimalaria treatment policy
Medicine
Year adopted
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
AS+AQ AS+AQ QN QN –
2005 2005 2005 2005 –
P.f + all species (Combo)
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine AS+AQ
Year
Min
Median
Max
2005–2009
0
3.7
6.9
Sources of financing
2002
Government
No No No Yes
Intervention
Follow-up No. of studies Species 28 days
P. f
7
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, PMI/ USAID, Other Bilaterals, World Bank, UNICEF,WHO, Other
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
14 12 10 8 6 4 2 0 2012
Cases per 1000
Admissions
Cases (all species)
2006
2007
2011
2012
0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Malaria admissions and deaths (100 000)
20 2005
2010
Slide positivity rate
40
2004
2009
20
1 200
2003
2008
40
60
2002
2007
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
60
1 600
2001
2006
80
Confirmed cases (per 1000)
2000
2005
100
80
0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
2009
2010
2011
2012
800 400 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
45 40 35 30 25 20 15 10 5
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: DHS 2007
ABER (%)
Population (%)
100
Admissions (P. vivax) Deaths (P. vivax)
Impact: Insufficiently consistent data to assess trends
WORLD MALARIA REPORT 2013 | 125
Djibouti
Eastern Mediterranean Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
0 430 000 430 000 860 000
0 50 50
Major plasmodium species: Major anopheles species:
P. falciparum (100%), P. vivax (0%) An. gambiae, arabiensis
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes No
2008 –
IRS
IRS is recommended DDT is used for IRS
Yes No
2006 –
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2007 2007
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2007 – –
Contribution (US$m)
III. Financing 1.4 1.2 1.0 0.8 0.6 0.4 0.2 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
No No No No No
Antimalaria treatment policy
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
Medicine
Year adopted
AL AL AL QN –
2013 2013 2008 – –
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
P.f only
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine
Year
Min
Sources of financing
2002
Government
No No No No
Intervention
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Global Fund, World Bank, UNICEF, WHO
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
80
0.8
60
0.6
40
0.4
20
0.2 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
0 2012
2001
2002
2003
Cases per 1000
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2000
2005
100
Confirmed cases 6 000 5 000 4 000 3 000 2 000 1 000 0
2004
Proportion of malaria cases due to P. vivax 1.0
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
Impact: Insufficiently consistent data to assess trends
126 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
1 400 1 200 1 000 800 600 400 200 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
35 30 25 20 15 10 5 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: MIS 2009
ABER (%)
Population (%)
100
Dominican Republic
Region of the Americas Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
442 000 8 350 000 1 480 000 10 272 000
4 81 14
Major plasmodium species: Major anopheles species:
P. falciparum (100%), P. vivax (0%) An. albimanus
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2008 2008
IRS
IRS is recommended DDT is used for IRS
Yes No
1946 –
Larval control Use of larval control
Yes
1964
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
1964 1964
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
No – Yes
– – 1964
Contribution (US$m)
III. Financing 8 7 6 5 4 3 2 1 0
2000
2001
1964 – – –
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes Yes Yes No No
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– 1964 1964 – –
Year adopted
Medicine
– – CQ+PQ(3d) – AS+D – CQ; QN – CQ+PQ – 0.25 mg/kg (14 days)
P.f only
Type of RDT used
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine
Year
Min
Sources of financing
2002
Government
Yes No Yes No
Intervention
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, Other Bilaterals, Other
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20
40
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
3 2 1 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
7 6 5 4 3 2 1 0 2012
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
Total cases
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2000
2005
100
Confirmed cases 3 500 3 000 2 500 2 000 1 500 1 000 500 0
2004
Proportion of malaria cases due to P. vivax
4
2001
2003
Suspected cases tested P. vivax cases potentially treated with primaquine
5
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
2008
Cases (P. vivax)
2009
2010
2011
2012
1 0.8 0.6 0.4 0.2 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
18 16 14 12 10 8 6 4 2 0
Deaths
2000
At high risk protected with ITNs Households with at least one ITN
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
Admissions (P. vivax) Deaths (P. vivax)
Impact: 75% decrease in incidence 2000–2015
128 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
2001
2002
2003
2004
Indigenous cases (all species)
2005
2006
2007
2008
2009
Indigenous cases (P. vivax)
2010
2011
2012
El Salvador
Region of the Americas Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
I. Epidemiological profile Population (UN Population Division)
2012
Number of active foci Number of people living within active foci Number of people living in malaria-free areas Total
%
10 7 960 6 290 000 6 297 960
Parasites and vectors P. falciparum (14%), P. vivax (57%) An.albimanus, pseudopunctipennis
Major plasmodium species: Major anopheles species: 100
Programme phase: Pre-elimination
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
No No
– –
IRS
IRS is recommended DDT is used for IRS
Yes No
– –
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2010 –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
No – Yes
– – –
Yes No Yes No
– – – –
Contribution (US$m)
III. Financing 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted Foci and case investigation undertaken Case reporting from private sector is mandatory
Yes No No Yes No Yes No
Antimalaria treatment policy
Medicine
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
– CQ+PQ – – CQ+PQ
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – – – – – –
Year adopted – – – – – 0.25 mg/kg (14 days)
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine
Year
Min
Sources of financing
2002
Government
Intervention
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20 2000
2001
2002
2003
2004
2005
2006
40
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
25 20 15 10 5 0 2012
2001
2002
Total cases
2003
2004
2005
2006
2007
2008
Imported cases
Confirmed cases
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial
80 60 40 20 0
2000
Slide positivity rate
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Among total cases
Among indigenous cases
Indigenous malaria cases by species Confirmed cases
2000
2005
100
Malaria cases by source 800 700 600 500 400 300 200 100 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. vivax cases potentially treated with primaquine
100
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
2009
2010
2011
2012
800 700 600 500 400 300 200 100 0 2000
2001
2002
2003
2004
Indigenous cases (all species)
2005
2006
2007
2008
2009
2010
2011
2012
Indigenous cases (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 129
Equatorial Guinea
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
736 000 0 0 736 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae, melas
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes No
– –
IRS
IRS is recommended DDT is used for IRS
Yes No
– –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
–
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
– –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes No No
2010 2010 –
Contribution (US$m)
III. Financing 20 16 12 8 4 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– No Yes Yes No
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
Antimalaria treatment policy
Medicine
Year adopted
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
AS+AQ AS+AQ QN QN –
2004 2004 2004 2004 – P.f only
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine AS+AQ
Year
Min
Median
Max
2006–2011
0
2.8
4.9
Sources of financing
2002
Government
No No No No
Intervention
Follow-up No. of studies Species 28 days
P. f
4
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Other
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20
40
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
9 8 7 6 5 4 3 2 1 0 2012
2001
2002
2003
Cases per 1000
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2000
2005
100
Confirmed cases (per 1000) 90 80 70 60 50 40 30 20 10 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
2008
Cases (P. vivax)
Impact: Insufficiently consistent data to assess trends
130 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
2 500 2 000 1 500 1 000 500 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
12 10 8 6 4 2 0
Deaths
2000
With access to an ITN (model) With access to an ITN (survey)
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
Eritrea
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
4 350 000 1 780 000 0 6 130 000
71 29 0
Major plasmodium species: Major anopheles species:
P. falciparum (54%), P. vivax (46%) An. gambiae
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2002 2000
IRS
IRS is recommended DDT is used for IRS
Yes Yes
1995 –
Larval control Use of larval control
Yes
1995
IPT
IPT used to prevent malaria during pregnancy
No
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
1997 1997
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2007 – –
Yes No No Yes
– – – –
Contribution (US$m)
III. Financing 25 20 15 10 5 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes No No No No
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – – – –
Year adopted
Medicine AS+AQ AS+AQ QN QN AS+AQ+PQ
2007 2007 2007 2007 2007 0.50 mg/kg (14 days) P.f + P.v, P.o, P.m (Combo)
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine AS+AQ
Year
Min
Median
Max
2006–2010
0
4.55
7.9
Sources of financing
2002
Government
Intervention
Follow-up No. of studies Species 28 days
P. f
8
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Global Fund
Coverage of ITNs and IRS
80
80 Cases (%)
100
60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
80
2.0
60
1.5
40
1.0
20
0.5 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
0 2012
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
Cases per 1000
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2000
2005
100
Confirmed cases (per 1000) 7 6 5 4 3 2 1 0
2004
Proportion of malaria cases due to P. vivax 2.5
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
2009
2010
2011
2012
300 250 200 150 100 50 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
3.5 3.0 2.5 2.0 1.5 1.0 0.5 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
Cases tested and potentially treated (public sector)
100
ABER (%)
Population (%)
IV. Coverage
Admissions (P. vivax) Deaths (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 131
Ethiopia
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
917 000 60 500 000 30 300 000 91 717 000
1 66 33
Major plasmodium species: Major anopheles species:
P. falciparum (56%), P. vivax (44%) An. arabiensis, pharoensis, funestus, nili
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2004 2004
IRS
IRS is recommended DDT is used for IRS
Yes No
1960 –
Larval control Use of larval control
Yes
1960
IPT
IPT used to prevent malaria during pregnancy
No
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
1960 1960
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2004 – –
Contribution (US$m)
III. Financing 180 160 140 120 100 80 60 40 20 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
No No No No No
Antimalaria treatment policy
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
Medicine
Year adopted
AL AL QN QN CQ
– – – – –
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
–
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine QN AL
Year
Min
Median
Max
2006–2006 2006–2009
10 0
10 0.6
10 3.2
Sources of financing
2002
Government
No No No No
Intervention
Follow-up No. of studies Species 28 days 28 days
P. f P. f
1 7
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Global Fund
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
7 6 5 4 3 2 1 0 2012
2001
2002
2003
Cases per 1000
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2000
2005
100
Confirmed cases (per 1000) 20 16 12 8 4 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
Impact: 50%–75% decrease in incidence projected 2000–2015
132 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
120 100 80 60 40 20 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
5 4 3 2 1 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: DHS 2005
ABER (%)
Population (%)
100
French Guiana, France
Region of the Americas Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
208 000 35 200 0 243 200
86 14 0
Major plasmodium species: Major anopheles species:
P. falciparum (36%), P. vivax (64%) An. darlingi
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
No No
– –
IRS
IRS is recommended DDT is used for IRS
Yes No
– –
–
–
Larval control Use of larval control IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
– –
Treatment
ACT is free for all ages in public sector Yes Artemisinin-based monotherapies withdrawn – Single dose of primaquine (0.25 mg base/kg) is used as gametocidal No medicine for P. falciparum Primaquine is used for radical treatment of P. vivax – G6PD test is a requirement before treatment with primaquine – Directly observed treatment with primaquine is undertaken – System for monitoring of adverse reaction to antimalarials exists –
– – –
0 0 0 0 0 0 0 0 0 0
2000
2001
2003
2004
Global Fund
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
2006
2007
2008
USAID/PMI
Medicine
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
– AL; AT+PG AS; QN+D CQ+PQ
–
–
Medicine
Year
Min
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Coverage of ITNs and IRS
No data reported for 2012
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2000
2001
2002
80 60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
35 30 25 20 15 10 5 0 2012
2002
2003
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2001
2005
100
Confirmed cases (per 1000)
2000
2004
Proportion of malaria cases due to P. vivax
100
2001
2003
Suspected cases tested P. vivax cases potentially treated with primaquine
Malaria test positivity rate and ABER
V. Impact
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
Cases due to P. vivax (%)
2000
At high risk protected with ITNs Households with at least one ITN
Total cases per 1000
– – – – –
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
100
25 20 15 10 5 0
– – – – –
Year adopted
Antimalaria treatment policy
100
0
– – – – –
Type of RDT used
ABER (%)
Population (%)
2005
World Bank
IV. Coverage
Positivity rate (%)
Surveillance
Sources of financing
2002
Government
Policies/strategies
2008
Cases (P. vivax)
2009
2010
2011
2012
120 100 80 60 40 20 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
6 5 4 3 2 1 0
Deaths
Contribution (US$m)
III. Financing
Yes/ Year No adopted
Intervention
Admissions (P. vivax) Deaths (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 133
Gabon
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
1 630 000 0 0 1 630 000
100 0 0
Parasites and vectors P. falciparum (75%), P. vivax (25%) An. funestus, gambiae
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2003 2007
IRS
IRS is recommended DDT is used for IRS
No No
– –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
Yes
2003
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes No
2009 –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2003 2003 –
2000
2001
Government
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– No No No No
2002
2003
2004
Global Fund
2005
2006
World Bank
2007
Medicine
Year adopted
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
AS+AQ AS+AQ AL QN –
2003 2003 2003 2003 –
– – – –
Medicine
Year
Min
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
2012
Others
Coverage of ITNs and IRS
Max
Follow-up No. of studies Species
No data reported for 2012
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2000
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
12 10 8 6 4 2 0 2012
2002
2003
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2001
2005
100
Confirmed cases (per 1000)
2000
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
Cases per 1000
Median
Expenditure by intervention in 2012
100
60 50 40 30 20 10 0
–
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
100
0
– – – – –
Antimalaria treatment policy
Cases due to P. vivax (%)
Population (%)
Surveillance
Sources of financing
IV. Coverage
Positivity rate (%)
Yes/ Year No adopted
2008
Cases (P. vivax)
Impact: Insufficiently consistent data to assess trends
134 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
4 500 4 000 3 500 3 000 2 500 2 000 1 500 1 000 500 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
180 160 140 120 100 80 60 40 20 0
Deaths
7 6 5 4 3 2 1 0
Policies/strategies
Therapeutic efficacy tests (clinical and parasitological failure, %)
ABER (%)
Contribution (US$m)
III. Financing
No No No No
Intervention
Gambia
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
1 790 000 0 0 1 790 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae, arabiensis, melas, pharoensis, funestus, nili
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2000 1998
IRS
IRS is recommended DDT is used for IRS
Yes Yes
2008 2007
Larval control Use of larval control
–
–
IPT
IPT used to prevent malaria during pregnancy
Yes
2002
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2009 1998
Treatment
ACT is free for all ages in public sector Yes Artemisinin-based monotherapies withdrawn No Single dose of primaquine (0.25 mg base/kg) is used as gametocidal – medicine for P. falciparum Primaquine is used for radical treatment of P. vivax – G6PD test is a requirement before treatment with primaquine – Directly observed treatment with primaquine is undertaken – System for monitoring of adverse reaction to antimalarials exists –
2008 – –
Contribution (US$m)
III. Financing 12 10 8 6 4 2 0
2000
2001
Policies/strategies
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Antimalaria treatment policy
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – – – –
– – – – –
Medicine
Year adopted
AL AL QN QN –
2005 2005 2005 2005 –
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
P.f only
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine AL
Year
Min
Median
Max
2007–2010
0
2.45
11.9
Sources of financing
2002
Government
Yes/ Year No adopted
Intervention
Follow-up No. of studies Species 28 days
P. f
4
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, WHO, Other
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20
40
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
60 50 40 30 20 10 0 2012
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
Cases per 1000
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2000
2005
100
Confirmed cases (per 1000) 180 160 140 120 100 80 60 40 20 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
2008
Cases (P. vivax)
2009
2010
2011
2012
1 600 1 400 1 200 1 000 800 600 400 200 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
35 30 25 20 15 10 5 0
Deaths
2000
With access to an ITN (model) With access to an ITN (survey)
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
Admissions (P. vivax) Deaths (P. vivax)
Impact: Insufficiently consistent data to assess trends
WORLD MALARIA REPORT 2013 | 135
Ghana
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
25 400 000 0 0 25 400 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae, funestus, arabiensis
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2004 2010
IRS
IRS is recommended DDT is used for IRS
Yes No
2005 –
Larval control Use of larval control
Yes
1999
IPT
IPT used to prevent malaria during pregnancy
Yes
2003
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes No
2008 –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
No Yes No
– 2010 –
Contribution (US$m)
III. Financing 140 120 100 80 60 40 20 0
2000
2001
– – – 2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
no No No No No
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
Medicine
Year adopted
AS+AQ AL; AS+AQ QN QN –
2004 2004 2004 2004 –
Antimalaria treatment policy
P.f only
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine AS+AQ AL
Year
Min
Median
Max
2003–2006 2003–2007
0 1.7
4.3 4
14 13.8
Sources of financing
2002
Government
No No No Yes
Intervention
Follow-up No. of studies Species 28 days 28 days
4 5
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, PMI/ USAID, Other Bilaterals, UNICEF, WHO, Other
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
80
20
60
15
40
10
20
5 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
0 2012
2001
2002
2003
Cases per 1000
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2000
2005
100
Confirmed cases (per 1000) 160 140 120 100 80 60 40 20 0
2004
Proportion of malaria cases due to P. vivax 25
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
Impact: Insufficiently consistent data to assess trends
136 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
2 000 1 750 1 500 1 250 1 000 750 500 250 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
35 30 25 20 15 10 5 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: DHS 2003, DHS 2008
ABER (%)
Population (%)
100
Guatemala
Region of the Americas Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
2 260 000 4 600 000 8 220 000 14 080 000
86 14 0
Major plasmodium species: Major anopheles species:
P. falciparum (36%), P. vivax (64%) An. darlingi
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2006 2006
IRS
IRS is recommended DDT is used for IRS
Yes No
– –
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
– –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes – Yes
– – –
Contribution (US$m)
III. Financing 16 14 12 10 8 6 4 2 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes No No No No
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – – – –
Year adopted
Medicine
– – CQ+PQ(3d) – – – CQ – CQ+PQ(14d) – 0.25 mg/kg (14 days)
–
Type of RDT used
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine
Year
Min
Sources of financing
2002
Government
Yes No Yes No
Intervention
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Global Fund, PMI/ USAID, WHO
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20
40
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2000
2001
2002
80 60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
6 5 4 3 2 1 0 2012
2002
2003
Cases (all species)
2004
2005
2006
2007
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Malaria admissions and deaths
Admissions 2001
2006
Slide positivity rate
Total cases per 1000
2000
2005
100
Confirmed cases (per 1000) 60 000 50 000 40 000 30 000 20 000 10 000 0
2004
Proportion of malaria cases due to P. vivax
100
2001
2003
Suspected cases tested P. vivax cases potentially treated with primaquine
Malaria test positivity rate and ABER
V. Impact
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
2008
Cases (P. vivax)
2009
2010
2011
2012
1.0 0.8 0.6 0.4 0.0 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
5 4 3 2 1 0
Deaths
2000
At high risk protected with ITNs With access to an ITN in household
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
Admissions (P. vivax) Deaths (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 137
Guinea
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
11 500 000 0 0 11 500 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae, funestus, melas, arabiensis
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2009 2009
IRS
IRS is recommended DDT is used for IRS
Yes No
2013 –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
–
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2012 2012
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2010 – –
Contribution (US$m)
III. Financing 25 20 15 10 5 0
2000
2001
– – – 2009
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– No No Yes No
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – 2009 –
Antimalaria treatment policy
Medicine
Year adopted
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
AS+AQ AS+AQ QN QN –
– – – – –
P.f + all species (Combo)
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine AS+AQ
Year
Min
Median
Max
2004–2004
1
1
1
Sources of financing
2002
Government
No No No Yes
Intervention
Follow-up No. of studies Species 28 days
1
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, PMI/ USAID, Other Bilaterals, UNICEF, WHO, Other
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
1.8 1.6 1.4 1.2 1.0 0.8 0.6 0.4 0.2 0 2012
2001
2002
2003
Cases per 1000
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2000
2005
100
Confirmed cases (per 1000) 30 25 20 15 10 5 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
Impact: Insufficiently consistent data to assess trends
138 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
800 700 600 500 400 300 200 100 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
9 8 7 6 5 4 3 2 1 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: DHS 2005
ABER (%)
Population (%)
100
Guinea-Bissau
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
1 660 000 0 0 1 660 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae, funestus
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes No
2005 –
IRS
IRS is recommended DDT is used for IRS
No No
– –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
–
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2008 2008
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
No Yes No
– – –
Contribution (US$m)
III. Financing 120 100 80 60 40 20 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– No No – –
Antimalaria treatment policy
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – – – –
Medicine
Year adopted
AL AL QN QN –
– – – – –
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
–
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine AL
Year
Min
Median
Max
2006–2008
3.6
3.6
3.6
Sources of financing
2002
Government
No No No Yes
Intervention
Follow-up No. of studies Species 28 days
P. f
1
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, UNICEF, WHO
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20
40
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
14 12 10 8 6 4 2 0 2012
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
Cases per 1000
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2000
2005
100
Confirmed cases (per 1000) 50 40 30 20 10 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
2008
Cases (P. vivax)
2009
2010
2011
2012
1 600 1 400 1 200 1 000 800 600 400 200 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
90 80 70 60 50 40 30 20 10 0
Deaths
2000
With access to an ITN (model) With access to an ITN (survey)
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
Admissions (P. vivax) Deaths (P. vivax)
Impact: Insufficiently consistent data to assess trends
WORLD MALARIA REPORT 2013 | 139
Guyana
Region of the Americas Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
278 000 461 000 55 700 794 700
35 58 7
Major plasmodium species: Major anopheles species:
P. falciparum (64%), P. vivax (36%) An. darlingi, aquasalis
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2005 2005
IRS
IRS is recommended DDT is used for IRS
Yes No
– –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
1946 1946
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes Yes
2005 2004 –
Contribution (US$m)
III. Financing 3.0 2.5 2.0 1.5 1.0 0.5 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
No No Yes No No
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
Year adopted
Medicine
– – AL+PQ(1d) 2004 QN+T 2004 – – CQ+PQ(14d) 2004 0.25 mg/kg (14 days)
–
Type of RDT used
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine
Year
Min
Sources of financing
2002
Government
Yes No No No
Intervention
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, PMI/ USAID, WHO
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2000
2001
2002
80 60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
35 30 25 20 15 10 5 0 2012
2001
2002
2003
2004
2005
Total cases per 1000
Cases (all species)
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2000
2005
100
Confirmed cases (per 1000) 60 50 40 30 20 10 0
2004
Proportion of malaria cases due to P. vivax
100
2001
2003
Suspected cases tested P. vivax cases potentially treated with primaquine
Malaria test positivity rate and ABER
V. Impact
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
2008
Cases (P. vivax)
Impact: Increase in incidence 2000–2012
140 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
1 200 1 000 800 600 400 200 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
25 20 15 10 5 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: DHS 2009
ABER (%)
Population (%)
100
Haiti
Region of the Americas Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
5 390 000 4 780 000 0 10 170 000
53 47 0
Major plasmodium species: Major anopheles species:
P. falciparum (100%), P. vivax (0%) An. albimanus
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2012 2012
IRS
IRS is recommended DDT is used for IRS
No No
– –
Larval control Use of larval control
Yes
2011
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
1988 2011
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes – Yes
– – –
9 8 7 6 5 4 3 2 1 0
2000
2001
2003
2004
Global Fund
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes No No Yes No
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
2006
2007
2008
USAID/PMI
– – – –
Medicine
P. f. only Year
Min
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
2012
Others
Coverage of ITNs and IRS
No data reported for 2012
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2000
2001
2002
80 60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
45 40 35 30 25 20 15 10 5 0 2012
2002
2003
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2001
2005
100
Confirmed cases (per 1000)
2000
2004
Proportion of malaria cases due to P. vivax
100
2001
2003
Suspected cases tested P. vivax cases potentially treated with primaquine
Malaria test positivity rate and ABER
V. Impact
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
Cases due to P. vivax (%)
2000
At high risk protected with ITNs Households with at least one ITN
Total cases per 1000
Median
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
100
9 8 7 6 5 4 3 2 1 0
– – CQ+PQ(1d) – – – – – CQ+PQ(14d) – 0.25 mg/kg (14 days)
Therapeutic efficacy tests (clinical and parasitological failure, %)
100
0
– – – – –
Year adopted
Medicine
Type of RDT used
ABER (%)
Population (%)
2005
World Bank
IV. Coverage
Positivity rate (%)
Yes/ Year No adopted
Sources of financing
2002
Government
Policies/strategies
2008
Cases (P. vivax)
2009
2010
2011
2012
1 200 1 000 800 600 400 200 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
35 30 25 20 15 10 5 0
Deaths
Contribution (US$m)
III. Financing
Yes No Yes No
Intervention
Admissions (P. vivax) Deaths (P. vivax)
Impact: Insufficiently consistent data to assess trends
WORLD MALARIA REPORT 2013 | 141
Honduras
Region of the Americas Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
1 110 000 4 670 000 2 160 000 7 940 000
14 59 27
Major plasmodium species: Major anopheles species:
P. falciparum (9%), P. vivax (91%) An. albimanus
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2009 2009
IRS
IRS is recommended DDT is used for IRS
Yes No
– –
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
– –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes – Yes
– – –
Contribution (US$m)
III. Financing 3.5 3.0 2.5 2.0 1.5 1.0 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes No Yes No No
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
Year adopted
Medicine
– – CQ+PQ(1d) – SP – QN 2011 CQ+PQ(14d) – 0.25 mg/kg (14 days)
P.f + P.v specific (Combo)
Type of RDT used
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine CQ
Year
Min
Median
Max
2008–2009
0
0
0
Sources of financing
2002
Government
Yes No Yes No
Intervention
Follow-up No. of studies Species 28 days
P.f
1
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, PMI/ USAID, WHO
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20
40
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2000
2001
2002
80 60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
4.5 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0 2012
2002
2003
Cases (all species)
2004
2005
2006
2007
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Malaria admissions and deaths
Admissions 2001
2006
Slide positivity rate
Total cases per 1000
2000
2005
100
Confirmed cases 40 000 35 000 30 000 25 000 20 000 15 000 10 000 5 000 0
2004
Proportion of malaria cases due to P. vivax
100
2001
2003
Suspected cases tested P. vivax cases potentially treated with primaquine
Malaria test positivity rate and ABER
V. Impact
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
2008
Cases (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
142 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
1.0 0.8 0.6 0.4 0.2 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
5 4 3 2 1 0
Deaths
2000
At high risk protected with ITNs Households with at least one ITN
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
India
South-East Asia Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
272 000 000 829 000 000 136 000 000 1 237 000 000
22 67 11
Major plasmodium species: Major anopheles species:
P. falciparum (50%), P. vivax (50%) An. culicifacies, fluviatilis, stephensi, minimus, dirus, annularis
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2001 2001
IRS
IRS is recommended DDT is used for IRS
Yes Yes
1953 1953
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
1958 1953
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes Yes
2008 – –
Yes No No Yes
– – – –
Contribution (US$m)
III. Financing 160 120 100 80 60 40 20 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes Yes Yes No No
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
Medicine
Year adopted
AS+SP+PQ AS+SP+PQ QN+D; QN+T AM; AS; QN CQ+PQ(14d)
– 2004 2004 2004 2004
Antimalaria treatment policy
– P.f only
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine AS+SP
Year
Min
Median
Max
2005–2007
0
0
4
Sources of financing
2002
Government
Intervention
Follow-up No. of studies Species 28 days
9
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, World Bank
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20
40
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
3 2 1 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
12 10 8 6 4 2 0 2012
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
Cases per 1000
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2000
2005
100
Confirmed cases (per 1000) 2.5 2.0 1.5 1.0 0.5 0
2004
Proportion of malaria cases due to P. vivax
4
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
5
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
2008
Cases (P. vivax)
2009
2010
2011
2012
6 000 5 000 4 000 3 000 2 000 1 000 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
1 800 1 500 1 200 900 600 300 0
Deaths
2000
At high risk protected with ITNs Households with at least one ITN
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
Admissions (P. vivax) Deaths (P. vivax)
Impact: 50%–75% decrease in incidence projected 2000–2015
WORLD MALARIA REPORT 2013 | 143
Indonesia
South-East Asia Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
42 000 000 109 000 000 93 300 000 247 300 000
17 44 39
Major plasmodium species: Major anopheles species:
P. falciparum (55%), P. vivax (45%) An. sundaicus, balabacensis, maculatus, farauti, subpictus
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2006 –
IRS
IRS is recommended DDT is used for IRS
Yes No
1959 –
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2007 –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes Yes
2004 – –
Yes No No Yes
– – – –
Contribution (US$m)
III. Financing 50 40 30 20 10 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes Yes Yes Yes Yes
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
Year adopted
Medicine
– – AS+AQ; DHA-PP+PQ 2008 QN+D+PQ 2004 AM; AS; QN 2004 AS+AQ; DHA-PP+PQ(14d) 2008 0.25 mg/kg (14 days) P.f only, P.f + P.v specific (Combo)
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine
Year
Min
Median
Max
AS+AQ DHA-PPQ
2003–2006 2004–2008
0 2.7
8.8 4.1
24.1 4.8
Sources of financing
2002
Government
Intervention
Follow-up No. of studies Species 28 days 42 days
8 3
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, UNICEF, WHO
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity
2010
2011
1.8 1.6 1.4 1.2 1.0 0.8 0.6 0.4 0.2 0 2012
2001
2002
2003
Cases per 1000
Cases (all species)
2004
2005
2006
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2000
2005
100
Confirmed cases (per 1000) 3.0 2.5 2.0 1.5 1.0 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
2007
2008
Cases (P. vivax)
Impact: Insufficiently consistent data to assess trends
144 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
6 000 5 000 4 000 3 000 2 000 1 000 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
1 000 800 600 400 200 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: DHS 2007. Other Nat.
ABER (%)
Population (%)
100
Iran (Islamic Republic of )
Eastern Mediterranean Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
Based on 2011 reported data
Based on 2011 reported data
I. Epidemiological profile Population (UN Population Division) Number of active foci Number of people living within active foci Number of people living in malaria-free areas Total
2012
%
444 764 000 75 700 000 76 464 000
1 99
Parasites and vectors P. falciparum (10%), P. vivax (90%) An.stephensi, culicifacies, fluviatilis, Superpictus
Major plasmodium species: Major anopheles species:
Programme phase: Elimination
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2005 2005
IRS
IRS is recommended DDT is used for IRS
Yes No
– –
Larval control Use of larval control
Yes
1949
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
– 1949
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
– Yes Yes
– – 1949
Yes No Yes Yes
1949 – 1949 1949
Contribution (US$m)
III. Financing 16 14 12 10 8 6 4 2 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted Foci and case investigation undertaken Case reporting from private sector is mandatory
Yes Yes No No No Yes Yes
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
1949 1949 – – – 2010 1949
Year adopted
Medicine
– – AS+SP 2006 AL 2006 AS; QN+D – CQ+PQ(14d & 8w) 2005 0.75 mg/kg (8 weeks)
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine AS+SP
Year
Min
Median
Max
2005–2010
0
0
0.5
Sources of financing
2002
Government
Intervention
Follow-up No. of studies Species 28 days
P. f
8
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, WHO
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2000
2001
2002
2003
2004
2005
2006
V. Impact 3.0 2.5 2.0 1.5 1.0 0.5 0 2000
2007
2008
2009
2010
2011
0
2012
2000
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at leas one ITN
2001
2002
Malaria test positivity rate and ABER 40 30 20 10 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
0 2012
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Among total cases
Among indigenous cases
Malaria cases by source
Indigenous malaria cases by species
20 000
18 000 15 000 12 000 9 000 6 000 3 000 0 2000
Confirmed cases
Confirmed cases
2005
100
Slide positivity rate
25 000 15 000 10 000 5 000 0
2004
Proportion of malaria cases due to P. vivax 50
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: Other Nat.
ABER (%)
Population (%)
100
2000
2001
2002
Total cases
2003
2004
2005
2006
2007
2008
Imported cases
2009
2010
2011
2012
2001
2002
2003
2004
Indigenous cases (all species)
2005
2006
2007
2008
2009
2010
2011
2012
Indigenous cases (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 145
Kenya
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
15 500 000 17 300 000 10 400 000 43 200 000
36 40 24
Major plasmodium species: Major anopheles species:
P. falciparum (100%), P. vivax (0%) An. gambiae, arabiensis, funestus, merus
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2006 2010
IRS
IRS is recommended DDT is used for IRS
Yes No
2003 –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
Yes
2001
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes No
2009 –
Treatment
ACT is free for all ages in public sector Yes Artemisinin-based monotherapies withdrawn Yes Single dose of primaquine (0.25 mg base/kg) is used as gametocidal – medicine for P. falciparum Primaquine is used for radical treatment of P. vivax – G6PD test is a requirement before treatment with primaquine – Directly observed treatment with primaquine is undertaken – System for monitoring of adverse reaction to antimalarials exists –
2006 – –
Contribution (US$m)
III. Financing 120 100 80 60 40 20 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
No No No No –
Antimalaria treatment policy
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
Medicine
Year adopted
AL AL QN QN –
2004 2004 2004 2004 –
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
P.f only
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine AL
Year
Min
Median
Max
2002–2008
0
2.65
6.6
Sources of financing
2002
Government
Intervention
Follow-up No. of studies Species 28 days
12
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, PMI/ USAID, Other Bilaterals, World Bank
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
18 16 14 12 10 8 6 4 2 0 2012
2001
2002
2003
Cases per 1000
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2000
2005
100
Confirmed cases (per 1000) 40 35 30 25 20 15 10 5 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
Impact: Insufficiently consistent data to assess trends
146 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
600 500 400 300 200 100 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
180 160 140 120 100 80 60 40 20 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: DHS 2003, DHS 2009
ABER (%)
Population (%)
100
Kyrgyzstan
European Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
I. Epidemiological profile Population (UN Population Division)
2012
Number of active foci Number of people living within active foci Number of people living in malaria-free areas Total
%
0 22 900 5 450 000 5 472 000
Parasites and vectors P. falciparum (0%), P. vivax (0%) An.superpictus, pulcherrimus, claviger, hyrcanus, messeae
Major plasmodium species: Major anopheles species: 100
Programme phase: Control (Prevention of re-introduction as of December 2013)
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2003 2006
IRS
IRS is recommended DDT is used for IRS
Yes No
2001 –
Larval control Use of larval control
Yes
2002
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
– Yes
– 2007
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes – Yes
– – 2007
Yes No Yes Yes
2007 – 2007 2007
III. Financing
Intervention
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted Foci and case investigation undertaken Case reporting from private sector is mandatory
Yes No Yes No No Yes Yes
Antimalaria treatment policy
Medicine
Year
2002
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
Contribution (US$m)
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
0.4 2001
Median
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
0.8
2000
Min
Sources of financing
1.2
0
– – – – – – – – CQ+PQ(14d) – 0.25 mg/kg (14 days)
Therapeutic efficacy tests (clinical and parasitological failure, %)
1.6
Government
Year adopted
Medicine
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
– 2007 2010 – – 2007 2007
2009
2010
2011
WHO/UNICEF
2012
Others
Funding source(s): Government, Global Fund
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20 2000
2001
2002
2003
2004
2005
2006
40
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
3 2 1 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
4 000 3 500 3 000 2 500 2 000 1 500 1 000 500 0 2012
2001
2002
Total cases
2003
2004
2005
2006
2007
2008
Imported cases
Confirmed cases
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
Slide positivity rate
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Among total cases
Among indigenous cases
Indigenous malaria cases by species Confirmed cases
2000
2005
100
Malaria cases by source 3 000 2 500 2 000 1 500 1 000 500 0
2004
Proportion of malaria cases due to P. vivax
4
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
5
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
2009
2010
2011
2012
3 000 2 500 2 000 1 500 1 000 5 0 2000
2001
2002
2003
2004
Indigenous cases (all species)
2005
2006
2007
2008
2009
2010
2011
2012
Indigenous cases (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 147
Lao People’s Democratic Republic
Western Pacific Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
2 390 000 1 530 000 2 720 000 6 640 000
36 23 41
Major plasmodium species: Major anopheles species:
P. falciparum (87%), P. vivax (13%) An. dirus, minimus, maculatus, jeyporiensis
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2003 2000
IRS
IRS is recommended DDT is used for IRS
Yes No
2010 –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2003 2005
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2005 2008 –
No Yes No No
– 2010 – –
Contribution (US$m)
III. Financing 9 8 7 6 5 4 3 2 1 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes Yes No No No
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
2012 2012 – – –
Medicine
Year adopted
– AL QN+D AS+AL CQ+PQ(14d)
– 2001 2001 2001 2001
Antimalaria treatment policy
– P.f only, P.f + P.v specific (Combo)
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine AL
Year
Min
Median
Max
2005–2013
0
0
8.3
Sources of financing
2002
Government
Intervention
Follow-up No. of studies Species 28 days
P. f
11
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Global Fund, PMI/ USAID, Other Bilaterals, WHO, Other
Coverage of ITNs and IRS
80
80 Cases (%)
100
60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact 100 80 60 40 20 10 0 2000
2007
2008
2009
2010
2011
0
2012
2000
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
2001
2002
Malaria test positivity rate and ABER 8 6 4 2 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
0 2012
2001
2002
2003
Cases per 1000
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2000
2005
100
Confirmed cases (per 1000) 8 7 6 5 4 3 2 1 0
2004
Proportion of malaria cases due to P. vivax 10
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
2008
Cases (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
148 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
25 000 20 000 15 000 10 000 5 000 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
400 350 300 250 200 150 50 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
Cases tested and potentially treated (public sector)
100
ABER (%)
Population (%)
IV. Coverage
Liberia
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
4 190 000 0 0 4 190 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2005 2008
IRS
IRS is recommended DDT is used for IRS
Yes No
2009 –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
Yes
2005
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2005 2005
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2005 – –
Contribution (US$m)
III. Financing 35 30 25 20 15 10 5 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
No No No No No
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – – – –
Antimalaria treatment policy
Medicine
Year adopted
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
AS+AQ AS+AQ QN QN –
2004 2004 2004 2004 – P.f only
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine AS+AQ
Year
Min
Median
Max
2007–2007
0
0
0
Sources of financing
2002
Government
No No No Yes
Intervention
Follow-up No. of studies Species 28 days
P. f
2
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, PMI/ USAID, WHO
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
60 50 40 30 20 10 0 2012
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
Cases per 1000
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2000
2005
100
Confirmed cases (per 1000) 500 400 300 200 100 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
2009
2010
2011
2012
6 000 5 000 4 000 3 000 2 000 1 000 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
50 40 30 20 10 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: MIS, 2009, MIS 2011
ABER (%)
Population (%)
100
Admissions (P. vivax) Deaths (P. vivax)
Impact: Insufficiently consistent data to assess trends
WORLD MALARIA REPORT 2013 | 149
Madagascar
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
6 690 000 15 600 000 0 22 290 000
30 70 0
Major plasmodium species: Major anopheles species:
P. falciparum (100%), P. vivax (0%) An. funestus, gambiae, arabiensis
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2004 2009
IRS
IRS is recommended DDT is used for IRS
Yes No
1993 –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
–
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2006 2006
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2006 – –
Contribution (US$m)
III. Financing 80 70 60 50 40 30 20 10 0
2000
2001
– – – 2008
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– Yes No Yes Yes
2003
2004
Global Fund
2005
2006
World Bank
2007
– 1993 – 2006 –
Antimalaria treatment policy
Medicine
Year adopted
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
AS+AQ AS+AQ QN QN –
2006 2006 2006 2006 –
P.f + P.v specific (Combo)
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine AS+AQ
Year
Min
Median
Max
2006–2007
0
0
8.7
Sources of financing
2002
Government
No No No Yes
Intervention
Follow-up No. of studies Species 28 days
10
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, PMI/ USAID, UNICEF, WHO, Other
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
80
4
60
3
40
2
20
1 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
0 2012
2001
2002
2003
Cases per 1000
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2000
2005
100
Confirmed cases (per 1000) 18 16 14 12 10 8 6 4 2 0
2004
Proportion of malaria cases due to P. vivax 5
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
Impact: 75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
15 900 000 0 0 15 900 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. funestus, gambiae, arabiensis
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2006 2010
IRS
IRS is recommended DDT is used for IRS
Yes No
2007 –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
Yes
1993
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes No
2011 –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2007 2009 –
60 50 40 30 20 10 0
2000
2001
2003
2004
Global Fund
2005
2006
World Bank
IV. Coverage
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
No No No No No
2007
2008
USAID/PMI
2009
2010
2011
WHO/UNICEF
Medicine
Year adopted
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
AL AL AS+AQ QN –
2007 2007 2007 2007 –
Medicine AS+AQ AL
2012
Others
Year
Min
Median
Max
2005–2005 2005–2005
0 7.1
1.8 7.1
3.6 7.1
28 days 28 days
2 1
No data reported for 2012
Cases tested and potentially treated (public sector) 80 Cases (%)
40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
80
20
60
15
40
10
20
5 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
0 2012
2002
2003
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2001
2005
100
Confirmed cases (per 1000)
2000
2004
Proportion of malaria cases due to P. vivax 25
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
Cases due to P. vivax (%)
2000
With access to an ITN (model) With access to an ITN (survey)
Cases per 1000
Follow-up No. of studies Species
100
Source: DHS 2004, DHS 2010
60
120 100 80 60 40 20 0
P.f only
Therapeutic efficacy tests (clinical and parasitological failure, %)
Coverage of ITNs and IRS
80
0
– – – – –
Antimalaria treatment policy
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
ABER (%)
Population (%)
Surveillance
Expenditure by intervention in 2012
100
Positivity rate (%)
Yes/ Year No adopted
Sources of financing
2002
Government
– – – 2007
Policies/strategies
2008
Cases (P. vivax)
2009
2010
2011
2012
1 400 1 200 1 00 800 600 400 200 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
70 60 50 40 30 20 10 0
Deaths
Contribution (US$m)
III. Financing
No No No Yes
Intervention
Admissions (P. vivax) Deaths (P. vivax)
Impact: Insufficiently consistent data to assess trends
WORLD MALARIA REPORT 2013 | 151
Malaysia
Western Pacific Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40 40–60 60–80 80–100
I. Epidemiological profile Population (UN Population Division) Number of active foci Number of people living within active foci Number of people living in malaria-free areas Total
2012
%
3 134 1 190 000 28 100 000 29 290 000
4 96
Parasites and vectors P. falciparum (18%), P. vivax (24%) An.balabacensis, donaldi, maculatus, sundaicus, flavirostris
Major plasmodium species: Major anopheles species:
Programme phase: Pre-elimination
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
1995 1995
IRS
IRS is recommended DDT is used for IRS
– No
– –
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
– Yes
– 1967
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
– Yes No
– – –
Yes Yes Yes Yes
– – – –
Contribution (US$m)
III. Financing 50 40 30 20 10 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted Foci and case investigation undertaken Case reporting from private sector is mandatory
Yes No Yes Yes Yes Yes Yes
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – – – 1975
Year adopted
Medicine
– – AS+MQ N2006 QN+T 2006 QN+T 2006 CQ+PQ(14d) 2006 0.25 mg/kg (14 days)
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine
Year
Min
Sources of financing
2002
Government
Intervention
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government
Coverage of ITNs and IRS
80
80 Cases (%)
100
60 40 20
60 40 20
2000
2001
2002
2003
2004
2005
2006
V. Impact 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0 2000
2007
2008
2009
2010
2011
0
2012
2000
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
2001
2002
Malaria test positivity rate and ABER
2001
2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2003
2001
2002
Confirmed cases
Total cases
2003
2004
2005
2006
2007
2008
Imported cases
Impact: On track for >75% decrease in incidence 2000–2015
152 | WORLD MALARIA REPORT 2013
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
2010
2011
100 80 60 40 20 0
2000
Slide positivity rate
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Among total cases
Among indigenous cases
Indigenous malaria cases by species Confirmed cases
2000
2005
Proportion of malaria cases due to P. vivax 250 200 150 100 50 0 2012
Malaria cases by source 14 000 12 000 10 000 8 000 6 000 4 000 2 000 0
2004
Suspected cases tested P. falciparum cases potentially treated with ACT
Cases due to P. vivax (%)
0
Positivity rate (%)
Cases tested and potentially treated (public sector)
100
ABER (%)
Population (%)
IV. Coverage
2009
2010
2011
2012
14 000 12 000 10 000 8 000 6 000 4 000 2 000 0 2000
2001
2002
2003
2004
Indigenous cases (all species)
2005
2006
2007
2008
2009
Indigenous cases (P. vivax)
2010
2011
2012
Mali
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
13 400 000 1 490 000 0 14 890 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae, funestus
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes No
2005 –
IRS
IRS is recommended DDT is used for IRS
Yes No
2007 –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
Yes
2003
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2008 2008
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
No Yes No
– – –
30 25 20 15 10 5 0
2000
2001
2003
2004
Global Fund
2005
2006
World Bank
IV. Coverage
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– Yes No Yes –
– – – 2010
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2007
2008
USAID/PMI
2009
2010
2011
WHO/UNICEF
Medicine AS+AQ AL
2012
Others
2007 2007 2007 – –
Year
Min
Median
Max
2002–2006 2004–2008
0 0
2 3
7.6 6
Follow-up No. of studies Species 28 days 28 days
4 6
No data reported for 2012
Cases tested and potentially treated (public sector) 100
Source:DHS 2006, DHS 2010
80 Cases (%)
40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
12 10 8 6 4 2 0 2012
2002
2003
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2001
2005
100
Confirmed cases (per 1000)
2000
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
Cases due to P. vivax (%)
2000
With access to an ITN (model) With access to an ITN (survey)
Cases per 1000
AS+AQ AL; AS+AQ AL QN –
P.f only, P.f + all species (Combo)
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
60
70 60 50 40 30 20 10 0
Year adopted
Therapeutic efficacy tests (clinical and parasitological failure, %)
Coverage of ITNs and IRS
80
0
– 2008 – 1993 –
Medicine
Antimalaria treatment policy
ABER (%)
Population (%)
Surveillance
Expenditure by intervention in 2012
100
Positivity rate (%)
Yes/ Year No adopted
Sources of financing
2002
Government
Policies/strategies
2008
Cases (P. vivax)
2009
2010
2011
2012
4 500 4 000 3 500 3 000 2 500 2 000 1 500 1 000 500 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
25 20 15 10 5 0
Deaths
Contribution (US$m)
III. Financing
No – No Yes
Intervention
Admissions (P. vivax) Deaths (P. vivax)
Impact: Insufficiently consistent data to assess trends
WORLD MALARIA REPORT 2013 | 153
Mauritania
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
2 240 000 1 180 000 380 000 3 800 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae, arabiensis, pharoensis
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes No
1998 –
IRS
IRS is recommended DDT is used for IRS
Yes –
– –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
Yes
2008
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2011 2009
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2009 – –
12 10 8 6 4 2 0
2000
2001
2003
2004
Global Fund
2005
2006
World Bank
IV. Coverage
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– – Yes Yes Yes
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2007
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
– – – –
Medicine
Year
Min
2012
Coverage of ITNs and IRS
– – – – –
Median
Max
Follow-up No. of studies Species
No data reported for 2012
Cases tested and potentially treated (public sector) 100
Source: MIS 2007
80 Cases (%)
40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
1.2 1.0 0.8 0.6 0.4 0.2 0 2012
2002
2003
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2001
2005
100
Confirmed cases (per 1000)
2000
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
Cases due to P. vivax (%)
2000
With access to an ITN (model) With access to an ITN (survey)
Cases per 1000
AS+AQ AL; AS+AQ – QN –
P.f + P.v specific (Combo)
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
60
0.9 0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1 0
Year adopted
Therapeutic efficacy tests (clinical and parasitological failure, %)
Others
80
0
– – – – –
Medicine
Antimalaria treatment policy
ABER (%)
Population (%)
Surveillance
Expenditure by intervention in 2012
100
Positivity rate (%)
Yes/ Year No adopted
Sources of financing
2002
Government
Policies/strategies
2008
Cases (P. vivax)
Impact: Insufficiently consistent data to assess trends
154 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
700 600 500 400 300 200 100 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
7 6 5 4 3 2 1 0
Deaths
Contribution (US$m)
III. Financing
Yes Yes No Yes
Intervention
Mayotte, France
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40 40–60 60–80 80–100
I. Epidemiological profile Population (UN Population Division) Number of active foci Number of people living within active foci Number of people living in malaria-free areas Total
2012
%
1 3 480 213 000 216 480
2 98
Parasites and vectors P. falciparum (84%), P. vivax (8%) An.Funestus, An.gambiae, s.s.
Major plasmodium species: Major anopheles species:
Programme phase: Elimination
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2010 2010
IRS
IRS is recommended DDT is used for IRS
Yes No
1980 –
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
– –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
– Yes Yes Yes
– – –
Contribution (US$m)
III. Financing 0 0 0 0 0 0 0
2000
2001
2003
2004
Global Fund
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted Foci and case investigation undertaken Case reporting from private sector is mandatory
No Yes No Yes Yes Yes Yes
2006
2007
2008
USAID/PMI
Antimalaria treatment policy
Medicine
Year adopted
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
– AL QN – CQ+PQ
– – – – –
Medicine
Year
Min
2009
2010
2011
WHO/UNICEF
2012
Others
Coverage of ITNs and IRS
Follow-up No. of studies Species
No data reported for 2012
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2000
2001
2002
2003
2004
2005
2006
V. Impact
2008
2009
2010
2011
0
2012
2000
2001
2002
Malaria test positivity rate and ABER 4 3 2 1 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
0 2012
2002
Total cases
2003
2004
2005
2006
2007
2008
Imported cases
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
Slide positivity rate
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Among total cases
Among indigenous cases
Indigenous malaria cases by species Confirmed cases
2001
2005
100
Malaria cases by source
2000
2004
Proportion of malaria cases due to P. vivax 5
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
Cases due to P. vivax (%)
100 80 60 40 20 0 2000
2007
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs With access to an ITN in household
Confirmed cases
Max
Expenditure by intervention in 2012
100
900 800 700 600 500 400 300 200 100 0
Median
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
100
0
– – – – – – –
Therapeutic efficacy tests (clinical and parasitological failure, %)
ABER (%)
Population (%)
2005
World Bank
IV. Coverage
Positivity rate (%)
Policies/strategies
Sources of financing
2002
Government
– – – – –
Yes Yes Yes Yes
Intervention
2009
2010
2011
2012
250 200 150 100 50 0 2000
2001
2002
2003
2004
Indigenous cases (all species)
2005
2006
2007
2008
2009
2010
2011
2012
Indigenous cases (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 155
Mexico
Region of the Americas Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
I. Epidemiological profile Population (UN Population Division) Number of active foci Number of people living within active foci Number of people living in malaria-free areas Total
2012
%
71 4 160 000 117 000 000 121 160 000
3 97
Parasites and vectors P. falciparum (0%), P. vivax (100%) An.pseudopunctipennis, albimanus, punctimacula
Major plasmodium species: Major anopheles species:
Programme phase: Pre-elimination
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2012 2012
IRS
IRS is recommended DDT is used for IRS
No No
– –
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
– –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
No – Yes
– – –
Yes No Yes Yes
– – – –
Contribution (US$m)
III. Financing 30 25 20 15 10 5 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted Foci and case investigation undertaken Case reporting from private sector is mandatory
Yes Yes No No No Yes Yes
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – – – –
Antimalaria treatment policy
Medicine
Year adopted
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
– CQ+PQ – – CQ+PQ
– – – – –
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine
Year
Min
Sources of financing
2002
Government
Intervention
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20 2000
2001
2002
2003
2004
2005
2006
40
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
60 50 40 30 20 10 0 2012
2001
2002
Confirmed cases
Total cases
2003
2004
2005
2006
2007
2008
Imported cases
Impact: On track for >75% decrease in incidence 2000–2015
156 | WORLD MALARIA REPORT 2013
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial
80 60 40 20 0
2000
Slide positivity rate
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Among total cases
Among indigenous cases
Indigenous malaria cases by species Confirmed cases
2000
2005
100
Malaria cases by source 8 000 7 000 6 000 5 000 4 000 3 000 2 000 1 000 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. vivax cases potentially treated with primaquine
100
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
2009
2010
2011
2012
8 000 7 000 6 000 5 000 4 000 3 000 2 000 1 000 0 2000
2001
2002
2003
2004
Indigenous cases (all species)
2005
2006
2007
2008
2009
Indigenous cases (P. vivax)
2010
2011
2012
Mozambique
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
25 200 000 0 0 25 200 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. funestus, gambiae, arabiensis
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
– –
IRS
IRS is recommended DDT is used for IRS
Yes Yes
– –
Larval control Use of larval control
–
–
IPT
IPT used to prevent malaria during pregnancy
Yes
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
– –
Treatment
ACT is free for all ages in public sector Yes Artemisinin-based monotherapies withdrawn Yes Single dose of primaquine (0.25 mg base/kg) is used as gametocidal – medicine for P. falciparum Primaquine is used for radical treatment of P. vivax – G6PD test is a requirement before treatment with primaquine – Directly observed treatment with primaquine is undertaken – System for monitoring of adverse reaction to antimalarials exists –
70 60 50 40 30 20 10 0
2000
2001
2003
2004
Global Fund
2005
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Antimalaria treatment policy
– 2010 –
2007
2008
USAID/PMI
– – – –
Medicine AL
Year
Min
Median
Max
2005–2008
0
1.6
3.1
AL AL – QN –
2004 2004 – 2004 –
Follow-up No. of studies Species 28 days
4
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
2012
Others
Coverage of ITNs and IRS
No data reported for 2012
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
80
20
60
15
40
10
20
5 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
0 2012
2002
2003
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2001
2005
100
Confirmed cases (per 1000)
2000
2004
Proportion of malaria cases due to P. vivax 25
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
Cases due to P. vivax (%)
2000
With access to an ITN (model) With access to an ITN (survey)
Cases per 1000
Year adopted
P.f only
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
100
80 70 60 50 40 30 20 10 0
– – – – –
Medicine
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
100
0
– – – – –
Therapeutic efficacy tests (clinical and parasitological failure, %)
ABER (%)
Population (%)
2006
World Bank
IV. Coverage
Positivity rate (%)
Surveillance
Sources of financing
2002
Government
Policies/strategies
2008
Cases (P. vivax)
2009
2010
2011
2012
700 600 500 400 300 200 100 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
30 25 20 15 10 5 0
Deaths
Contribution (US$m)
III. Financing
Yes/ Year No adopted
Intervention
Admissions (P. vivax) Deaths (P. vivax)
Impact: Insufficiently consistent data to assess trends
WORLD MALARIA REPORT 2013 | 157
Myanmar
South-East Asia Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
19 500 000 12 100 000 21 100 000 52 700 000
37 23 40
Major plasmodium species: Major anopheles species:
P. falciparum (65%), P. vivax (35%) An. minimus, dirus
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2003 2003
IRS
IRS is recommended DDT is used for IRS
Yes Yes
– –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
– –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes No Yes
– – 2010
Yes No No Yes
– – – –
Contribution (US$m)
III. Financing 25 20 15 10 5 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
No No No No No
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
Year adopted
Medicine
– – AL; AM; AS+MQ; DHA-PPQ; PQ 2008 AS+D; AS+T 2008 AM; AS; QN 2008 CQ+PQ(14d) 2008 0.25 mg/kg (14 days) P.f + P.v specific (Combo)
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine
Year
Min
Median
Max
DHA-PPQ AL
2005–2011 2007–2011
0 0
0.7 0
5 5.9
Sources of financing
2002
Government
Intervention
Follow-up No. of studies Species 28 days 28 days
P. f P. f
14 13
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Global Fund, PMI/ USAID, Other Bilaterals, UNICEF, WHO, Other
Coverage of ITNs and IRS
80
80 Cases (%)
100
60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
80
4
60
3
40
2
20
1 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
0 2012
2006
2007
2008
2009
2010
2011
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
100 000 80 000 60 000 40 000 20 000 0 2000
Admissions
6 4 2 2001
2002
2003
Cases (all species)
2004
2005
2006
2007
2012
Malaria admissions and deaths
8
2000
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
100
Confirmed cases (per 1000) Cases per 1000
2005
Slide positivity rate
10
0
2004
Proportion of malaria cases due to P. vivax 5
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
2008
Cases (P. vivax)
Impact: Insufficiently consistent data to assess trends
158 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
3 000 2 500 2 000 1 500 1 000 500 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
Cases tested and potentially treated (public sector)
100
ABER (%)
Population (%)
IV. Coverage
Namibia
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
1 510 000 113 000 633 000 2 256 000
67 5 28
Major plasmodium species: Major anopheles species:
P. falciparum (100%), P. vivax (0%) An. arabiensis, gambiae, funestus
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes No
1998 –
IRS
IRS is recommended DDT is used for IRS
Yes Yes
1965 1965
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
Yes
2007
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2010 1990
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2005 – –
Contribution (US$m)
III. Financing 7 6 5 4 3 2 1 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes No Yes No No
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
2012 – – – –
Medicine
Year adopted
AL AL QN QN AL
2006 2006 2006 2006 2006
P.f only, P.f + all species (Combo)
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine
Year
Min
Sources of financing
2002
Government
Yes No No Yes
Intervention
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
4.5 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0 2012
2002
2003
Cases (all species)
2004
2005
2006
2007
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Malaria admissions and deaths
Admissions 2001
2006
Slide positivity rate
Cases per 1000
2000
2005
100
Confirmed cases 45 000 40 000 35 000 30 000 25 000 20 000 15 000 10 000 5 000 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
2009
2010
2011
2012
45 000 40 000 35 000 30 000 25 000 20 000 15 000 10 000 5 000 0 2000
2 000 1 500 1 000
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: DHS 2007
ABER (%)
Population (%)
100
500 2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
0
Admissions (P. vivax) Deaths (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 159
Nepal
South-East Asia Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
1 020 000 22 000 000 4 510 000 27 530 000
4 80 16
Major plasmodium species: Major anopheles species:
P. falciparum (30%), P. vivax (70%) An. fluviatilis, annularis, maculatus
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2007 2007
IRS
IRS is recommended DDT is used for IRS
Yes No
1962 –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
1962 1962
Treatment
ACT is free for all ages in public sector Yes Artemisinin-based monotherapies withdrawn Yes Single dose of primaquine (0.25 mg base/kg) is used as gametocidal – medicine for P. falciparum Primaquine is used for radical treatment of P. vivax – G6PD test is a requirement before treatment with primaquine – Directly observed treatment with primaquine is undertaken – System for monitoring of adverse reaction to antimalarials exists –
2007 – –
Contribution (US$m)
III. Financing 7 6 5 4 3 2 1 0
2000
2001
Policies/strategies
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
– – – – –
Medicine
Year adopted
AL+PQ AL+PQ – QN CQ+PQ(14d)
– 2004 – 2004 2004
Antimalaria treatment policy
– P.f + P.v specific (Combo)
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine AL
Year
Min
Median
Max
2005–2010
0
0
0
Sources of financing
2002
Government
Yes/ Year No adopted
Intervention
Follow-up No. of studies Species 28 days
P. f
5
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Global Fund, WHO
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20
40
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
1.2 1.0 0.8 0.6 0.4 0.2 0 2012
2002
2003
Cases (all species)
2004
2005
2006
2007
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Malaria admissions and deaths
Admissions 2001
2006
Slide positivity rate
Cases per 1000
2000
2005
100
Confirmed cases (per 1000) 14 000 12 000 10 000 8 000 6 000 4 000 2 000 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
2008
Cases (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
160 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
3 000 2 500 2 000 1 500 1 000 500 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
45 40 35 30 25 20 15 10 5 0
Deaths
2000
At high risk protected with ITNs Households with at least one ITN
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
Nicaragua
Region of the Americas Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
77 900 2 930 000 2 980 000 5 987 900
1 49 50
Major plasmodium species: Major anopheles species:
P. falciparum (20%), P. vivax (80%) An. albimanus, pseudopunctipennis
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2004 2004
IRS
IRS is recommended DDT is used for IRS
Yes No
1959 –
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
– –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
No – Yes
– – –
Contribution (US$m)
III. Financing 3.0 2.5 2.0 1.5 1.0 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes Yes No No No
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – – – –
Year adopted
Medicine
– – CQ+PQ – AS+MQ; AS+SP – QN+CL – CQ+PQ(7d) – 0.5 mg/kg (7 days)
P.f + P.v specific (Combo)
Type of RDT used
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine CQ
Year
Min
Median
Max
2005–2006
0
0
0
Sources of financing
2002
Government
Yes No Yes Yes
Intervention
Follow-up No. of studies Species 28 days
P. f
1
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Global Fund, PMI/ USAID
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20
40
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2000
2001
2002
80 60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
21 20 19 18 17 16 15 2012
2002
2003
Cases (all species)
2004
2005
2006
2007
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Malaria admissions and deaths
Admissions 2001
2006
Slide positivity rate
Total cases per 1000
2000
2005
100
Confirmed cases 30 000 25 000 20 000 15 000 10 000 5 000 0
2004
Proportion of malaria cases due to P. vivax
100
2001
2003
Suspected cases tested P. vivax cases potentially treated with primaquine
Malaria test positivity rate and ABER
V. Impact
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
2008
Cases (P. vivax)
2009
2010
2011
2012
250 200 150 100 50 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
9 8 7 6 5 4 3 2 1 0
Deaths
2000
At high risk protected with ITNs Households with at least one ITN
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
Admissions (P. vivax) Deaths (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 161
Niger
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
11 800 000 5 320 000 380 000 17 120 000
69 31 0
Major plasmodium species: Major anopheles species:
P. falciparum (100%), P. vivax (0%) An. gambiae, funestus, arabiensis
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes No
2005 –
IRS
IRS is recommended DDT is used for IRS
Yes No
2003 –
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
Yes
2005
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
– –
Treatment
ACT is free for all ages in public sector No Artemisinin-based monotherapies withdrawn Yes Single dose of primaquine (0.25 mg base/kg) is used as gametocidal – medicine for P. falciparum Primaquine is used for radical treatment of P. vivax – G6PD test is a requirement before treatment with primaquine – Directly observed treatment with primaquine is undertaken – System for monitoring of adverse reaction to antimalarials exists –
– – –
Contribution (US$m)
III. Financing 3 000 2 500 2 000 1 500 1 000 500 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– No No – –
Antimalaria treatment policy
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
Medicine
Year adopted
AL AL QN QN –
2005 2005 2005 2005 –
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
–
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine AL
Year
Min
Median
Max
2006–2006
4.4
4.4
4.4
Sources of financing
2002
Government
Intervention
Follow-up No. of studies Species 28 days
1
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, PMI/ USAID, World Bank, UNICEF
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
60 50 40 30 20 10 0 2012
2006
2007
2008
2009
2010
2011
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
2012
Malaria admissions and deaths (100 000) 1 600
2000
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
Slide positivity rate
Admissions
Cases per 1000
2005
100
Confirmed cases (per 1000) 60 50 40 30 20 10 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
Impact: Insufficiently consistent data to assess trends
162 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
1 200 800 400 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
30 25 20 15 10 5 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: DHS 2006
ABER (%)
Population (%)
100
Nigeria
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
169 000 000 0 0 169 000 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae, funestus, arabiensis, Moucheti, melas, nili
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2001 2009
IRS
IRS is recommended DDT is used for IRS
Yes No
2007 –
Larval control Use of larval control
Yes
2010
IPT
IPT used to prevent malaria during pregnancy
Yes
2004
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes No
2010 –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2009 2009 –
180 160 140 120 100 80 60 40 20 0
2000
2001
2003
2004
Global Fund
2005
2006
World Bank
IV. Coverage
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
No No No No No
2007
2008
USAID/PMI
2009
2010
2011
WHO/UNICEF
– – – –
Medicine AL AS+AQ
Year
Min
Median
Max
0 0
0 0
2 7.8
2012
Others
2004 2004 2004 2004 –
28 days 28 days
5 5
No data reported for 2012
Cases tested and potentially treated (public sector) 100
Source: DHS 2003, DHS 2008, MIS 2010
80 Cases (%)
40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0 2012
Admissions
2 1 2002
2003
2004
2005
2006
2007
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Malaria admissions and deaths (100 000)
3
Cases (all species)
2006
100
Confirmed cases (per 1000)
2001
2005
Slide positivity rate
4
2000
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
Cases due to P. vivax (%)
2000
With access to an ITN (model) With access to an ITN (survey)
Cases per 1000
AL; AS+AQ AL; AS+AQ QN AM; AS; QN –
Follow-up No. of studies Species
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
60
0
Year adopted
–
2002–2007 2004–2006
Coverage of ITNs and IRS
80
0
Medicine
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
– – – – –
Therapeutic efficacy tests (clinical and parasitological failure, %)
ABER (%)
Population (%)
Surveillance
Expenditure by intervention in 2012
100
Positivity rate (%)
Yes/ Year No adopted
Sources of financing
2002
Government
Policies/strategies
2008
Cases (P. vivax)
2009
2010
2011
2012
600 500 400 300 200 100 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
8 7 6 5 4 3 2 1 0
Deaths
Contribution (US$m)
III. Financing
No No No No
Intervention
Admissions (P. vivax) Deaths (P. vivax)
Impact: Insufficiently consistent data to assess trends
WORLD MALARIA REPORT 2013 | 163
Pakistan
Eastern Mediterranean Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
Based on 2009 reported data
Based on 2009 reported data
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
51 800 000 124 000 000 3 030 000 178 030 000
29 69 2
Major plasmodium species: Major anopheles species:
P. falciparum (25%), P. vivax (75%) An. culicifacies, stephensi
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2008 2008
IRS
IRS is recommended DDT is used for IRS
Yes –
1961 –
Larval control Use of larval control
Yes
1961
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2011 1961
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes Yes
2009 2007 2012
Yes Yes No No
2009 2009 – –
Contribution (US$m)
III. Financing 16 14 12 10 8 6 4 2 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
No No No No No
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
Year adopted
Medicine
CQ – AS+SP 2007 QN – AS; QN 2007 CQ+PQ(14d) 2007 0.25 mg/kg (14 days) P.f + all species (Combo)
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine AS+SP
Year
Min
Median
Max
2007–2011
0
0
1.5
Sources of financing
2002
Government
Intervention
Follow-up No. of studies Species 28 days
P. f
7
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Global Fund
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20
40
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
3.5 3.0 2.5 2.0 1.5 1.0 0.5 0 2012
Admissions
Cases per 1000
1.2 0.8 0.4 2002
2003
Cases (all species)
2004
2005
2006
2007
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Malaria admissions and deaths
1.6
2001
2006
100
Confirmed cases (per 1000)
2000
2005
Slide positivity rate
2.0
0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
2008
Cases (P. vivax)
Impact: Insufficiently consistent data to assess trends
164 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
70 000 60 000 50 000 40 000 30 000 20 000 10 000 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
300 250 200 150 100 50 0
Deaths
2000
At high risk protected with ITNs Households with at least one ITN
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
Panama
Region of the Americas Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
167 000 2 710 000 928 000 3 805 000
4 71 24
Major plasmodium species: Major anopheles species:
P. falciparum (0%), P. vivax (100%) An. albimanus, pseudopunctipennis, punctimacula, aquasalis, darlingi
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
No No
– –
IRS
IRS is recommended DDT is used for IRS
No No
– –
Larval control Use of larval control
Yes
1957
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
1957 1957
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes – Yes
– – –
Contribution (US$m)
III. Financing 7 6 5 4 3 2 1 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes Yes Yes No No
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – – – –
Year adopted
Medicine
– – AL 2012 – – MQ – CQ+PQ(7d);CQ+PQ(14d) – 0.25 mg/kg (14 days)
–
Type of RDT used
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine
Year
Min
Sources of financing
2002
Government
Yes No Yes No
Intervention
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, PMI/ USAID, WHO
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20
40
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2000
2001
2002
80 60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
9 8 7 6 5 4 3 2 1 0 2012
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
Total cases per 1000
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2000
2005
100
Confirmed cases 6 000 5 000 4 000 3 000 2 000 1 000 0
2004
Proportion of malaria cases due to P. vivax
100
2001
2003
Suspected cases tested P. vivax cases potentially treated with primaquine
Malaria test positivity rate and ABER
V. Impact
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
2008
Cases (P. vivax)
2009
2010
2011
2012
120 100 80 60 40 20 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
5 4 3 2 1 0
Deaths
2000
At high risk protected with ITNs Households with at least one ITN
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
Admissions (P. vivax) Deaths (P. vivax)
Impact: 75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
6 740 000 430 000 0 7 170 000
94 16 0
Major plasmodium species: Major anopheles species:
P. falciparum (89%), P. vivax (11%) An. punctulatus, farauti, koliensis
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2004 2005
IRS
IRS is recommended DDT is used for IRS
Yes –
2000 –
–
2010
Larval control Use of larval control IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2010 2004
Treatment
ACT is free for all ages in public sector Yes Artemisinin-based monotherapies withdrawn No Single dose of primaquine (0.25 mg base/kg) is used as gametocidal – medicine for P. falciparum Primaquine is used for radical treatment of P. vivax – G6PD test is a requirement before treatment with primaquine – Directly observed treatment with primaquine is undertaken – System for monitoring of adverse reaction to antimalarials exists –
2010 – –
Contribution (US$m)
III. Financing 40 35 30 25 20 15 10 5 0
2000
2001
Policies/strategies
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
– – – – –
Antimalaria treatment policy
Medicine
Year adopted
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
– AL DHA-PPQ AM; AS AL+PQ
– 2008 2008 2008 2009 – –
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine
Year
Min
Median
Max
DHA-PPQ AL
2005–2007 2005–2007
12 2.7
12 2.7
12 2.7
Sources of financing
2002
Government
Yes/ Year No adopted
Intervention
Follow-up No. of studies Species 42 days 28 days
P. f P. f
1 1
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government
Coverage of ITNs and IRS
80
80 Cases (%)
100
60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact 100 80 60 40 20 10 0 2000
2007
2008
2009
2010
2011
0
2012
2000
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
2001
2002
Malaria test positivity rate and ABER
2001
2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2003
2001
2002
2003
Cases per 1000
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
2010
2011
100 80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2000
2005
Proportion of malaria cases due to P. vivax 6 5 4 3 2 1 0 2012
Confirmed cases (per 1000) 25 20 15 10 5 0
2004
Suspected cases tested P. falciparum cases potentially treated with ACT
2008
Cases (P. vivax)
Impact: 75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 167
Peru
Region of the Americas Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
1 350 000 3 450 000 25 200 000 30 000 000
5 12 84
Major plasmodium species: Major anopheles species:
P. falciparum (11%), P. vivax (89%) An. darlingi, pseudopunctipennis, albimanus
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
– –
IRS
IRS is recommended DDT is used for IRS
Yes No
– –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
– –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes Yes
– – –
No No Yes Yes
– – – –
Contribution (US$m)
III. Financing 140 120 100 80 60 40 20 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes Yes Yes Yes Yes
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
Antimalaria treatment policy
Medicine
Year adopted
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
– AS+MQ – – CQ+PQ
– – – – – –
–
Type of RDT used
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine AS+MQ
Year
Min
Median
Max
2005–2006
1.1
1.1
1.1
Sources of financing
2002
Government
Intervention
Follow-up No. of studies Species 28 days
P. f
1
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, PMI/ USAID
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20
40
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2000
2001
2002
80 60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
40 35 30 25 20 15 10 5 0 2012
2001
2002
2003
Total cases per 1000
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2000
2005
100
Confirmed cases (per 1000) 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0
2004
Proportion of malaria cases due to P. vivax
100
2001
2003
Suspected cases tested P. vivax cases potentially treated with primaquine
Malaria test positivity rate and ABER
V. Impact
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
2008
Cases (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
168 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
3 000 2 500 2 000 1 500 1 000 500 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
30 25 20 15 10 5 0
Deaths
2000
At high risk protected with ITNs Households with at least one ITN
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
Philippines
Western Pacific Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
6 940 000 70 200 000 19 600 000 96 740 000
7 73 20
Major plasmodium species: Major anopheles species:
P. falciparum (69%), P. vivax (31%) An. flavirostris, maculatus, balabacensis, Litoralis
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2006 2000
IRS
IRS is recommended DDT is used for IRS
Yes No
2002 –
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2004 2003
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes Yes
2003 – 2006
Yes Yes Yes Yes
2007 2011 2010 2009
Contribution (US$m)
III. Financing 40 35 30 25 20 15 10 5 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes No Yes No No
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
2009 – 2009 – –
Year adopted
Medicine
AL 2009 AL+PQ 2009 QN+T 2002 QN+T 2002 CQ+PQ(14d) 2002 0.25 mg/kg (14 days) –
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine CQ AL
Year
Min
Median
Max
2000–2010 2005–2009
0 0
0 0
0 5.6
Sources of financing
2002
Government
Intervention
Follow-up No. of studies Species 28 days 28 days
P. v P. f
5 9
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund
Coverage of ITNs and IRS
80
80 Cases (%)
100
60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact 100 80 60 40 20 10 0 2000
2007
2008
2009
2010
2011
0
2012
2000
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
2001
2002
Malaria test positivity rate and ABER 0.8 0.6 0.4 0.2 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
0 2012
2002
2003
Cases (all species)
2004
2005
2006
2007
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Malaria admissions and deaths
Admissions 2001
2006
Slide positivity rate
Cases per 1000
2000
2005
100
Confirmed cases (per 1000) 60 000 50 000 40 000 30 000 20 000 10 000 0
2004
Proportion of malaria cases due to P. vivax 1.0
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
2008
Cases (P. vivax)
2009
2010
2011
2012
5 000 4 000 3 000 2 000 1 000 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
600 500 400 300 200 100 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
Cases tested and potentially treated (public sector)
100
ABER (%)
Population (%)
IV. Coverage
Admissions (P. vivax) Deaths (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 169
Republic of Korea
Western Pacific Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40 40–60 60–80 80–100
I. Epidemiological profile Population (UN Population Division) Number of active foci Number of people living within active foci Number of people living in malaria-free areas Total
2012
%
22 3 760 000 45 200 000 48 960 000
8 92
Parasites and vectors P. falciparum (7%), P. vivax (93%) An.sinensis
Major plasmodium species: Major anopheles species:
Programme phase: Elimination
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2001 –
IRS
IRS is recommended DDT is used for IRS
– No
– –
Larval control Use of larval control
Yes
2001
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
– Yes
– 2001
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
– – –
– – –
Yes No No Yes
2001 – – 2011
Contribution (US$m)
III. Financing 7 6 5 4 3 2 1 0
2000
2001
2003
2004
Global Fund
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted Foci and case investigation undertaken Case reporting from private sector is mandatory
No No No No Yes Yes Yes
Antimalaria treatment policy
2006
2007
Medicine
Year
Min
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
2012
Others
Coverage of ITNs and IRS
No data reported for 2012
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
1.2 1.0 0.8 0.6 0.4 0.2 0 2012
2002
Total cases
2003
2004
2005
2006
2007
2008
Imported cases
Impact: On track for >75% decrease in incidence 2000–2015
170 | WORLD MALARIA REPORT 2013
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
Slide positivity rate
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Among total cases
Among indigenous cases
Indigenous malaria cases by species Confirmed cases
2001
2005
100
Malaria cases by source
2000
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
Cases due to P. vivax (%)
2000
At high risk protected with ITNs Households with at least one ITN
Confirmed cases
Median
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
100
4 500 4 000 3 500 3 000 2 500 2 000 1 500 1 000 500 0
CQ – – N2006 – 2006 – 2006 CQ+PQ(14d) 2006 0.25 mg/kg (14 days), 0.25 mg base/kg
Therapeutic efficacy tests (clinical and parasitological failure, %)
100
0
– – – – – 2001 1963
Year adopted
Medicine
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
ABER (%)
Population (%)
2005
World Bank
IV. Coverage
Positivity rate (%)
Policies/strategies
Sources of financing
2002
Government
Intervention
2009
2010
2011
2012
4 500 4 000 3 500 3 000 2 500 2 000 1 500 1 000 500 0 2000
2001
2002
2003
2004
Indigenous cases (all species)
2005
2006
2007
2008
2009
Indigenous cases (P. vivax)
2010
2011
2012
Rwanda
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
11 500 000 0 0 11 500 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae, funestus, arabiensis
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes No
2004 –
IRS
IRS is recommended DDT is used for IRS
Yes No
2009 –
Larval control Use of larval control
–
–
IPT
IPT used to prevent malaria during pregnancy
No
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes No
2009 –
Treatment
ACT is free for all ages in public sector No Artemisinin-based monotherapies withdrawn Yes Single dose of primaquine (0.25 mg base/kg) is used as gametocidal – medicine for P. falciparum Primaquine is used for radical treatment of P. vivax – G6PD test is a requirement before treatment with primaquine – Directly observed treatment with primaquine is undertaken – System for monitoring of adverse reaction to antimalarials exists –
Contribution (US$m)
III. Financing 45 40 35 30 25 20 15 10 5 0
2000
2001
Policies/strategies
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – – – –
– – – – –
Antimalaria treatment policy
Medicine
Year adopted
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
AL AL QN AM; QN –
2005 2005 2005 2005 – –
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine AL
Year
Min
Median
Max
2004–2007
0
1.5
6.9
Sources of financing
2002
Government
– – –
Yes/ Year No adopted
Intervention
Follow-up No. of studies Species 28 days
3
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): WHO
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
30 25 20 15 10 5 0 2012
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
Cases per 1000
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2000
2005
100
Confirmed cases (per 1000) 80 70 60 50 40 30 20 10 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
2009
2010
2011
2012
2 000 1 600 1 200 800 400 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
60 50 40 30 20 10 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: DHS 2005, DHS 2008, DHS 2010
ABER (%)
Population (%)
100
Admissions (P. vivax) Deaths (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 171
Sao Tome and Principe
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
188 000 0 0 188 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes No
2005 –
IRS
IRS is recommended DDT is used for IRS
Yes No
2003 –
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
Yes
2004
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2001 2008
Treatment
ACT is free for all ages in public sector Yes Artemisinin-based monotherapies withdrawn – Single dose of primaquine (0.25 mg base/kg) is used as gametocidal – medicine for P. falciparum Primaquine is used for radical treatment of P. vivax – G6PD test is a requirement before treatment with primaquine – Directly observed treatment with primaquine is undertaken – System for monitoring of adverse reaction to antimalarials exists –
2009 – –
Contribution (US$m)
III. Financing 5 4 3 2 1 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– Yes No No No
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
Antimalaria treatment policy
Medicine
Year adopted
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
AS+AQ AS+AQ AL QN –
2004 2004 2004 2004 – –
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine
Year
Min
Sources of financing
2002
Government
Intervention
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, Other Bilaterals, World Bank, UNICEF, WHO, Other
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
120 100 80 60 40 20 0 2012
Admissions
Cases per 1000
200 100 2002
2003
Cases (all species)
2004
2005
2006
2007
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Malaria admissions and deaths (100 000)
300
2001
2006
100
Confirmed cases (per 1000)
2000
2005
Slide positivity rate
400
0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
172 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
12 000 10 000 8 000 6 000 4 000 2 000 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
250 200 150 100 50 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: DHS 2009
ABER (%)
Population (%)
100
Saudi Arabia
Eastern Mediterranean Region Confirmed cases per 1000 population
Islamic Republic of Iran
Iraq
Egypt
Proportion of cases due to P. falciparum
Islamic Republic of Iran
Iraq
Insufficient data
Insufficient data
0
no cases
Egypt
0–0.1
Very low PP
0.1–1.0 Oman
10–50
Red Sea
Sudan
0–20 Oman
1.0–10
Yemen
Red Sea
Sudan
50–100
20–40 40–60 60–80
Yemen
≥100
80–100
Based on 2011 reported data
Based on 2011 reported data
I. Epidemiological profile Population (UN Population Division) Number of active foci Number of people living within active foci Number of people living in malaria-free areas Total
2012
%
68 2 300 000 26 000 000 28 300 000
8 92
Parasites and vectors Major plasmodium species: Major anopheles species:
P. falciparum (100%), P. vivax (0%) An.arabiensis, sergentii, funestus, bacroftii, albimanus, balabacensis
Programme phase: Elimination
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
1980 1980
IRS
IRS is recommended DDT is used for IRS
Yes No
– –
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
– 1963
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
– Yes Yes
– – 1985
No Yes No Yes
– 1985 – 1990
35 30 25 20 15 10 5 0
2000
2001
2002
Government
2003
2004
Global Fund
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted Foci and case investigation undertaken Case reporting from private sector is mandatory
Yes Yes No No No Yes Yes
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
2006
2007
2008
USAID/PMI
Year adopted
– AS+SP AL AS; AM; QN CQ+PQ(14d)
– – – – –
–
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine
Year
Min
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Coverage of ITNs and IRS
No data reported for 2012
Cases tested and potentially treated (public sector)
80
80
60
60
Cases (%)
100
40 20
40 20
2000
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
3 2 1 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2010
2011
35 30 25 20 15 10 5 0 2012
2001
2002
Total cases
2003
2004
2005
2006
2007
2008
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
60 40 20 0
2000
Slide positivity rate
Imported cases
2006
80
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Among total cases
Among indigenous cases
Malaria cases by source
2000
2005
100
Indigenous malaria cases by species Confirmed cases
2009
2004
Proportion of malaria cases due to P. vivax
4
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
5
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
7 000 6 000 5 000 4 000 3 000 2 000 1 000 0
1980 1980 – – – 1990 1990
Medicine
Antimalaria treatment policy
100
0
Positivity rate (%)
Yes/ Year No adopted
Cases due to P. vivax (%)
Population (%)
2005
World Bank
IV. Coverage
Confirmed cases
Policies/strategies
Sources of financing
ABER (%)
Contribution (US$m)
III. Financing
Intervention
2009
2010
2011
2012
5 000 4 000 3 000 2 000 1 000 0 2000
2001
2002
2003
2004
Indigenous cases (all species)
2005
2006
2007
2008
2009
2010
2011
2012
Indigenous cases (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
world malaria report 2013 | 173
Senegal
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
13 200 000 549 000 0 13 749 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae, arabiensis, funestus, pharoensis, melas
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
1998 1998
IRS
IRS is recommended DDT is used for IRS
Yes No
2005 –
Larval control Use of larval control
Yes
2010
–
–
IPT
IPT used to prevent malaria during pregnancy
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2007 2007
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2010 2010 –
Contribution (US$m)
III. Financing 40 35 30 25 20 15 10 5 0
2000
2001
– – – 2006
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– Yes No No No
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
– 2012 – – –
Medicine
Year adopted
AS+AQ AL; AS+AQ – QN –
2005 2005 – 2005 –
Antimalaria treatment policy
–
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine AS+AQ AL
Year
Min
Median
Max
2002–2008 2002–2008
0 0
0 0.85
0.5 3.2
Sources of financing
2002
Government
No No No Yes
Intervention
Follow-up No. of studies Species 28 days 28 days
7 6
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Global Fund
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
6 5 4 3 2 1 0 2012
2001
2002
2003
Cases per 1000
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2000
2005
100
Confirmed cases (per 1000) 30 25 20 15 10 5 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
Impact: Insufficiently consistent data to assess trends
174 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
250 200 150 100 50 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
18 16 14 12 10 8 6 4 2 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: DHS 2005, MIS 2006, MIS 2009, DHS 2011
ABER (%)
Population (%)
100
Sierra Leone
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
5 980 000 0 0 5 980 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae, funestus, melas
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes –
2010 –
IRS
IRS is recommended DDT is used for IRS
Yes No
2005 –
Larval control Use of larval control
–
–
IPT
IPT used to prevent malaria during pregnancy
Yes
2005
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2010 2008
Treatment
ACT is free for all ages in public sector Yes Artemisinin-based monotherapies withdrawn Yes Single dose of primaquine (0.25 mg base/kg) is used as gametocidal – medicine for P. falciparum Primaquine is used for radical treatment of P. vivax – G6PD test is a requirement before treatment with primaquine – Directly observed treatment with primaquine is undertaken – System for monitoring of adverse reaction to antimalarials exists Yes
2010 – –
Contribution (US$m)
III. Financing 16 14 12 10 8 6 4 2 0
2000
2001
Policies/strategies
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– – – 2005
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – – – –
– – – – –
Medicine
Year adopted
AS+AQ AL; AS+AQ QN AM; QN –
2004 2004 2004 2004 –
Antimalaria treatment policy
P.f only
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine AS+AQ
Year
Min
Median
Max
2004–2004
27
27
27
Sources of financing
2002
Government
Yes/ Year No adopted
Intervention
Follow-up No. of studies Species 28 days
1
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, UNICEF, WHO
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
45 40 35 30 25 20 15 10 5 0 2012
2006
2007
2008
2009
2010
2011
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
2012
Malaria admissions and deaths (100 000) 1 600
2000
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
Slide positivity rate
Admissions
Cases per 1000
2005
100
Confirmed cases (per 1000) 300 250 200 150 100 50 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
2009
2010
2011
2012
1 200 800 400 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
160 140 120 100 80 60 40 20 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: DHS 2008
ABER (%)
Population (%)
100
Admissions (P. vivax) Deaths (P. vivax)
Impact: Insufficiently consistent data to assess trends
WORLD MALARIA REPORT 2013 | 175
Solomon Islands
Western Pacific Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
544 000 0 5 500 549 500
99 0 1
Major plasmodium species: Major anopheles species:
P. falciparum (64%), P. vivax (36%) An. farauti, punctulatus, koliensis
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2009 1996
IRS
IRS is recommended DDT is used for IRS
Yes No
– –
Larval control Use of larval control
Yes
2009
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
1968 2007
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2008 2009 –
Yes Yes No No
2009 2009 – –
Contribution (US$m)
III. Financing 10 8 6 4 2 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– – Yes No No
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
Year adopted
Medicine
AL 2009 AL 2009 QN 2002 AS; AL 2002 AL+PQ(14d) 2002 0.25 mg/kg (14 days) P.f + all species (Combo)
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine AL AL
Year
Min
Median
Max
2008–2013 2008–2013
0 4
0 5.1
6.3 31.6
Sources of financing
2002
Government
Intervention
Follow-up No. of studies Species 28 days 28 days
P. f P. v
3 3
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, Other Bilaterals, WHO
Coverage of ITNs and IRS
80
80 Cases (%)
100
60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact 100 80 60 40 20 10 0 2000
2007
2008
2009
2010
2011
0
2012
2000
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
2001
2002
Malaria test positivity rate and ABER
2001
2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2003
2001
2002
2003
Cases per 1000
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
2010
2011
100 80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2000
2005
Proportion of malaria cases due to P. vivax 80 70 60 50 40 30 20 10 0 2012
Confirmed cases (per 1000) 250 200 150 100 50 0
2004
Suspected cases tested P. falciparum cases potentially treated with ACT
2008
Cases (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
176 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
2 000 1 600 1 200 800 400 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
80 70 60 50 40 30 20 10 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
Cases tested and potentially treated (public sector)
100
ABER (%)
Population (%)
IV. Coverage
Somalia
Eastern Mediterranean Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
Based on 2011 reported data
Based on 2011 reported data
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
7 140 000 3 060 000 0 10 200 000
70 30 0
Major plasmodium species: Major anopheles species:
P. falciparum (100%), P. vivax (0%) An. arabiensis, funestus
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2005 2005
IRS
IRS is recommended DDT is used for IRS
Yes No
2004 –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
–
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2006 2006
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes No No
2006 – –
Contribution (US$m)
III. Financing 14 12 10 8 6 4 2 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes No No No No
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
2006 – – – –
Medicine
Year adopted
AS+SP AS+SP QN AS; QN CQ+PQ(14d)
2006 2006 2006 2006 2006
Antimalaria treatment policy
–
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine AS+SP
Year
Min
Median
Max
2005–2006
0
0.5
1
Sources of financing
2002
Government
No No No No
Intervention
Follow-up No. of studies Species 28 days
P. f
2
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Global Fund, Other Bilaterals, WHO
Coverage of ITNs and IRS
80
80 Cases (%)
100
60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
80
2.0
60
1.5
40
1.0
20
0.5 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
0 2012
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
Cases per 1000
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2000
2005
100
Confirmed cases (per 1000) 4.5 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0
2004
Proportion of malaria cases due to P. vivax 2.5
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
2009
2010
2011
2012
10 000 8 000 6 000 4 000 2 000 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
90 80 70 60 50 40 30 20 10 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
Cases tested and potentially treated (public sector)
100
ABER (%)
Population (%)
IV. Coverage
Admissions (P. vivax) Deaths (P. vivax)
Impact: Insufficiently consistent data to assess trends
WORLD MALARIA REPORT 2013 | 177
South Africa
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
2 100 000 3 140 000 47 100 000 52 340 000
4 6 90
Major plasmodium species: Major anopheles species:
P. falciparum (99%), P. vivax (1%) An. arabiensis, funestus
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
No No
– –
IRS
IRS is recommended DDT is used for IRS
Yes Yes
1930 –
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
No
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
– 1997
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2001 – –
60 50 40 30 20 10 0
2000
2001
2003
2004
Global Fund
2005
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes Yes No No No
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2007
– – – –
Medicine AL
– AL; QN+CL; QN+D AS; QN QN AL+PQ; CQ+PQ
– 2001 2001 2001 – P.f only
Year
Min
Median
Max
2007–2007
0
2.6
5.2
Follow-up No. of studies Species 28 days
P. f
2
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Coverage of ITNs and IRS
No data reported for 2012
Cases tested and potentially treated (public sector)
80
80 Cases (%)
100
60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
8 7 6 5 4 3 2 1 0 2012
2003
2004
2005
2006
2007
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Malaria admissions and deaths
Admissions 2002
Cases (all species)
2006
Slide positivity rate
Cases per 1000
2001
2005
100
Confirmed cases (per 1000)
2000
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
Cases due to P. vivax (%)
2000
With access to an ITN (model) With access to an ITN (survey)
30 000 25 000 20 000 15 000 10 000 5 000 0
Year adopted
Therapeutic efficacy tests (clinical and parasitological failure, %)
100
0
– – – – –
Medicine
Antimalaria treatment policy
ABER (%)
Population (%)
2006
World Bank
IV. Coverage
Positivity rate (%)
Yes/ Year No adopted
Sources of financing
2002
Government
Policies/strategies
2008
Cases (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
178 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
3 000 2 500 2 000 1 500 1 000 500 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
450 400 350 300 250 200 150 100 50 0
Deaths
Contribution (US$m)
III. Financing
No No No No
Intervention
South Sudan*
Eastern Mediterranean Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
10 800 000 0 0 10 800 000
100 0 0
Parasites and vectors P. falciparum (95%), P. vivax (5%) An. gambiae, arabiensis, funestus, nili
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2008 2008
IRS
IRS is recommended DDT is used for IRS
Yes –
2006 –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
Yes
2006
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
No Yes
– 2005
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2006 2012 –
Contribution (US$m)
III. Financing 60 50 40 30 20 10 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
No No No No No
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – – – –
Medicine
Year adopted
AS+AQ AS+AQ AL AM; AS; QN AS+AQ+PQ
2006 2006 2006 2004 –
Antimalaria treatment policy
–
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine AS+AQ AL
Year
Min
Median
Max
2003–2005 2004–2004
1 2.8
3.05 2.8
5.1 2.8
Sources of financing
2002
Government
No No No No
Intervention
Follow-up No. of studies Species 28 days 28 days
2 1
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, PMI/ USAID, UNICEF, WHO, Other
Coverage of ITNs and IRS
80
80 Cases (%)
100
60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
80
2.0
60
1.5
40
1.0
20
0.5 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
0 2012
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
Cases per 1000
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Malaria admissions and deaths
2008
2009
Cases (P. vivax)
Impact: Insufficiently consistent data to assess trends
2006
Slide positivity rate
Admissions 2000
2005
100
Confirmed cases (per 1000) 100 80 60 40 20 0
2004
Proportion of malaria cases due to P. vivax 2.5
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2010
2011
2012
10 000 8 000 6 000 4 000 2 000 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species) *
2005
2006
2007
2008
2009
2010
2011
2012
1 400 1 200 1 000 800 600 400 200 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
Cases tested and potentially treated (public sector)
100
ABER (%)
Population (%)
IV. Coverage
Admissions (P. vivax) Deaths (P. vivax)
In May 2013 South Sudan was reassigned to the Who African Region (WHA resolution 66.21 http://apps.who.int/gb/ebwha/pdf_files/WHA66/ A66_R21-en.pdf ). Nonetheless, since most data in this report precede 2013, South Sudan is placed in Eastern Mediterranean Region
WORLD MALARIA REPORT 2013 | 179
Sri Lanka
South-East Asia Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40 40–60 60–80 80–100
I. Epidemiological profile Population (UN Population Division) Number of active foci Number of people living within active foci Number of people living in malaria-free areas Total
2012
%
17 501 000 20 600 000 21 101 000
2 98
Parasites and vectors P. falciparum (17%), P. vivax (83%) An.culicifacies, subpictus, annularis, varuna
Major plasmodium species: Major anopheles species:
Programme phase: Elimination
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
1992 2004
IRS
IRS is recommended DDT is used for IRS
Yes No
1945 –
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
– Yes
– 1911
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
– Yes Yes
– – –
Yes Yes Yes Yes
– – – –
Contribution (US$m)
III. Financing 10 8 6 4 2 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted Foci and case investigation undertaken Case reporting from private sector is mandatory
Yes Yes Yes Yes No Yes Yes
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – 2008 – 1958 2008
Year adopted
Medicine
– – AL+PQ N2006 – 2006 QN 2006 CQ+PQ(14d) 2006 0.25 mg/kg (14 days)
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine
Year
Min
Sources of financing
2002
Government
Intervention
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund
Coverage of ITNs and IRS
80
80 Cases (%)
100
60 40 20
60 40 20
2000
2001
2002
2003
2004
2005
2006
V. Impact 14 12 10 8 6 4 2 0 2000
2007
2008
2009
2010
2011
0
2012
2000
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
2001
2002
Malaria test positivity rate and ABER
2001
2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2003
2010
2011
2002
Total cases
2003
2004
2005
2006
2007
2008
Imported cases
Impact: On track for >75% decrease in incidence 2000–2015
180 | WORLD MALARIA REPORT 2013
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 80
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Among total cases
Among indigenous cases
Indigenous malaria cases by species Confirmed cases
2001
2006
100
Slide positivity rate
Confirmed cases
2000
2005
Proportion of malaria cases due to P. vivax 45 40 35 30 25 20 15 10 5 0 2012
Malaria cases by source 250 000 200 000 150 000 100 000 50 000 0
2004
Suspected cases tested P. falciparum cases potentially treated with ACT
Cases due to P. vivax (%)
0
Positivity rate (%)
Cases tested and potentially treated (public sector)
100
ABER (%)
Population (%)
IV. Coverage
2009
2010
2011
2012
250 000 200 000 150 000 100 000 50 000 0 2000
2001
2002
2003
2004
Indigenous cases (all species)
2005
2006
2007
2008
2009
Indigenous cases (P. vivax)
2010
2011
2012
Sudan
Eastern Mediterranean Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
30 900 000 6 320 000 0 37 220 000
83 17 0
Major plasmodium species: Major anopheles species:
P. falciparum (95%), P. vivax (5%) An. arabiensis, funestus, gambiae, nili, pharoensis
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2005 2010
IRS
IRS is recommended DDT is used for IRS
Yes No
1956 –
Larval control Use of larval control
–
–
IPT
IPT used to prevent malaria during pregnancy
No
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes No
2009 –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2005 2004 –
Yes No No No
2005 – – –
Contribution (US$m)
III. Financing 90 80 70 60 50 40 30 20 10 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
No No No No No
Antimalaria treatment policy
Medicine
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
AS+SP AS+SP AL AM; QN AL
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – – – –
Year adopted 2004 2004 2006 2006 2004 0.25 mg/kg (14 days) –
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine AS+SP AL
Year
Min
Median
Max
2005–2010 2005–2010
0 0
2 0
5.3 4.5
Sources of financing
2002
Government
Intervention
Follow-up No. of studies Species 28 days 28 days
P. f P. f
8 11
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, UNICEF, WHO, Other
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
9 8 7 6 5 4 3 2 1 0 2012
2006
2007
2008
2009
2010
2011
2000
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths 180 000 150 000 120 000 90 000 60 000 30 000 0 2000
Admissions
Cases per 1000
2005
100
Confirmed cases (per 1000) 35 30 25 20 15 10 5 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
2009
2010
2011
2012
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
3 000 2 500 2 000 1 500 1 000 500 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: MIS 2009, MIS 2012.
ABER (%)
Population (%)
100
Admissions (P. vivax) Deaths (P. vivax)
Impact: Insufficiently consistent data to assess trends
WORLD MALARIA REPORT 2013 | 181
Suriname
Region of the Americas Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
Based on 2010 reported data
Based on 2010 reported data
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
83 900 0 451 000 534 900
16 0 84
Major plasmodium species: Major anopheles species:
P. falciparum (43%), P. vivax (57%) An. darlingi
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2006 2006
IRS
IRS is recommended DDT is used for IRS
No No
– –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
1955 1955
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes Yes
– – –
Contribution (US$m)
III. Financing 1.0 0.8 0.6 0.4 0.2 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes No Yes No No
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
2003
2004
Global Fund
2005
2006
World Bank
2007
2000 – 2000 – –
Year adopted
Medicine
– – AL+PQ 2004 AS+MQ 2004 AS – CQ+PQ(14d) 2004 0.25 mg/kg (14 days)
–
Type of RDT used
2004 – – –
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine AL
Year
Min
Median
Max
2005–2011
0
2.35
4.7
Sources of financing
2002
Government
Yes No No No
Intervention
Follow-up No. of studies Species 28 days
P. f
2
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Global Fund
Coverage of ITNs and IRS
80
80 Cases (%)
100
60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2000
2001
2002
100
80
80
60
60
40
40
20
20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
0 2012
2001
2002
2003
Total cases per 1000
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2000
2005
100
Confirmed cases (per 1000) 40 35 30 25 20 15 10 0
2004
Proportion of malaria cases due to P. vivax
100
2001
2003
Suspected cases tested P. vivax cases potentially treated with primaquine
Malaria test positivity rate and ABER
V. Impact
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
2008
Cases (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
182 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
400 350 300 250 200 150 100 50 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
30 25 20 15 10 5 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
Cases tested and potentially treated (public sector)
100
ABER (%)
Population (%)
IV. Coverage
Swaziland
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
0 345 000 886 000 1 231 000
0 28 72
Major plasmodium species: Major anopheles species:
P. falciparum (100%), P. vivax (0%) An. arabiensis, gambiae, funestus
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2002 2010
IRS
IRS is recommended DDT is used for IRS
Yes Yes
1946 –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
No
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2010 2010
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes No Yes
2010 – 2010
3.5 3.0 2.5 2.0 1.5 1.0 0.5 0
2000
2001
2003
2004
Global Fund
2005
2006
World Bank
IV. Coverage
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes Yes Yes No No
Antimalaria treatment policy
– – – 2010
2007
2008
USAID/PMI
2009
2010
2011
WHO/UNICEF
Medicine
Year
2012
Min
Coverage of ITNs and IRS
– 2009 2009 – – –
Median
Max
Follow-up No. of studies Species
No data reported for 2012
Cases tested and potentially treated (public sector)
Cases (%)
80
40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
9 8 7 6 5 4 3 2 1 0 2012
2002
2003
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2001
2005
100
Confirmed cases (per 1000)
2000
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
Cases due to P. vivax (%)
2000
With access to an ITN (model) With access to an ITN (survey)
Cases per 1000
– AL QN QN –
100
Source: DHS 2007
60
1 600 1 400 1 200 1 000 800 600 400 200 0
Year adopted
Therapeutic efficacy tests (clinical and parasitological failure, %)
Others
80
0
2012 2010 – – –
Medicine
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
ABER (%)
Population (%)
Surveillance
Expenditure by intervention in 2012
100
Positivity rate (%)
Yes/ Year No adopted
Sources of financing
2002
Government
Policies/strategies
2008
Cases (P. vivax)
2009
2010
2011
2012
2 000 1 600 1 200 800 400 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
70 60 50 40 30 20 10 0
Deaths
Contribution (US$m)
III. Financing
No No No Yes
Intervention
Admissions (P. vivax) Deaths (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 183
Tajikistan
European Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
I. Epidemiological profile Population (UN Population Division) Number of active foci Number of people living within active foci Number of people living in malaria-free areas Total
2012
%
22 2 150 000 5 860 000 8 010 000
27 73
Parasites and vectors P. falciparum (0%), P. vivax (100%) An.superpictus, pulcherrimus
Major plasmodium species: Major anopheles species:
Programme phase: Elimination
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2006 2006
IRS
IRS is recommended DDT is used for IRS
Yes No
1997 –
Larval control Use of larval control
Yes
1998
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
– 1997
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes Yes
– – 2004
Yes No Yes Yes
1997 – 2004 1997
Contribution (US$m)
III. Financing 4.5 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted Foci and case investigation undertaken Case reporting from private sector is mandatory
No Yes No Yes No Yes Yes
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
2003
2004
Global Fund
2005
2006
World Bank
2007
– 2004 – 1997 – 2004 2000
Year adopted
Medicine
– – AL – QN – AN – CQ+PQ(14d) – 0.25 mg/kg (14 days)
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine
Year
Min
Sources of financing
2002
Government
Intervention
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, WHO
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20 2000
2001
2002
2003
2004
2005
2006
40
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
6 4 2 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
160 140 120 100 80 60 40 20 0 2012
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Among total cases
Among indigenous cases
Malaria cases by source
Indigenous malaria cases by species
20 000
25 000 20 000 15 000 10 000 8 000 6 000 4 000 2 000 0 2000
Confirmed cases
Confirmed cases
2005
100
Slide positivity rate
25 000 15 000 10 000 5 000 0
2004
Proportion of malaria cases due to P. vivax
8
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
10
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
Positivity rate (%)
60 20
Cases due to P. vivax (%)
0
ABER (%)
Population (%)
IV. Coverage
2000
2001
2002
Total cases
2003
2004
2005
2006
2007
2008
Imported cases
Impact: On track for >75% decrease in incidence 2000–2015
184 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
2001
2002
2003
2004
Indigenous cases (all species)
2005
2006
2007
2008
2009
Indigenous cases (P. vivax)
2010
2011
2012
Thailand
South-East Asia Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
5 340 000 28 000 000 33 400 000 66 740 000
8 42 50
Major plasmodium species: Major anopheles species:
P. falciparum (40%), P. vivax (60%) An. dirus, minimus, maculatus, sundaicus
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
1992 1992
IRS
IRS is recommended DDT is used for IRS
Yes No
1953 –
Larval control Use of larval control
Yes
1953
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
1991 1953
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes Yes
1995 – 1995
Yes No Yes No
1965 – 2008 –
Contribution (US$m)
III. Financing 30 25 20 15 10 5 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes No Yes No No
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
1958 – 1958 – –
Year adopted
Medicine
– – AS+MQ 2004 QN+D – AS; QN 2004 CQ+PQ(14d) 2004 0.25 mg/kg (14 days) –
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine AS+QM
Year
Min
Median
Max
2001–2009
0
0.5
10.4
Sources of financing
2002
Government
Intervention
Follow-up No. of studies Species 28 days
20
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, WHO, Other
Coverage of ITNs and IRS
80
80 Cases (%)
100
60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact 14 12 10 8 6 4 2 0 2000
2007
2008
2009
2010
2011
0
2012
2000
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
2001
2002
Malaria test positivity rate and ABER
2001
2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2003
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
Cases per 1000
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
2010
2011
100 80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2000
2005
Proportion of malaria cases due to P. vivax 16 14 12 10 8 6 4 2 0 2012
Confirmed cases (per 1000) 1.4 1.2 1.0 0.8 0.6 0.4 0.2 0
2004
Suspected cases tested P. falciparum cases potentially treated with ACT
2008
Cases (P. vivax)
2009
2010
2011
2012
18 000 16 000 14 000 12 000 10 000 8 000 6 000 4 000 2 000 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
700 600 500 400 300 200 100 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
Cases tested and potentially treated (public sector)
100
ABER (%)
Population (%)
IV. Coverage
Admissions (P. vivax) Deaths (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 185
Democratic Republic of Timor-Leste
South-East Asia Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
858 000 256 000 0 1 114 000
77 23 0
Major plasmodium species: Major anopheles species:
P. falciparum (56%), P. vivax (44%) An. subpictus, barbirostris
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2005 2008
IRS
IRS is recommended DDT is used for IRS
Yes No
2006 –
Larval control Use of larval control
Yes
2007
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2007 2000
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes No No
2007 – –
Yes No No No
2006 – – –
Contribution (US$m)
III. Financing 9 8 7 6 5 4 3 2 1 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes Yes No No No
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
2012 2009 – – –
Year adopted
Medicine
– – AL – QN+D – AM; AS; QN – CQ+PQ(14d) – 0.50 mg/kg (14 days) P.f + all species (Combo)
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine
Year
Min
Sources of financing
2002
Government
Intervention
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, WHO, Other
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact 100 80 60 40 20 10 0 2000
2007
2008
2009
2010
2011
0
2012
2000
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
2001
2002
Malaria test positivity rate and ABER 20 15 10 5 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
0 2012
2001
2002
2003
Cases per 1000
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2000
2005
100
Confirmed cases (per 1000) 60 50 40 30 20 10 0
2004
Proportion of malaria cases due to P. vivax 25
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
2008
Cases (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
186 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
2 000 1 600 1 200 800 400 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
80 70 60 50 40 30 20 10 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: DHS 2010
ABER (%)
Population (%)
100
Togo
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
6 640 000 0 0 6 640 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae, funestus, melas, arabiensis
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2004 2011
IRS
IRS is recommended DDT is used for IRS
Yes No
2011 –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
Yes
2003
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes No
2010 –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
No No No
– – –
Contribution (US$m)
III. Financing 18 15 12 9 6 3 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– No No Yes No
– – – 2009
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
– – – – –
Medicine
Year adopted
AL; AS+AQ AL; AS+AQ – QN –
– – – – –
Antimalaria treatment policy
P.f only
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine AS+AQ AL
Year
Min
Median
Max
2005–2009 2005–2009
0 0
0 0.7
6 4.4
Sources of financing
2002
Government
No – – Yes
Intervention
Follow-up No. of studies Species 28 days 28 days
P. f P. f
8 8
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, Other Bilaterals, WHO
Coverage of ITNs and IRS
80
80 Cases (%)
100
60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
80
16
60
12
40
8
20
4 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
0 2012
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
Cases per 1000
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2000
2005
100
Confirmed cases (per 1000) 120 100 80 60 40 20 0
2004
Proportion of malaria cases due to P. vivax 20
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
2009
2010
2011
2012
1 000 800 600 400 200 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
50 40 30 20 10 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
Cases tested and potentially treated (public sector)
100
ABER (%)
Population (%)
IV. Coverage
Admissions (P. vivax) Deaths (P. vivax)
Impact: Insufficiently consistent data to assess trends
WORLD MALARIA REPORT 2013 | 187
Turkey
European Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
I. Epidemiological profile Population (UN Population Division)
2012
Number of active foci Number of people living within active foci Number of people living in malaria-free areas Total
%
1 2 500 74 000 000 74 002 500
Parasites and vectors P. falciparum (0%), P. vivax (0%) An.sacharovi, superpictus
Major plasmodium species: Major anopheles species: 100
Programme phase: Elimination
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
No No
– –
IRS
IRS is recommended DDT is used for IRS
Yes No
1926 –
Larval control Use of larval control
Yes
1926
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
– Yes
– 1926
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
– – No
– – 1926
Yes No Yes No
– – 2007 –
Contribution (US$m)
III. Financing 50 40 30 20 10 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted Foci and case investigation undertaken Case reporting from private sector is mandatory
No Yes No No No Yes Yes
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
2003
2004
Global Fund
2005
2006
World Bank
2007
– 2010 – – – 1983 1930
Year adopted
Medicine
– – – – – – – – CQ+PQ(14d) – 0.50 mg/kg (14 days)
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine
Year
Min
Sources of financing
2002
Government
Intervention
Median
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 100
80
80 Cases (%)
100 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
40
V. Impact
2007
2008
2009
2010
2011
0
2012
2001
2002
Malaria test positivity rate and ABER 12 000 10 000 8 000 6 000 4 000 2 000 0 2012
ABER (%)
6 4 2 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
2010
2011
80 60 40 20 0
2000
Slide positivity rate
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Among total cases
Among indigenous cases
Indigenous malaria cases by species 12 000 10 000 8 000 6 000 4 000 2 000 0 2000
Confirmed cases
Confirmed cases
2005
100
Malaria cases by source 14 000 12 000 10 000 8 000 6 000 4 000 2 000 0
2004
Proportion of malaria cases due to P. vivax
8
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
10
0 2000
2000
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
Positivity rate (%)
60 20
Cases due to P. vivax (%)
Population (%)
IV. Coverage
2000
2001
2002
Total cases
2003
2004
2005
2006
2007
2008
Imported cases
Impact: On track for >75% decrease in incidence 2000–2015
188 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
2001
2002
2003
2004
Indigenous cases (all species)
2005
2006
2007
2008
2009
Indigenous cases (P. vivax)
2010
2011
2012
Uganda
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
32 700 000 3 630 000 0 36 330 000
90 10 0
Major plasmodium species: Major anopheles species:
P. falciparum (100%), P. vivax (0%) An. gambiae, funestus
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2006 2013
IRS
IRS is recommended DDT is used for IRS
Yes No
2005 –
Larval control Use of larval control
Yes
2012
IPT
IPT used to prevent malaria during pregnancy
N/A
2000
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
1997 2006
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2006 2005 –
250 200 150 100 50 0
2000
2001
2003
2004
Global Fund
2005
2006
World Bank
IV. Coverage
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
No No No No No
Antimalaria treatment policy
2007
2008
USAID/PMI
2009
2010
2011
WHO/UNICEF
– – – –
Medicine AL
2012
Others
AL AL QN QN –
2004 2004 2004 2004 –
Year
Min
Median
Max
2002–2008
0
2.3
8.9
Follow-up No. of studies Species 28 days
8
No data reported for 2012
Cases tested and potentially treated (public sector) 100
Source: DHS 2006, MIS 2009, DHS 2011
Cases (%)
80
40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
18 16 14 12 10 8 6 4 2 0 2012
2002
2003
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2001
2005
100
Confirmed cases (per 1000)
2000
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
Cases due to P. vivax (%)
2000
With access to an ITN (model) With access to an ITN (survey)
Cases per 1000
Year adopted
P.f only
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
60
80 70 60 50 40 30 20 10 0
Medicine
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
Coverage of ITNs and IRS
80
0
– – – – –
Therapeutic efficacy tests (clinical and parasitological failure, %)
ABER (%)
Population (%)
Surveillance
Expenditure by intervention in 2012
100
Positivity rate (%)
Yes/ Year No adopted
Sources of financing
2002
Government
Policies/strategies
2008
Cases (P. vivax)
2009
2010
2011
2012
2 500 2 000 1 500 1 000 500 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
30 25 20 15 10 5 0
Deaths
Contribution (US$m)
III. Financing
No No No Yes
Intervention
Admissions (P. vivax) Deaths (P. vivax)
Impact: Insufficiently consistent data to assess trends
WORLD MALARIA REPORT 2013 | 189
United Republic of Ta nzania (Mainland)
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
33 900 000 12 500 000 0 46 400 000
73 27 0
Major plasmodium species: Major anopheles species:
P. falciparum (100%), P. vivax (0%) An. gambiae, arabiensis, funestus
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
No No
– –
IRS
IRS is recommended DDT is used for IRS
Yes No
2006 –
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
Yes
2001
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes No
2009 –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes – No
– – –
Contribution (US$m)
III. Financing 250 200 150 100 50 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– – – No No
Antimalaria treatment policy
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
Medicine
Year adopted
AL AL QN QN –
2004 2004 2004 2004 –
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
P.f + all species (Combo)
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine AL
Year
Min
Median
Max
2002–2008
0
2.85
8.6
Sources of financing
2002
Government
No No No Yes
Intervention
Follow-up No. of studies Species 28 days
8
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, PMI/ USAID, Other Bilaterals, WHO
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
80
20
60
15
40
10
20
5 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
0 2012
2001
2002
2003
Cases per 1000
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2000
2005
100
Confirmed cases (per 1000) 80 70 60 50 40 30 20 10 0
2004
Proportion of malaria cases due to P. vivax 25
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
Impact: Insufficiently consistent data to assess trends
190 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
2 500 2 000 1 500 1 000 500 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
60 50 40 30 20 10 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: DHS 2005, DHS 2008, DHS 2010
ABER (%)
Population (%)
100
United Republic of Ta nzania (Zanzibar)
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
1 410 000 0 0 1 410 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2005 2008
IRS
IRS is recommended DDT is used for IRS
Yes No
2006 –
Larval control Use of larval control
Yes
2012
IPT
IPT used to prevent malaria during pregnancy
Yes
2004
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2007 2004
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2003 2012 –
III. Financing
No No No Yes
– – – 2003
Intervention
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes Yes Yes No No
Antimalaria treatment policy
Medicine
Year adopted
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
AS+AQ AS+AQ QN QN –
2004 2004 2004 2004 –
Medicine AL
Contribution (US$m)
Median
Max
0
0
0
2002
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
Follow-up No. of studies Species 42 days
P. f
1
Expenditure by intervention in 2012
2 2001
Min
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
4
2000
Year 2006–2007
Sources of financing
6
0
P.f + all species (Combo)
Therapeutic efficacy tests (clinical and parasitological failure, %)
8
Government
2008 2011 2011 – –
2009
2010
2011
WHO/UNICEF
2012
Others
Funding source(s): Government, PMI/ USAID, Other Bilaterals, WHO
Coverage of ITNs and IRS
80
80 Cases (%)
100
60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
80
30
60
20
40
10
20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2010
2011
0 2012
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
Cases per 1000
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2000
2005
100
Confirmed cases (per 1000) 20 16 12 8 4 0
2004
Proportion of malaria cases due to P. vivax 40
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
2009
2010
2011
2012
1 000 800 600 400 200 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
40 35 30 25 20 15 10 5 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
Cases tested and potentially treated (public sector)
100
ABER (%)
Population (%)
IV. Coverage
Admissions (P. vivax) Deaths (P. vivax)
Impact: Insufficiently consistent data to assess trends
WORLD MALARIA REPORT 2013 | 191
Uzbekistan
European Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
I. Epidemiological profile Population (UN Population Division)
2012
Number of active foci Number of people living within active foci Number of people living in malaria-free areas Total
%
0 0 28 500 000 28 500 000
Parasites and vectors P. falciparum (0%), P. vivax (0%) An.superpictus, pulcherrimus, hyrcanus, claviger
Major plasmodium species: Major anopheles species: 100
Programme phase: Control (Prevention of re-introduction as of December 2013)
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2005 2005
IRS
IRS is recommended DDT is used for IRS
Yes No
1925 –
Larval control Use of larval control
Yes
1925
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
– Yes
– 1925
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
– – Yes
– – 1939
Yes No Yes Yes
1939 – 1939 1939
Contribution (US$m)
III. Financing 2.5 2.0 1.5 1.0 0.5 0
2000
2001
2003
2004
Global Fund
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted Foci and case investigation undertaken Case reporting from private sector is mandatory
Yes Yes Yes Yes Yes Yes Yes
Antimalaria treatment policy
2006
2007
Medicine
Year
Min
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
2012
Others
Coverage of ITNs and IRS
No data reported for 2012
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
0.6 0.4 0.2 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
4 000 3 500 3 000 2 500 2 000 1 500 1 000 500 0 2012
2002
Total cases
2003
2004
2005
2006
2007
2008
Imported cases
Impact: On track for >75% decrease in incidence 2000–2015
192 | WORLD MALARIA REPORT 2013
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
Slide positivity rate
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Among total cases
Among indigenous cases
Indigenous malaria cases by species Confirmed cases
2001
2005
100
Malaria cases by source
2000
2004
Proportion of malaria cases due to P. vivax
0.8
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
1.0
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
Cases due to P. vivax (%)
2000
At high risk protected with ITNs Households with at least one ITN
Confirmed cases
Median
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
100
140 120 100 80 60 40 20 0
– – – – – – – – CQ+PQ (14d) – 0.25 mg/kg (14 days)
Therapeutic efficacy tests (clinical and parasitological failure, %)
100
0
1925 1925 1939 1939 – 1925 1925
Year adopted
Medicine
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
ABER (%)
Population (%)
2005
World Bank
IV. Coverage
Positivity rate (%)
Policies/strategies
Sources of financing
2002
Government
Intervention
2009
2010
2011
2012
70 60 50 40 30 20 10 0 2000
2001
2002
2003
2004
Indigenous cases (all species)
2005
2006
2007
2008
2009
Indigenous cases (P. vivax)
2010
2011
2012
Vanuatu
Western Pacific Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
245 000 0 2 470 247 470
99 0 1
Major plasmodium species: Major anopheles species:
P. falciparum (32%), P. vivax (68%) An. farauti
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2008 1990
IRS
IRS is recommended DDT is used for IRS
No No
– –
Larval control Use of larval control
Yes
2010
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes No
2009 –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes No No
2009 – –
Yes Yes No No
2009 2009 – –
6 5 4 3 2 1 0
2000
2001
2003
2004
Global Fund
2005
2006
World Bank
IV. Coverage
2007
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
No No No No No
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
Medicine AL
Year
Min
Median
Max
2011–2012
0
0
0
Follow-up No. of studies Species 28 days
P. v
1
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
2012
Others
Coverage of ITNs and IRS
No data reported for 2012
Cases tested and potentially treated (public sector) 100
Source: Other Nat.
80 Cases (%)
60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact 100 80 60 40 20 10 0 2000
2007
2008
2009
2010
2011
0
2012
2000
At high risk protected with IRS All ages who slept under an ITN
2001
2002
Malaria test positivity rate and ABER
2001
2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2003
2010
2011
2003
2004
2005
2006
2007
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
100 80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Malaria admissions and deaths
Admissions 2002
Cases (all species)
2006
Slide positivity rate
Cases per 1000
2001
2005
Proportion of malaria cases due to P. vivax 35 30 25 20 15 10 5 0 2012
Confirmed cases (per 1000)
2000
2004
Suspected cases tested P. falciparum cases potentially treated with ACT
Cases due to P. vivax (%)
2000
At high risk protected with ITNs Households with at least one ITN
18 000 15 000 12 000 9 000 6 000 3 000 0
– 2009 AL 2009 QN 2002 QN 2002 AL+PQ(14d) 2002 0.25 mg/kg (14 days) P.f + all species (Combo)
Therapeutic efficacy tests (clinical and parasitological failure, %)
80
0
– – – – –
Year adopted
Medicine
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
ABER (%)
Population (%)
2008
USAID/PMI
100
Positivity rate (%)
Yes/ Year No adopted
Sources of financing
2002
Government
Policies/strategies
2008
Cases (P. vivax)
2009
2010
2011
2012
1 200 1 000 800 600 400 200 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
16 14 12 10 8 6 4 2 0
Deaths
Contribution (US$m)
III. Financing
Intervention
Admissions (P. vivax) Deaths (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 193
Venezuela (Bolivarian Republic of )
Region of the Americas Proportion of cases due to P. falciparum
Confirmed cases per 1000 population Insufficient data
Insufficient data
0
no cases
0–0.1
Very low PP
0.1–1.0
0–20
1.0–10
20–40
10–50
40–60
50–100
60–80
≥100
80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
779 000 4 850 000 24 300 000 29 929 000
3 16 81
Major plasmodium species: Major anopheles species:
P. falciparum (25%), P. vivax (75%) An. darlingi, aquasalis, nuneztovari, braziliensis, albitarsis
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2005 2005
IRS
IRS is recommended DDT is used for IRS
Yes No
– –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
1936 1936
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes Yes
2004 – –
60 50 40 30 20 10 0
2000
2001
2003
2004
Global Fund
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes Yes No No No
Antimalaria treatment policy
2006
2007
– – – –
Medicine
– Year
Min
Max
Follow-up No. of studies Species
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
2012
Others
Coverage of ITNs and IRS
No data reported for 2012
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2000
2001
2002
10
80
8
60
6
40
4
20
2 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
0 2012
2002
2003
2004
2005
Cases (all species)
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2001
2005
100
Confirmed cases (per 1000)
2000
2004
Proportion of malaria cases due to P. vivax
100
2001
2003
Suspected cases tested P. vivax cases potentially treated with primaquine
Malaria test positivity rate and ABER
V. Impact
0 2000
0
2012
At high risk protected with IRS All ages who slept under an ITN
Cases due to P. vivax (%)
2000
At high risk protected with ITNs Households with at least one ITN
Total cases per 1000
Median
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
100
2.0 1.6 1.2 0.8 0.4 0
– – AL+MQ+PQ 2004 QN+CL; QN+D; QN+T 2004 AM; QN 2004 CQ+PQ(14d) 2004 0.25 mg/kg (14 days)
Type of RDT used
100
0
Year adopted
Medicine
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
– – – – –
Therapeutic efficacy tests (clinical and parasitological failure, %)
ABER (%)
Population (%)
2005
World Bank
IV. Coverage
Positivity rate (%)
Yes/ Year No adopted
Sources of financing
2002
Government
Policies/strategies
2008
Cases (P. vivax)
Impact: Increase in incidence 2000–2012
194 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
1.0 0.8 0.6 0.4 0.2 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
45 40 35 30 25 20 15 10 5 0
Deaths
Contribution (US$m)
III. Financing
Yes No Yes No
Intervention
Viet Nam
Western Pacific Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
15 900 000 18 100 000 56 800 000 90 800 000
18 20 63
Major plasmodium species: Major anopheles species:
P. falciparum (63%), P. vivax (37%) An. minimus, dirus, sundaicus, maculatus, sinensis
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
1992 1992
IRS
IRS is recommended DDT is used for IRS
Yes No
1958 –
Larval control Use of larval control
No
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
1958 1958
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes Yes
2003 – 2003
Yes No Yes Yes
1960 – – 1980
Contribution (US$m)
III. Financing 14 12 10 8 6 4 2 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes Yes No No No
Antimalaria treatment policy First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
2003
2004
Global Fund
2005
2006
World Bank
2007
2008
USAID/PMI
1958 1958 – – –
Year adopted
Medicine
– 2009 DHA-PPQ 2009 AS+MQ; QN 2002 AS; QN 2002 CQ+PQ(14d) 2002 0.25 mg/kg (14 days) P.f + P.v specific (Combo)
Therapeutic efficacy tests (clinical and parasitological failure, %) Medicine
Year
Min
Median
Max
DHA-PPQ
2001–2010
0
0
6.1
Sources of financing
2002
Government
Intervention
Follow-up No. of studies Species 28 days
14
Expenditure by intervention in 2012
2009
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, WHO
Coverage of ITNs and IRS
80
80 Cases (%)
100
60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact 100 80 60 40 20 10 0 2000
2007
2008
2009
2010
2011
0
2012
2000
At high risk protected with IRS All ages who slept under an ITN
At high risk protected with ITNs Households with at least one ITN
2001
2002
Malaria test positivity rate and ABER
2001
2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
RDT positivity rate
2009
2003
2010
2011
Admissions
Cases per 1000
0.4 0.2 2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Malaria admissions and deaths
0.6
Cases (all species)
2007
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
Slide positivity rate
0.8
2001
2006
100
Confirmed cases (per 1000)
2000
2005
Proportion of malaria cases due to P. vivax 14 12 10 8 6 4 2 0 2012
1.0
0
2004
Suspected cases tested P. falciparum cases potentially treated with ACT
2008
Cases (P. vivax)
2009
2010
2011
2012
70 000 60 000 50 000 40 000 30 000 20 000 10 000 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
160 140 120 100 80 60 40 20 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
Cases tested and potentially treated (public sector)
100
ABER (%)
Population (%)
IV. Coverage
Admissions (P. vivax) Deaths (P. vivax)
Impact: On track for >75% decrease in incidence 2000–2015
WORLD MALARIA REPORT 2013 | 195
Yemen
Eastern Mediterranean Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
Based on 2011 reported data
Based on 2011 reported data
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
10 300 000 5 350 000 8 180 000 23 830 000
43 22 34
Major plasmodium species: Major anopheles species:
P. falciparum (99%), P. vivax (1%) An. arabiensis, culicifacies, sergentii
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2002 2009
IRS
IRS is recommended DDT is used for IRS
Yes No
2001 –
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
N/A
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2001 2002
Treatment
ACT is free for all ages in public sector Yes Artemisinin-based monotherapies withdrawn Yes Single dose of primaquine (0.25 mg base/kg) is used as gametocidal – medicine for P. falciparum Primaquine is used for radical treatment of P. vivax Yes G6PD test is a requirement before treatment with primaquine – Directly observed treatment with primaquine is undertaken – System for monitoring of adverse reaction to antimalarials exists –
2009 2009 –
Contribution (US$m)
III. Financing 18 16 14 12 10 8 6 4 2 0
2000
2001
Policies/strategies
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
– – – – –
Medicine
Year adopted
AS+SP AS+SP AL AM; QN CQ+PQ(14d)
2009 2009 2009 2009 –
Antimalaria treatment policy
0.25 mg/kg (14 days) –
Type of RDT used
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine AS+SP
Year
Min
Median
Max
2007–2011
0
0
1.5
Sources of financing
2002
Government
Yes/ Year No adopted
Intervention
Follow-up No. of studies Species 28 days
P. f
6
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, Other Bilaterals, Other
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
7 6 5 4 3 2 1 0 2012
2001
2002
2003
Cases per 1000
Cases (all species)
2004
2005
2006
2007
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths
Admissions 2000
2005
100
Confirmed cases (per 1000) 5 4 3 2 1 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) Households with at least one ITN
2008
Cases (P. vivax)
Impact: Insufficiently consistent data to assess trends
196 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
3 500 3 000 2 500 2 000 1 500 1 000 500 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
100 80 60 40 20 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: MIS 2009
ABER (%)
Population (%)
100
Zambia
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
13 900 000 0 0 13 900 000
100 0 0
Parasites and vectors P. falciparum (100%), P. vivax (0%) An. gambiae, funestus, arabiensis
Major plasmodium species: Major anopheles species:
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
– –
IRS
IRS is recommended DDT is used for IRS
Yes Yes
– –
Larval control Use of larval control
–
–
IPT
IPT used to prevent malaria during pregnancy
Yes
–
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
– –
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2003 2003 –
Contribution (US$m)
III. Financing 70 60 50 40 30 20 10 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
– – – No No
Antimalaria treatment policy
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
Medicine
Year adopted
AL AL QN QN –
2002 2002 2002 2002 –
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
–
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine AL
Year
Min
Median
Max
2005–2009
0
0
6.7
Sources of financing
2002
Government
No No No Yes
Intervention
Follow-up No. of studies Species 28 days
P. f
7
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, PMI/ USAID, World Bank, UNICEF, WHO, Other
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
80
30
60
20
40
10
20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
0 2012
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
Cases per 1000
2006
2007
2008
2009
2010
2011
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Slide positivity rate
Malaria admissions and deaths (100 000)
Admissions 2000
2005
100
Confirmed cases (per 1000) 20 16 12 8 4 0
2004
Proportion of malaria cases due to P. vivax 40
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
2009
2010
2011
2012
3 500 3 000 2 500 2 000 1 500 1 000 500 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
2010
2011
2012
100 80 60 40 20 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: DHS 2002, DHS 2007
ABER (%)
Population (%)
100
Admissions (P. vivax) Deaths (P. vivax)
Impact: 50%–75% decrease in incidence projected 2000–2015
WORLD MALARIA REPORT 2013 | 197
Zimbabwe
African Region Proportion of cases due to P. falciparum
Confirmed cases per 1000 population/ Parasite prevalence (PP)
Insufficient data no cases
Insufficient data 0
Very low PP
0–0.1 0.1–1.0 1.0–10 PP
0–20 20–40 40–60
>75 0
60–80 80–100
I. Epidemiological profile Population (UN Population Division) High transmission (>1 case per 1000 population) Low transmission (0–1 cases per 1000 population) Malaria-free (0 cases) Total
2012
%
Parasites and vectors
6 510 000 0 6 510 000 13 020 000
50 0 50
Major plasmodium species: Major anopheles species:
P. falciparum (100%), P. vivax (0%) An. arabiensis, gambiae, funestus
Programme phase: Control
II. Intervention policies and strategies Intervention
Policies/strategies
Yes/ Year No adopted
ITN
ITNs/LLINs distributed free of charge ITNs/LLINs distributed to all age groups
Yes Yes
2009 2009
IRS
IRS is recommended DDT is used for IRS
Yes Yes
1947 2004
Larval control Use of larval control
Yes
–
IPT
IPT used to prevent malaria during pregnancy
Yes
1997
Diagnosis
Patients of all ages should receive diagnostic test Malaria diagnosis is free of charge in the public sector
Yes Yes
2008 2008
Treatment
ACT is free for all ages in public sector Artemisinin-based monotherapies withdrawn Single dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparum Primaquine is used for radical treatment of P. vivax G6PD test is a requirement before treatment with primaquine Directly observed treatment with primaquine is undertaken System for monitoring of adverse reaction to antimalarials exists
Yes Yes No
2008 – –
Contribution (US$m)
III. Financing 35 30 25 20 15 10 5 0
2000
2001
Policies/strategies
Yes/ Year No adopted
Surveillance
ACD for case investigation (reactive) ACD at community level of febrile cases (pro-active) Mass screening is undertaken Uncomplicated P. falciparum cases routinely admitted Uncomplicated P. vivax cases routinely admitted
Yes Yes Yes Yes Yes
Antimalaria treatment policy
2003
2004
Global Fund
2005
2006
World Bank
2007
– – – – –
Medicine
Year adopted
AL AL QN QN –
2004 2004 2004 2004 –
First-line treatment of unconfirmed malaria First-line treatment of P. falciparum For treatment failure of P. falciparum Treatment of severe malaria Treatment of P. vivax Dosage of primaquine for radical treatment of P. vivax Type of RDT used
–
Therapeutic efficacy tests (clinical and parasitological failure, %)
– – – –
Medicine AL
Year
Min
Median
Max
2006–2008
0
0.95
8.1
Sources of financing
2002
Government
No No No Yes
Intervention
Follow-up No. of studies Species 28 days
P. f
12
Expenditure by intervention in 2012
2008
2009
USAID/PMI
2010
2011
WHO/UNICEF
Insecticides & spray materials ITNs Diagnostic testing Antimalarial medicines Monitoring and evaluation Human resources & technical assistance Management and other costs
2012
Others
Funding source(s): Government, Global Fund, PMI/ USAID, Other Bilaterals, UNICEF, Other
IV. Coverage
Coverage of ITNs and IRS
Cases tested and potentially treated (public sector) 80 Cases (%)
80 60 40 20
60 40 20
2001
2002
2003
2004
2005
2006
V. Impact
2007
2008
2009
2010
2011
2000
2001
2002
Malaria test positivity rate and ABER
60 40 20 2002
2003
2004
ABER (Micr. & RDT)
2005
2006
2007
2008
2009
RDT positivity rate
2010
2011
12 10 8 6 4 2 0 2012
2006
2007
2008
2009
2010
2011
80 60 40 20 0
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2001
2002
2003
Cases (all species)
2004
2005
2006
2007
2012
Malaria admissions and deaths (100 000) 400
2000
2012
Cases potentially treated with any antimalarial P. vivax cases potentially treated with primaquine
Slide positivity rate
Admissions
Cases per 1000
2005
100
Confirmed cases (per 1000) 30 25 20 15 10 5 0
2004
Proportion of malaria cases due to P. vivax
80
2001
2003
Suspected cases tested P. falciparum cases potentially treated with ACT
100
0 2000
0
2012
At risk protected with IRS All ages who slept under an ITN
With access to an ITN (model) With access to an ITN (survey)
2008
Cases (P. vivax)
Impact: Insufficiently consistent data to assess trends
198 | WORLD MALARIA REPORT 2013
2009
2010
2011
2012
300 200 100 0 2000
2001
2002
2003
2004
Admissions (all species) Deaths (all species)
2005
2006
2007
2008
2009
Admissions (P. vivax) Deaths (P. vivax)
2010
2011
2012
18 16 14 12 10 8 6 4 2 0
Deaths
2000
Cases due to P. vivax (%)
0
Positivity rate (%)
100
Source: DHS 2006, MIS 2009, DHS 2011
ABER (%)
Population (%)
100
