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WORLD MALARIA REPORT 2013 | 91 Country profiles Afghanistan 99 Algeria 100 Angola 101 Argentina 102 Azerbaijan 103 Bangladesh 104 Belize 105 Benin 106 Bhutan 107 Bolivia (Plurinational State of ) 108 Botswana 109 Brazil 110 Burkina Faso 111 Burundi 112 Cambodia 113 Cameroon 114 Cabo Verde 115 Central African Republic 116 Chad 117 China 118 Colombia 119 Comoros 120 Congo 121 Costa Rica 122 Côte d’Ivoire 123 Democratic People’s Republic of Korea 124 Democratic Republic of the Congo 125 Djibouti 126 Dominican Republic 127 Ecuador 128 El Salvador 129 Equatorial Guinea 130 Eritrea 131 Ethiopia 132 French Guiana, France 133 Gabon 134 Gambia 135 Ghana 136 Guatemala 137 Guinea 138 Guinea-Bissau 134 Guyana 135 Haiti 136 Honduras 137 India 138 Indonesia 139 Iran (Islamic Republic of ) 140 Kenya 141 Kyrgyzstan 142 Lao People’s Democratic Republic 143 Liberia 144 Madagascar 145 Malawi 146 Malaysia 147 Mali 148 Mauritania 149 Mayotte 150 Mexico 151 Mozambique 152 Myanmar 153 Namibia 154 Nepal 155 Nicaragua 156 Niger 157 Nigeria 158 Pakistan 159 Panama 160 Papua New Guinea 161 Paraguay 162 Peru 163 Philippines 164 Republic of Korea 165 Rwanda 166 Sao Tome and Principe 167 Saudi Arabia 168 Senegal 169 Sierra Leone 170 Solomon Islands 171 Somalia 172 South Africa 173 Sri Lanka 174 South Sudan 175 Sudan 176 Suriname 177 Swaziland 178 Tajikistan 179 Thailand 180 Democratic Republic of Timor-Leste 181 Togo 182 Turkey 183 Uganda 184 United Republic of Tanzania (Mainland) 185 United Republic of Tanzania (Zanzibar) 186 Uzbekistan 187 Vanuatu 188 Venezuela (Bolivarian Republic of ) 189 Viet Nam 190 Yemen 191 Zambia 192 Zimbabwe 193
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Page 1: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

WORLD MALARIA REPORT 2013 | 91

Country profi les

Afghanistan 99

Algeria 100

Angola 101

Argentina 102

Azerbaijan 103

Bangladesh 104

Belize 105

Benin 106

Bhutan 107

Bolivia (Plurinational State of ) 108

Botswana 109

Brazil 110

Burkina Faso 111

Burundi 112

Cambodia 113

Cameroon 114

Cabo Verde 115

Central African Republic 116

Chad 117

China 118

Colombia 119

Comoros 120

Congo 121

Costa Rica 122

Côte d’Ivoire 123

Democratic People’s Republic of Korea 124

Democratic Republic of the Congo 125

Djibouti 126

Dominican Republic 127

Ecuador 128

El Salvador 129

Equatorial Guinea 130

Eritrea 131

Ethiopia 132

French Guiana, France 133

Gabon 134

Gambia 135

Ghana 136

Guatemala 137

Guinea 138

Guinea-Bissau 134

Guyana 135

Haiti 136

Honduras 137

India 138

Indonesia 139

Iran (Islamic Republic of ) 140

Kenya 141

Kyrgyzstan 142

Lao People’s Democratic Republic 143

Liberia 144

Madagascar 145

Malawi 146

Malaysia 147

Mali 148

Mauritania 149

Mayotte 150

Mexico 151

Mozambique 152

Myanmar 153

Namibia 154

Nepal 155

Nicaragua 156

Niger 157

Nigeria 158

Pakistan 159

Panama 160

Papua New Guinea 161

Paraguay 162

Peru 163

Philippines 164

Republic of Korea 165

Rwanda 166

Sao Tome and Principe 167

Saudi Arabia 168

Senegal 169

Sierra Leone 170

Solomon Islands 171

Somalia 172

South Africa 173

Sri Lanka 174

South Sudan 175

Sudan 176

Suriname 177

Swaziland 178

Tajikistan 179

Thailand 180

Democratic Republic of Timor-Leste 181

Togo 182

Turkey 183

Uganda 184

United Republic of Tanzania (Mainland) 185

United Republic of Tanzania (Zanzibar) 186

Uzbekistan 187

Vanuatu 188

Venezuela (Bolivarian Republic of ) 189

Viet Nam 190

Yemen 191

Zambia 192

Zimbabwe 193

Page 2: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

92 | WORLD MALARIA REPORT 2013

This section describes the methods used for preparing

country profi les. These methods also apply to other

sections of the report.

C.1.1 Maps

Confi rmed cases per 1000 population

The epidemiological maps for each country shown in the

country profi les are based on the number of confi rmed cases

per 1000 population in 2012 (the working defi nition 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 <100 cases

■ >10 cases per 1000 population per year but <50 cases

■ >1 cases per 1000 population per year but <10 cases

■ >0.1 cases per 1000 population per year but <1 cases

■ >0 cases per 1000 population per year but <0.1 cases

■ 0 recorded cases.

The fi rst four categories correspond to the high-transmission

category defi ned below. Case incidence rates for 2012 do not

necessarily refl ect 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 modifi cations to administrative bound-

aries, or the use of names not verifi able by WHO.

The maps for countries in sub-Saharan Africa display a combina-

tion 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 para-

site rates (1, 2) was calculated at each point (~5 km2). Data on

environmental suitability for malaria transmission were used to

identify areas

that would be free of malaria.

Proportion of cases due to P. falciparum

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 <80% P. falciparum

■ 10% to <50% P. falciparum

■ >0% to <10% P. falciparum

■ 0% cases due to P. falciparum.

If no data are available for a subnational geographical area, or

there is an insuffi cient number of cases to calculate a reliable

proportion, the area is highlighted as such.

C.1.2 Epidemiological profi le

Population

The total population of each country is taken from 2012 revision

of the World population prospects (3). The country population is

subdivided into three levels of malaria endemicity, as reported

by the national malaria control programme (NMCP):

1 Areas of high transmission, where the reported incidence of

confi rmed malaria due to all species was >1 per 1000 popula-

tion 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.

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 envi-

ronmental factors that are unfavourable for malaria transmis-

sion, or they may become malaria free as a result of eff ective

control eff orts. In practice, malaria-free areas can be accu-

rately 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 popula-

tion 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 defi ned by the countries, based

on the resident populations in foci where active malaria

transmission occurs.

Parasites and vectors

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 offi ces. 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

confi rmed malaria cases.

C.1.3 Intervention policies and strategies

Intervention policy

The policies and strategies adopted by each country for malaria

prevention, diagnosis and treatment may vary according to the

epidemiological setting, socioeconomic factors and the capacity

C.1 Methods for preparing country profi les

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WORLD MALARIA REPORT 2013 | 93

of the NMCP or the country’s health system. Adoption of poli-

cies does not necessarily imply immediate implementation, nor

does it indicate full, continuous implementation nationwide.

Antimalarial treatment policy

Antimalarial treatment policies are shown, together with the

results of recent therapeutic effi cacy tests (where these are avail-

able). Data on therapeutic effi cacy were extracted from the WHO

global database on antimalarial drug effi cacy, and they originate

from three main sources: published data, unpublished data and

regular monitoring data from surveillance studies conducted

according to the WHO standard protocol. The percentage of

treatment failures is equal to the total number of failures (early

treatment failures plus late clinical failures plus late parasitological

failures), divided by the total number of patients who completed

the study follow-up. The number of studies included in the anal-

ysis and the years during which the studies were conducted are

shown for each antimalarial medicine. The minimum, median and

maximum describe the range of treatment failures observed in

the studies for each antimalarial medicine.

C.1.4 Financing

Sources of fi nancing

The data shown are those reported by the programme. The

fi rst graph shows fi nancial contributions by source or name of

agency, by year. The government contribution is usually the

declared government expenditure for the year. In cases where

government expenditure was not reported by the programme,

the government budget was used. External contributions are

contributions allocated to the programme by external agencies,

but these may or may not be disbursed. Additional information

about contributions from specifi c donor agencies, as reported

by these agencies, is given in Annex 2. All countries were asked

to convert their local currencies to US$.

Expenditure by intervention in 2012

The pie chart shows the proportion of malaria funding from

all sources that was spent on the following activities in 2012:

insecticide-treated nets (ITNs), insecticides and spraying mate-

rials, indoor residual spraying (IRS), diagnosis, antimalarial medi-

cines, monitoring and evaluation, human resources, technical

assistance and management. There may be diff erences in the

completeness of data, and the listed expenditures on activities

may not include all items of expenditure. For example, govern-

ment expenditures usually only include expenditures specifi c to

malaria control, but do not take into account costs related to

maintaining health systems, human resources and so on.

C.1.5 Coverage

Coverage of ITNs and IRS

Household surveys

The percentage of the population with access to an ITN in their

household and the percentage of people who sleep under an

ITN are taken from nationally representative household surveys,

such as multiple indicator cluster surveys (MICS), demographic

and health surveys (DHS), and malaria indicator surveys (MIS).

Other available national surveys were also included. The results

of subnational surveys undertaken to support local project

implementation are diffi cult to interpret nationwide (and

are therefore not presented in the profi les), but they can be

useful for assessing progress locally. Many of these surveys are

conducted during the dry season (for logistic reasons), and

actual rates of ITN use of nets may be higher during the time of

peak malaria transmission.

■ Proportion of population with access to an ITN within their

household – an indicator to measure the proportion of house-

holds that have a suffi cient number of ITNs to cover all indi-

viduals who spent the previous night in surveyed households,

assuming each ITN is shared by two people. This is labelled as

“With access to an ITN in household” in the graphs.

■ Proportion of population who slept under an ITN the previous

night – an indicator to provide a direct measure of ITN use by

all age groups at the time a survey is conducted. It is labelled

as “All ages who slept under an ITN” in the graphs.

Modelled estimates

For high-burden countries in the African Region, a model was

used to estimate the proportion of the population with access

to an ITN within their household for years in which household

survey results are not available. The model takes into account

data from three sources: household surveys, the number of ITNs

delivered by manufacturers to a country, and the number of

ITNs distributed by NMCPs (Section 4.1) (4). For years in which

survey results are available, the estimates of the model are close

to those of the survey. For years in which household survey

results are not available, the model uses data on ITNs procured

from manufacturers and distributed by NMCPs, to estimate the

change in coverage between survey years.

■ Programme data: For countries in WHO regions other than the

African Region, nationally representative surveys are usually

not undertaken frequently enough to allow assessment of

trends in intervention coverage or to provide contemporary

information. Therefore, ITN coverage is estimated using data

on the number of ITNs distributed by malaria programmes.

The information is used to estimate the proportion of the

population potentially protected with ITNs, as described

below.

■ Proportion of population potentially protected with ITNs –

calculated as the number of ITNs distributed multiplied by 1.8

(a ratio of one ITN for every two persons, but allowing for only

one person sleeping under some ITNs in households with an

odd number of inhabitants) divided by the population at high

risk. This is labelled as “At high risk protected with ITNs” in the

graphs.

Long-lasting insecticidal nets (LLINs) are considered to have an

average useful lifespan of 3 years; hence, the cumulative total

of mosquito nets distributed over the past consecutive 3 years

is taken as the number of ITNs available for any particular year.

Other ITNs are considered to have an average lifespan of 1 year,

but some nets will be eff ective for longer if re-treated with insec-

ticide. Therefore, the numerator for LLINs and ITNs is the sum of

the cumulative LLINs distributed in the most recent 3 years, plus

the number of ITNs distributed and re-treated during the most

recent year. Outside Africa, the population at high risk is used as

the denominator for vector control coverage; this is because the

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94 | WORLD MALARIA REPORT 2013

population at low risk is often at very low risk, and it is not clear

whether ITNs or IRS are needed by the entire population.

Programme data are also used to calculate the following indi-

cator:

■ Proportion of the population at risk protected by IRS – calcu-

lated as the number of people living in a household where IRS

has been applied during the preceding 12 months, divided

by the population at risk (the sum of populations living in

low- and high-transmission areas), multiplied by 100. For

areas outside Africa, the population at high risk is used as the

denominator.

Programme data are the most important source of informa-

tion for estimating IRS coverage, because household surveys

do not generally include questions on IRS. In addition, IRS is

often carried out on a limited geographical scale, and nationally

representative household surveys may not provide an adequate

sample size within targeted areas to allow coverage to be

measured accurately.

The percentage of people protected by IRS is a measure of the

extent to which IRS is implemented and the extent to which the

population at risk benefi ts from IRS nationwide. The data show

neither the quality of spraying nor the geographical distribution

of IRS coverage in a country.

Cases tested and artemisinin-based combination therapy

(ACT) delivered

The following indicator on access to diagnostic testing is calcu-

lated:

■ The proportion of suspected cases attending public health

facilities that receive a diagnostic test – the number of

suspected cases examined by microscopy or by rapid diag-

nostic test (RDT), divided by the total number of suspected

malaria cases, multiplied by 100. This indicator refl ects

the extent to which a programme can provide diagnostic

services to patients attending public health facilities. It does

not consider patients attending privately run health facilities,

and therefore does not refl ect the experience of all patients

seeking treatment. In many situations, health facilities in the

private sector are less likely to provide a diagnostic test than

those in the public sector. The indicator may also be biased if

those health facilities that provide a diagnostic test (e.g. hospi-

tals) are more likely than others to submit monthly reports.

Few countries have information systems that are able to record

the treatments given to individual patients. Instead, programme

data on the numbers of antimalarial medicines distributed

by the programmes are used to calculate proxy indicators for

access to treatment. Three indicators are calculated:

■ Proportion of malaria cases potentially treated with any anti-

malarial in the public sector – the number of antimalarial treat-

ment courses delivered, divided by the number of estimated

malaria cases in public health facilities, multiplied by 100.

■ Proportion of P. falciparum malaria cases potentially treated

with ACT in the public sector – the number of ACT courses

delivered, divided by the number of estimated P. falciparum

malaria cases in the public sector, multiplied by 100.

Proportion of P. vivax malaria cases potentially treated with

primaquine in the public sector – the number of ACT courses

delivered, divided by the number of estimated P. falciparum

malaria cases in the public sector, multiplied by 100.

These indicators can provide information on whether the malaria

control programme delivers suffi cient antimalarial medicines to

treat all malaria patients who seek treatment in the public sector.

For high-transmission countries in the African Region, the esti-

mated number of cases attending public sector health facilities

is used as a denominator. For other countries, the denominator

is the number of confi rmed cases plus the number of presumed

cases, adjusted for reporting completeness.

C.1.6 Impact

Malaria test positivity rate and annual blood examination

rate

The following indicators are presented to help interpret

observed trends:

■ Annual blood examination rate (ABER) – the number of para-

sitological tests (by microscopy or RDT) undertaken per 100

people at risk per year.

■ Slide positivity rate (SPR) – the number of microscopically

positive cases divided by the total number of slides examined,

multiplied by 100.

■ RDT positivity rate – the number of positive RDT tests divided

by the total number of RDT tests carried out, multiplied by

100.

The ABER provides information on the extent of diagnostic

testing in a population, and completeness of reporting of

health facilities, and is useful to take into account when inter-

preting trends in confi rmed cases (see Section A.1.6). To discern

decreases in malaria incidence, the ABER should ideally remain

constant or be increased.

RDT and SPRs are derived from the number of parasitologically

positive cases per 100 cases examined by RDT or microscopy.

They measure the prevalence of malaria parasites among people

who seek care and are examined in health facilities. Trends in

these indicators may be less distorted by variations in the ABER

than trends in the number of confi rmed cases.

Proportion of cases due to P. vivax

■ Proportion of cases due to P. vivax – The total number of cases

due to P. vivax, divided by the total number of positive cases.

Confi rmed cases, admissions and deaths

Where available, the numbers of confi rmed malaria cases,

admissions and deaths are shown, to provide information on

trends in malaria. The numbers of confi rmed cases, admissions

and deaths are derived from case reports divided by the popu-

lation at risk, multiplied by 100 000. These indicators are useful

in assessing changes in the incidence of malaria over the years,

provided that there has been consistency in case reporting

over time. The numbers of cases, admissions and deaths due to

P. vivax among total confi rmed cases are also presented; these

are useful in assessing changes in in the incidence of this para-

site over time. For countries in the pre-elimination or elimination

phases, the total number of indigenous cases (acquired within

the country) and imported cases are also plotted.

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WORLD MALARIA REPORT 2013 | 95

C.1.7 Assessing trends in the incidence of malaria

Assessing whether data are suffi ciently reliable to assess

trends in case incidence

The reported numbers of malaria cases and deaths are used

as core indicators for tracking the progress of malaria control

programmes (5). The main sources of information on these indi-

cators are the disease surveillance systems operated by minis-

tries of health. Data from such systems have three strengths: (i)

case reports are recorded continuously over time and can thus

refl ect changes in the implementation of interventions or other

factors; (ii) routine case and death reports are often available

for all geographical units of a country; and (iii) the data refl ect

the burden that malaria places on the health system. Changes

in the numbers of cases and deaths reported by countries do

not, however, necessarily refl ect changes in the incidence of

disease in the general population, because (i) not all health facil-

ities report each month, and so variations in case numbers may

refl ect fl uctuations in the number of health facilities reporting

rather than a change in underlying disease incidence; (ii) routine

reporting systems often do not include patients attending

private clinics or morbidity treated at home, so disease trends in

health facilities may not refl ect trends in the entire community;

and (iii) not all malaria cases reported are confi rmed by micros-

copy or RDT, so that some of the cases reported as malaria may

actually be other febrile illnesses (5, 6). When reviewing data

supplied by ministries of health in malaria-endemic countries,

the following strategy was used to minimize the infl uence of

these sources of error and bias:

■ Focusing on confi rmed cases (by microscopy or RDT) to

ensure that malaria (not other febrile illnesses) is tracked. For

high-burden countries in the African Region, where there is

little confi rmation of cases, the numbers of malaria admis-

sions (inpatient cases) and deaths are reviewed, because the

predictive value of diagnosis undertaken for an admitted

patient is considered to be higher than that of an outpatient

diagnosis based only on clinical signs and symptoms. In such

countries, the analysis may be heavily infl uenced by trends in

severe malaria rather than trends in all cases.

■ Monitoring the number of laboratory tests undertaken. It is

useful to measure the ABER, to ensure that potential diff er-

ences in diagnostic eff ort or completeness of reporting are

taken into account. To discern decreases in malaria incidence,

the ABER should ideally remain constant or be increased.1 In

countries progressively reducing their malaria endemicity, the

population at risk also reduces, becoming limited to active and

residual foci where malaria transmission is present, or where

there is potentially a high risk due to receptivity. In addition,

it is useful to monitor the percentage of suspected malaria

cases that were examined with a parasite-based test. When

reviewing the number of malaria admissions and deaths, the

1 Some authorities recommend that the ABER should exceed 10%, to en-

sure that all febrile cases are examined; however, the observed rate de-

pends partly on how the population at risk is estimated, and trends may

still be valid if the rate is <10%. Some authorities have noted that a value of

10% may not be suffi cient to detect all febrile cases. It is noteworthy that

the ABER in the Solomon Islands, a highly endemic country, exceeds 60%,

with an SPR of 25%, achieved solely through passive case detection.

health-facility reporting rate (the proportion of health facili-

ties that report) should remain constant and should be high

(i.e. >80%).

■ Monitoring trends in the SPR or RDT positivity rate. This rate

should be less severely distorted by variations in the ABER

than trends in the number of confi rmed cases.

■ Monitoring malaria admissions and deaths. For high-burden

African countries, when the number of malaria admissions or

deaths is being reviewed, it is also informative to examine the

percentage of admissions or deaths due to malaria, because

this proportion is less sensitive to variation in reporting rates

than the number of malaria admissions or deaths.

■ Monitoring the number of cases detected in the surveillance

system in relation to the total number of cases estimated to

occur in a country.2 Trends derived from countries with high

case detection rates are more likely to refl ect trends in the

broader community. When examining trends in the number

of deaths, it is useful to compare the total number of deaths

occurring in health facilities with the total number of deaths

estimated to occur in the country.

■ Examining the consistency of trends. Unusual variation in

the number of cases or deaths, which cannot be explained

by climate or other factors, or inconsistency between trends

in cases and in deaths, can suggest defi ciencies in reporting

systems.

■ Monitoring changes in the proportion of cases due to P.

falciparum or the proportion of cases occurring in children

<5 years of age. Decreases in the incidence of P. falciparum

malaria may precede decreases in P. vivax malaria, and there

may be a gradual shift in the proportion of cases occurring

in children <5 years; however, unusual fl uctuations in these

proportions may point to changes in health-facility reporting

or to errors in recording.

The aim of these procedures is to rule out data-related factors

(e.g. incomplete reporting, or changes in diagnostic practice)

as explanations for a change in the incidence of disease, and

to ensure that trends in health-facility data refl ect changes in

the wider community. The conclusion that trends inferred

from health-facility data refl ect changes in the community has

more weight if (i) the changes in disease incidence are large;

(ii) coverage with public health services is high; and (iii) inter-

ventions promoting change, such as use of ITNs, are delivered

throughout the community rather than being restricted to

health facilities.

Establishing a link between malaria disease trends and

control activities

In attempting to establish a causal link between malaria disease

trends and control activities, one should consider what the

disease trends would have been without application of the

control activities, and then assess whether the decrease in

malaria observed is greater than that expected without control

activities (i.e. counterfactual). A realistic view of what would

2 The total number of malaria cases in a country can be estimated from the

number of reported cases, taking into account variations in health-facility

reporting rates, care-seeking behaviour for fever as recorded in household

surveys, and the extent to which suspected cases are examined with labo-

ratory tests (1).

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96 | WORLD MALARIA REPORT 2013

have happened without control activities cannot be estab-

lished from the data currently available to WHO. However, it

can be expected that,without a change in control activities,

malaria incidence might fl uctuate in response to short-term

climate variations, but would otherwise be unlikely to change

markedly, because factors such as improved living conditions,

environmental degradation or long-term climate change have

only gradual eff ects (although there may be local exceptions).

Thus, a plausible link with control eff orts can be established if

the disease incidence decreases at the same time as control

activities increase; if the magnitude of the decrease in malaria

incidence is consistent with the magnitude of the increase in

control activities (a 50% decrease in the number of cases is

unlikely to occur if malaria control activities cover only 10% of

the population at risk); and if the decreases in malaria incidence

cannot readily be explained by other factors.

C.1.8 Classifi cation of countries according to malaria programme phase

The criteria used to classify countries according to programme

phase were updated in 2012 to facilitate tracking of progress

over time (7). The updated criteria are based on an evaluation of

three main components: the malaria epidemiological situation,

case-management practices, and the state of the surveillance

system (as shown in Table A.1).3 The evaluation concentrates

on the situation in those districts of the country reporting the

highest annual parasite index (API).

C.1.9 Estimates of malaria cases and deaths 2000–2012

Surveillance systems do not capture all malaria cases occurring

in a country, and the data reported to WHO are not suffi ciently

reliable to assess trends in some countries. It is therefore neces-

sary to use estimates of the total number of cases or deaths for

some analysis included in country profi les and elsewhere in the

report. The methods for producing estimates either (i) adjust the

number of reported cases to take into account the proportion

of cases that are not captured by a surveillance system, or (ii)

for countries with insuffi cient surveillance data, produce esti-

mates using a modeled relationship between malaria transmis-

sion, case incidence or mortality and intervention vector control

coverage:

Cases

The number of malaria cases was estimated by one of two

methods.

(i) Countries outside the WHO African Region and low transmis-

sion countries in Africa: Estimates of the number of cases were

made by adjusting the number of reported malaria cases for

completeness of reporting, the likelihood that cases are para-

site-positive and the extent of health service use. The proce-

dure, which is described in the World Malaria Report 2008 (6, 8),

combines data reported by NMCPs (reported cases, reporting

completeness, likelihood that cases are parasite positive) with

3 Other components, such as (i) the stated programme goal; (ii) vector con-

trol and malaria prevention practices; and (iii) health systems and fi nanc-

ing, are also important for tracking progress towards elimination; however,

they are less specifi c and therefore not included as classifi cation criteria.

those obtained from nationally representative household

surveys on health service use. If data from more than one

household survey was available for a country, estimates of health

service use for intervening years were imputed by linear regres-

sion. If only one household survey was available then health

service use was assumed to remain constant over time; analysis

summarized in the World Malaria Report 2008 indicated that the

percentage of fever cases seeking treatment in public sector

facilities varies little over time in countries with multiple surveys.

Such a procedure results in an estimate with wide uncertainty

intervals around the point estimate.

(ii) Other countries in the WHO African Region. For some African

countries the quality of surveillance data did not permit a

convincing estimate to be made from the number of reported

cases. For these countries, an estimate of the number of malaria

cases was derived from an estimate of the number of people

living at high, low or no risk of malaria. Malaria incidence rates

for these populations are inferred from longitudinal studies of

malaria incidence recorded in the published literature. Incidence

rates are adjusted downward for populations living in urban

settings and the expected impact of ITN and IRS programmes.

The procedure was initially developed by the RBM Monitoring

and Evaluation Reference Group in 2004 (9) and also described

in World Malaria Report 2008.

Deaths

The number of malaria deaths was estimated by one of two

methods:

(i) Countries outside the WHO African Region and for low trans-

mission countries in Africa4. The number of deaths was esti-

mated by multiplying the estimated number of P. falciparum

malaria cases by a fi xed case fatality rate for each country as

described in the World Malaria Report 2008 (8). This method is

used for all countries outside the African Region and for coun-

tries within the African Region where estimates of case inci-

dence were derived from routine reporting systems and where

malaria causes less than 5% of all deaths in children under 5 as

described in the Global Burden of Disease 2004 update (10). A

case fatality rate of 0.45% is applied to the estimated number of

P. falciparum cases for countries in the African Region and a case

fatality rate of 0.3% for P. falciparum cases in other Regions. In

situations where the fraction of all deaths due to malaria is small,

the use of a case fatality rate in conjunction with estimates of

case incidence was considered to provide a better guide to the

levels of malaria mortality than attempts to estimate the fraction

of deaths due to malaria.

(ii) Other countries in the WHO African Region, and South Sudan

in the Eastern Mediterranean Region. Child malaria deaths were

estimated using a verbal autopsy multi-cause model (VAMCM)

developed by the WHO Child Health Epidemiology Reference

Group (CHERG) to estimate causes of death for children aged

1–59 months in countries with less than 80% of vital registration

coverage (11, 12, 13). The model was updated to include commu-

nity-based verbal autopsy (VA) studies published between June

4 Botswana, Cabo Verde, Eritrea, Madagascar, Namibia, Swaziland, South Af-

rica, and Zimbabwe

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WORLD MALARIA REPORT 2013 | 97

2, 2010 and May 27, 2013, as well as national VA surveys. A total

of 128 data points from 95 VA studies and 37 countries that

met the inclusion criteria5 were included. Among them 47 data

points were either new or updated from the previous estimates

of malaria deaths published in World Malaria Report 2012 (7) and

World Malaria Report 2012. Mortality estimates for seven causes

of post-neonatal death were derived, including pneumonia,

diarrhoea, malaria, meningitis, injuries, congenital malfor-

mations, causes arising in the perinatal period (prematurity,

birth asphyxia and trauma, sepsis and other conditions of the

newborn), and other causes. Malnutrition deaths were included

in the other cause of death category. Deaths due to measles,

unknown causes, and HIV/AIDS are estimated separately. The

resulting cause-specifi c estimates were adjusted country-by-

country to fi t the estimated 1-59 month mortality envelopes

(excluding HIV and measles deaths) for corresponding years and

then estimates were further adjusted for intervention coverage

(pneumonia and meningitis estimates adjusted for the use of

Haemophilus infl uenzae type b vaccine; malaria estimates were

adjusted for the use of insecticide treated mosquito nets (ITNs)).

The bootstrap method was employed to estimate uncertainty

intervals by re-sampling from the study-level data to estimate

the distribution of the predicted percentage of deaths due to

each cause. Deaths above fi ve years were inferred from a rela-

tionship between levels of malaria mortality in diff erent age

groups and the intensity of malaria transmission as described

by Ross et al (14); thus the estimated malaria mortality rate in

children under 5 years fi ve was used to infer malaria- specifi c

mortality in older age groups.

References

1 Gething PW, Patil AP, Smith DL, Guerra CA, Elyazar IR,

Johnston GL et al. A new world malaria map: Plasmodium

falciparum endemicity in 2010. Malaria Journal, 2011, 10:378.

2 Gething PW, Elyazar IR, Moyes CL, Smith DL, Battle KE, Guerra

CA et al. A long neglected world malaria map: Plasmodium

vivax endemicity in 2010. PLoS Negl Trop Dis, 2012, 6(9):e1814

(http://www.ncbi.nlm.nih.gov/pubmed/22970336, accessed

20 November 2013).

3 World population prospects. New York, United Nations (UN),

UN Population Division, 2012 (http://esa.un.org/wpp/,

accessed 24 November 2013).

4 Flaxman AD, Fullman N, Otten MW, Menon M, Cibulskis

RE, Ng M et al. Rapid scaling up of insecticide-treated bed

net coverage in Africa and its relationship with develop-

ment assistance for health: A systematic synthesis of supply,

distribution, and household survey data. PLoS Med, 2010,

7(8):e1000328.

5 Studies that were conducted in year 1980 or later, a multiple of 12 months

in study duration, cause of death available for more than a single cause,

with at least 25 deaths in children <5 years of age, each death represented

once, and less than 25% of deaths due to unknown causes were included.

Studies conducted in sub-groups of the study population (e.g. interven-

tion groups in clinical trials) and verbal autopsy studies conducted without

use of a standardized questionnaire or the methods could not be con-

fi rmed were excluded from the analysis.

5 Cibulskis RE, Bell D, Christophel EM, Hii J, Delacollette C,

Bakyaita N et al. Estimating trends in the burden of malaria at

country level. Am J Trop Med Hyg, 2007, 77(6 Suppl):133-137

(http://www.ncbi.nlm.nih.gov/pubmed/18165485, accessed.

6 Cibulskis RE, Aregawi M, Williams R, Otten M, Dye C. Worldwide

incidence of malaria in 2009: estimates, time trends, and a

critique of methods. PLoS Med, 2011, 8(12):e1001142 (http://

www.ncbi.nlm.nih.gov/pubmed/22205883, accessed.

7 World Malaria Report 2012. Geneva, World Health

Organization, 2012 (http://www.who.int/malaria/publica-

tions/world_malaria_report_2012/en/index.html, accessed

15 October 2013).

8 World Malaria Report 2008. Geneva, World Health

Organization, 2008 (WHO/HTM/GMP/2008.1).

9 Korenromp E. Malaria incidence estimates at country level

for the year 2004. Geneva, World Health Organization, 2005

(draft) (www.malariaconsortium.org/resources.php?action=

download&id=177).

10 Global burden of disease: 2004 update. Geneva, World Health

Organization, 2008 (http://www.who.int/healthinfo/global_

burden_disease/2004_report_update/en/index.html).

11 Liu L et al. Global, regional, and national causes of child

mortality: an updated systematic analysis for 2010 with time

trends since 2000, 2012, Lancet 2012, 379: 2151–2161.

12 Black RE et al. Global, regional and national causes of child

mortality, 2008, Lancet 2010, 375: 1969–1987.

13 Johnson H et al. Estimating the distribution of causes of child

deaths in high mortality countries with incomplete death

certifi cation. International Journal of Epidemiology, 2010,

39:1103–1114.

14 Ross A, Maire N, Molineaux L, Smith T. An epidemiologic

model of severe morbidity and mortality caused by plasmo-

dium falciparum. Am. J. Trop. Med. Hyg., 75(Suppl 2), 2006, pp.

63–73

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98 | WORLD MALARIA REPORT 2013

Table A.1 Criteria for classifying countries according to malaria programme phase

Pre-elimination Elimination Prevention of reintroduction

Malaria situation in areas with most intense transmission

(1) Recently endemic country with zero local transmission for at least 3 years; or (2) country on the register or supplementary list that has ongoing local transmissiona

Test positivity rate <5% among suspected malaria patients (PCD) throughout the year

API in the district with the highest number of cases/1000 population/year (ACD and PCD),b averaged over the past 2 years

<5 (i.e. fewer than 5 cases/1000 population)

<1 (i.e. fewer than 1 case/1000 population)

Total number of reported malaria cases nationwide

A manageable number, (e.g. <1000 cases, local and imported) nationwide

Case management Imported malaria. Maintain capacity to detect malaria infection and manage clinical disease

All cases detected in the private sector are microscopically confi rmed

National policy being rolled out Yes Yes

All cases detected in the public sector are microscopically confi rmed

National policy being rolled out Yes Yes

Nationwide microscopy quality assurance system covers public and private sector

Initiated Yes Yes

Radical treatment with primaquine for P. vivax

National policy being updated National policy fully implemented Yes

Treatment with ACT plus single-dose primaquine for P. falciparum

National policy being updated National policy fully implemented Yes

Surveillance Vigilance by the general health services

Malaria is a notifi able disease nationwide (< 24–48 hours)

Laws and systems being put in place

Yes Yes

Centralized register on cases, foci and vectors

Initiated Yes Yes

Malaria elimination database Initiated Yes Certifi cation process (optional)

Active case detection in groups at high risk or with poor access to services (“proactive” case detection)

Initiated Yes In residual and cleared-up foci, among high-risk population groups

Case and foci investigation and classifi cation (including “reactive” case detection and entomological investigation)

Initiated Yes Yes

ABER, annual blood examination rate; ACD, active case detection; API, annual parasite index; PCD, passive case detection

a) Ongoing local transmission = 2 consecutive years of local P. falciparum malaria transmission, or 3 consecutive years of local P. vivax malaria transmission, in

the same locality or otherwise epidemiologically linked.

b) The API has to be evaluated against the diagnostic activity in the risk area (measured as the ABER). Low values of ABER in a district raise the possibility that

more cases would be found with improved diagnostic eff orts.

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WORLD MALARIA REPORT 2013 | 99

Afghanistan Eastern Mediterranean Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

1210

86420

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Global Fund, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

Source: MIS 2009, MIS 2011

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

3.02.52.01.51.00.50

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

6 0005 0004 0003 0002 0001 000

0

Death

s

50

40

30

20

10

0

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

7 960 00015 100 000

6 730 00029 790 000

275123

Parasites and vectors

Major plasmodium species: P. falciparum (2%), P. vivax (98%)Major anopheles species: An. stephensi, superpictus, hyrcanus, pulcherrimus, culicifacies, fl uviatilis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

20

16

12

8

4

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20052010

IRS IRS is recommendedDDT is used for IRS

YesNo

2012–

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20002000

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

YesYesNoNo

20032003

20102010

––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

Yes––

NoNo

2012––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

CQAS+SP

QNAM+QN

CQ+PQ(8w)

–2004

–––

Dosage of primaquine for radical treatment of P. vivax –

Type of RDT used P.f only, PAN-only

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+SP 2005–2012 0 0 3.8 28 days 8 P. f

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Based on 2011 reported dataBased on 2011 reported data

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100 | WORLD MALARIA REPORT 2013

Algeria African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

120100

80604020

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNWith access to an ITN in householdAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

10

8

6

4

2

0

1.41.21.00.80.60.40.20

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

70605040302010

0

Indigenous cases (all species) Indigenous cases (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

Number of active fociNumber of people living within active fociNumber of people living in malaria-free areasTotal

122 800 00037 800 00060 600 000

3862

Parasites and vectors

Major plasmodium species: P. falciparum (81%), P. vivax (19%)Major anopheles species: An.labranchiae, multicolor, sergentii, hispaniola

Programme phase: Elimination

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

Total cases Imported cases

1 000

800

600

400

200

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Among total casesAmong indigenous cases

Malaria cases by source Indigenous malaria cases by species

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

NoNo

––

IRS IRS is recommendedDDT is used for IRS

YesNo

1980–

Larval control Use of larval control Yes –

IPT IPT used to prevent malaria during pregnancy – –

Diagnosis Patients of all ages should receive diagnostic testMalaria diagnosis is free of charge in the public sector

–Yes

–1968

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

––

Yes

YesNoYesNo

–––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admittedFoci and case investigation undertakenCase reporting from private sector is mandatory

YesNoNoYesYesYesYes

–––––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

––––

CQ

–––––

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: Increase in incidence 2000–2012

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 101

Angola African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

120100

80604020

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Global Fund, PMI/ USAID, Other Bilaterals

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: MIS 2007, MIS2011

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

181614121086420

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

2 500

2 000

1 500

1 000

500

0

Death

s

300250200150100500

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

20 800 00000

20 800 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, funestus, nili

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

100

80

60

40

20

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesNo

2001–

IRS IRS is recommendedDDT is used for IRS

YesNo

2010–

Larval control Use of larval control Yes –

IPT IPT used to prevent malaria during pregnancy Yes 2010

Diagnosis Patients of all ages should receive diagnostic testMalaria diagnosis is free of charge in the public sector

YesYes

20102014

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYes–

YesYesNoYes

20062005

–––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–YesYesNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

–––

QN–

2006200620062006

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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102 | WORLD MALARIA REPORT 2013

Argentina Region of the Americas

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

3.02.52.01.51.00.5

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

5

4

3

2

1

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

500

400

300

200

100

0

Indigenous cases (all species) Indigenous cases (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

Number of active fociNumber of people living within active fociNumber of people living in malaria-free areasTotal

0–

41 100 00041 100 000

100

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An.pseudopunctipennis, darlingi

Programme phase: Pre-elimination

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

Total cases Imported cases

500

400

300

200

100

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Among total casesAmong indigenous cases

Malaria cases by source Indigenous malaria cases by species

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

NoNo

––

IRS IRS is recommendedDDT is used for IRS

YesNo

––

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 testMalaria diagnosis is free of charge in the public sector

YesYes

–1980

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

Yes––

YesNoYesYes

–––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admittedFoci and case investigation undertakenCase reporting from private sector is mandatory

YesNoYesYesNoYesYes

–––––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AL––

CQ+PQ

–––––

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 103

Azerbaijan European Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

6543210

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

0.5

0.4

0.3

0.2

0.1

0

300250200150100500

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

1 8001 5001 200

900600300

0

Indigenous cases (all species) Indigenous cases (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

Number of active fociNumber of people living within active fociNumber of people living in malaria-free areasTotal

611 800

9 200 0009 211 800

100

Parasites and vectors

Major plasmodium species: P. falciparum (0%), P. vivax (100%)Major anopheles species: An.arabiensis, sergentii, funestus, bacroftii, albimanus, balabacensis

Programme phase: Elimination

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

Total cases Imported cases

1 8001 5001 200

900600300

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Among total casesAmong indigenous cases

Malaria cases by source Indigenous malaria cases by species

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesNo

2009–

IRS IRS is recommendedDDT is used for IRS

YesNo

1930–

Larval control Use of larval control Yes 1930

IPT IPT used to prevent malaria during pregnancy N/A –

Diagnosis Patients of all ages should receive diagnostic testMalaria diagnosis is free of charge in the public sector

–Yes

–1930

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

Yes–

No

YesNoYesYes

2009––

1956–

19561956

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admittedFoci and case investigation undertakenCase reporting from private sector is mandatory

YesYesNoYesYesYesYes

19301930

–1998

–19301930

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AS+SPQN+CLAS; QN

CQ+PQ(14d)

–––––

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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104 | WORLD MALARIA REPORT 2013

Bangladesh South-East Asia Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

201612

8640

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

4.03.53.02.52.01.51.00.50

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

6 0005 0004 0003 0002 0001 000

0

Death

s

7006005004003002001000

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

4 110 00011 900 000

139 000 000155 010 000

38

90

Parasites and vectors

Major plasmodium species: P. falciparum (91%), P. vivax (9%)Major anopheles species: An. dirus, minimus, philippinensis, sundaicus, albimanus, annularis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

0.70.60.50.40.30.20.1

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20082008

IRS IRS is recommendedDDT is used for IRS

YesNo

2008–

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20082008

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

YesNoNoYes

2008––

2008––

2008

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesYesNoNoNo

20082008

–––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

AS+–––

AM; QNCQ+PQ(14d)

–2004200420042004

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Type of RDT used P.f only, PAN-only

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

ALQN-D

2006–20102008–2009

00

00

20

28 days42 days

71

P. fP. f

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 105

Belize Region of the Americas

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

0.80.70.60.50.40.30.20.1

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, PMI/ USAID

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

1614121086420

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1816141210

86420

Death

s

5

4

3

2

1

0

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

0224 000100 000324 000

06931

Parasites and vectors

Major plasmodium species: P. falciparum (3%), P. vivax (97%)Major anopheles species: An. albimanus, darlingi

Programme phase: Control (Pre-elimination as of December 2013)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

76543210

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20092009

IRS IRS is recommendedDDT is used for IRS

YesNo

––

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 testMalaria diagnosis is free of charge in the public sector

YesYes

––

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

Yes–

Yes

YesNoYesNo

2010––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesNoYesNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–CQ+PQ

–QN

CQ+PQ(14d)

–––––

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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106 | WORLD MALARIA REPORT 2013

Benin African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

4540353025201510

50

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2006

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

121086420

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

900800700600500400300200100

0

Death

s

25

20

15

10

5

0

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

10 100 00000

10 100 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, funestus, melas

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

120100

80604020

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesNo

2007–

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20112008

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

NoYesNo

No–

NoYes

–2008

–––

2005

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–NoNoYesNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

–––

QN–

2004200420042004

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AL 2005–2009 0 0.75 6.5 28 days 4 P. f

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 107

Bhutan South-East Asia Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

2.01.61.20.80.4

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, WHO, Other

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

10

8

6

4

2

0

20

16

12

8

4

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

7 0006 0005 0004 0003 0002 0001 000

0

Indigenous cases (all species) Indigenous cases (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

Number of active fociNumber of people living within active fociNumber of people living in malaria-free areasTotal

–518 000729 000

1 247 000

4258

Parasites and vectors

Major plasmodium species: P. falciparum (43%), P. vivax (57%)Major anopheles species: An.maculatus, culicifacies, philippiensis, annularis

Programme phase: Pre-elimination

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

Total cases Imported cases

7 0006 0005 0004 0003 0002 0001 000

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Among total casesAmong indigenous cases

Malaria cases by source Indigenous malaria cases by species

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20062006

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

19641964

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesYes

YesNoNoYes

2006–

2012

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admittedFoci and case investigation undertakenCase reporting from private sector is mandatory

NoNoYesYesNoYesYes

––

2011––

20122012

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–––

AM; QNCQ+PQ(14d)

–N2006200620062006

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AL 2005–2011 0 0 0 28 days 23 P. f

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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108 | WORLD MALARIA REPORT 2013

Bolivia (Plurinational State of ) Region of the Americas

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

543210

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, PMI/ USAID

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

76543210

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

300250200150100

500

Death

s

121086420

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

504 0003 200 0006 790 000

10 494 000

53065

Parasites and vectors

Major plasmodium species: P. falciparum (5%), P. vivax (95%)Major anopheles species: An. darlingi, pseudopunctipennis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Total

case

s

Cases (all species) Cases (P. vivax)

35 00030 00025 00020 00015 00010 000

5 0000

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20082005

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20001996

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesNoYes

YesNoNoNo

2003––

1998–––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesNoYesNoNo

––

1998––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AS+MQ+PQ

QN+CLQN

CQ+PQ(14d)

–2001

–20012001

Dosage of primaquine for radical treatment of P. vivax 0.25mg/Kg (14 days)

Type of RDT used P.f + P.v specifi c (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 109

Botswana African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

2.0

1.5

1.0

0.5

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

2.5

2.0

1.5

1.0

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1 2001 000

800600400200

0

Death

s

454035302520151050

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

361 000942 000701 000

2 004 000

184735

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. arabiensis, gambiae

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

9 0008 0007 0006 0005 0004 0003 0002 0001 000

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20091997

IRS IRS is recommendedDDT is used for IRS

YesYes

19501950

Larval control Use of larval control Yes –

IPT IPT used to prevent malaria during pregnancy No –

Diagnosis Patients of all ages should receive diagnostic testMalaria diagnosis is free of charge in the public sector

YesYes

20101995

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

NoNoNoYes

2007––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesYesNoNoNo

20122012

–––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

ALALQNQN–

2007200720072007

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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110 | WORLD MALARIA REPORT 2013

Brazil Region of the Americas

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

120100

80604020

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): PMI/ USAID

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNWith access to an ITN in householdAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

9876543210

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

16 00014 00012 00010 000

8 0006 0004 0002 000

0

Death

s

250

200

150

100

50

0

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

4 570 00035 800 000

158 000 000198 370 000

21880

Parasites and vectors

Major plasmodium species: P. falciparum (15%), P. vivax (85%)Major anopheles species: An. darlingi, albitarsis, aquasalis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Total

case

s per

1000

Cases (all species) Cases (P. vivax)

4.03.53.02.52.01.51.00.5

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20072007

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

19721972

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesYes

YesNoNoNo

200620102011

1972–––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesYesYesYesYes

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AL+PQ(1d); AS+MQ+PQ(1d)

–AM+CL; AS+CL

CQ+PQ(7d);CQ+PQ(14d)

–2012

–20122006

Dosage of primaquine for radical treatment of P. vivax 0.5 mg/kg (7 days)

Type of RDT used

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+MQAL

2005–20072005–2007

00

00

00

42 days28 days

32

P. fP. f

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 111

Burkina Faso African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

8070605040302010

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, PMI/ USAID, Other Bilaterals

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2003, MICS 2006, DHS 2010

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

35302520151050

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

3 0002 5002 0001 5001 000

5000

Death

s

706050403020100

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

16 500 00000

16 500 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, funestus, arabiensis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

250

200

150

100

50

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20071998

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20092009

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

NoYesNo

NoNoNoYes

–2009

–––

2009

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–NoNoYesNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AL; AS+AQAL; AS+AQ

QNQN–

20052005

–––

Type of RDT used P.f only

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

ALAS+AQ

2005–20092006–2009

1.93.2

715.3

12.521.5

28 days28 days

63

P. fP. f

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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112 | WORLD MALARIA REPORT 2013

Burundi African Region

III. Financing III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

25201510

50

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. CoverageIV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2010

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. ImpactV. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

6050403020100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1600

1200

800

400

0

Death

s

35302520151050

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

2 360 0005 320 0002 170 0009 850 000

245422

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, funestus, arabiensis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

250

200

150

100

50

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesNo

2004–

IRS IRS is recommendedDDT 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 testMalaria diagnosis is free of charge in the public sector

YesNo

2012–

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesNoNo

NoNoNoNo

2009–

–––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–NoNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AS+AQAS+AQ

QNQN–

2003200320032003

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+AQ 2005–2006 2.9 5.2 7.5 28 days 2 P. f

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Page 23: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

WORLD MALARIA REPORT 2013 | 113

Cambodia Western Pacifi c Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

5040302010

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, PMI/ USAID, Other Bilaterals, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

1008060402010

0

3.02.52.01.51.00.50

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

18 00016 00014 00012 00010 000

8 0006 0004 0002 000

0

Death

s

7006005004003002001000

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

6 540 0001 340 0006 990 000

14 870 000

449

47

Parasites and vectors

Major plasmodium species: P. falciparum (56%), P. vivax (44%)Major anopheles species: An. dirus, minimus, maculatus, sundaicus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

76543210

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20002000

IRS IRS is recommendedDDT is used for IRS

NoNo

––

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20002000

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

NoYesNoYes

20002000

–2012

–2010

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

NoNoNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AS+MQ; DHA-PPQ+PQ

QN+TAM; QN

DHA-PPQ

–––––

Dosage of primaquine for radical treatment of P. vivax –

Type of RDT used P.f + P.v specifi c (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

DHA-PPQDHA-PPQ

2008–20132010–2011

00

3.60

30.80

42 days28 days

153

P. fP. v

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Page 24: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

114 | WORLD MALARIA REPORT 2013

Cameroon African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

70605040302010

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2004, MICS 2006

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

5.90

5.85

5.80

5.75

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

2 500

2 000

1 500

1 000

500

0

Death

s

454035302520151050

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

15 400 0006 290 000

021 690 000

7129

0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, arabiensis, funestus, moucheti, nili

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

1816141210

86420

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

NoNo

––

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20112012

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

NoYesNo

No––

Yes

–2006

–––

2004

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–NoNoYesNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AS+AQAS+AQ

QNAM; QN

2004200420042004

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 115

Cabo Verde African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

3025201510

50

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNWith access to an ITN in householdAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

5

4

3

2

1

0

25

20

15

10

5

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

140120100

80604020

0

Indigenous cases (all species) Indigenous cases (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

Number of active fociNumber of people living within active fociNumber of people living in malaria-free areasTotal

–283 000211 000494 000

5743

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An.arabiensis

Programme phase: Pre-elimination

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

Total cases Imported cases

160140120100

80604020

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Among total casesAmong indigenous cases

Malaria cases by source Indigenous malaria cases by species

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

––

––

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

19981975

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesNoYes

Yes–

YesNo

2008––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admittedFoci and case investigation undertakenCase reporting from private sector is mandatory

YesYesNoYes–

YesYes

–––––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

ALALQNQN–

–––––

Dosage of primaquine for radical treatment of P. vivax –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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116 | WORLD MALARIA REPORT 2013

Central African Republic African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

876543210

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

1.41.21.00.80.60.40.20

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1 8001 6001 4001 2001 000

800600400200

0

Death

s

35302520151050

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

4 530 00000

4 530 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, funestus, arabiensis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

1210

86420

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesNo

2006–

IRS IRS is recommendedDDT is used for IRS

YesNo

––

Larval control Use of larval control – –

IPT IPT used to prevent malaria during pregnancy Yes 2004

Diagnosis Patients of all ages should receive diagnostic testMalaria diagnosis is free of charge in the public sector

YesNo

––

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

NoYesNo

NoNoNoNo

20102010

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–NoNo––

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

ALALQN

AM; QN–

2005––

2005–

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 117

Chad African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

1 2001 000

800600400200

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

4.54.03.53.02.52.01.51.00.50

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

400350300250200150100

500

Death

s

121086420

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

9 960 0002 370 000

124 00012 454 000

8019

1

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. arabiensis, funestus, pharoensis, nili

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

18 16 141210

86420

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesNo

2003–

IRS IRS is recommendedDDT is used for IRS

YesNo

––

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 testMalaria diagnosis is free of charge in the public sector

YesYes

––

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

NoYesNo

NoNoNoNo

–––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–No–

Yes–

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AL; AS+AQAL; AS+AQ

QNAM; QN

–––––

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+AQ 2009–2009 0 0 0 28 days 2 P. f

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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118 | WORLD MALARIA REPORT 2013

China Western Pacifi c Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

605040302010

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

1008060402010

0

1.81.61.41.21.00.80.60.40.20

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1.21.00.80.60.40.2

0

Death

s

6050403020100

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

196 000576 000 000801 000 000

1 377 196 000

04258

Parasites and vectors

Major plasmodium species: P. falciparum (58%), P. vivax (42%)Major anopheles species: An. sinensis, anthropophagus, dirus, minimus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

35 00030 00025 00020 00015 00010 000

5 0000

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20032000

IRS IRS is recommendedDDT is used for IRS

YesNo

2000–

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 testMalaria diagnosis is free of charge in the public sector

YesNo

2000–

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

YesNoYesYes

20062006

1970–

19701970

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesYesYesNoNo

200020001970

––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–ART+NQ; ART-PPQ; AS+AQ; DHA-PPQ

–AM; AS; PYRCQ+PQ(8d)

–2009

–20092006

Dosage of primaquine for radical treatment of P. vivax –

Type of RDT used –Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

CQ+PQCQDHA-PPQ

2008–20092009–20132012–2012

000

00

1.15

04.32.3

28 days28 days42 days

152

P. vP. vP. f

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Page 29: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

WORLD MALARIA REPORT 2013 | 119

Colombia Region of the Americas

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

3530252015201510

50

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, PMI/ USAID

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

Source: DHS 2000, Other Nat.

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

9876543210

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

700600500400300200100

0

Death

s

706050403020100

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

7 060 0003 670 000

37 000 00047 730 000

158

78

Parasites and vectors

Major plasmodium species: P. falciparum (27%), P. vivax (73%)Major anopheles species: An. darlingi, albimanus, nunestovari, neivai, punctimacula, pseudopunctipennis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Total

case

s per

1000

Cases (all species) Cases (P. vivax)

6543210

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20052005

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

19841958

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesNoNo

YesNoNoYes

2008––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesNoNoNoNo

1998––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AL

QN(3d)+CL(5d)AS

CQ+PQ(14d)

–2006200420041960s

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Type of RDT used P.f + P.v specifi c (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AL 2007–2010 0 0 1.3 28 days 3 P. f

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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120 | WORLD MALARIA REPORT 2013

Comoros African Region

III. Financing III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

543210

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, UNICEF, WHO

IV. CoverageIV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. ImpactV. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

25

20

15

10

5

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

4 000

3 000

2 000

1 000

0

Death

s

181614121086420

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

674 00043 100

0717 100

9460

Parasites and vectors

Major plasmodium species: P. falciparum (96%), P. vivax (1%)Major anopheles species: An. gambiae, funestus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

80

40

20

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20052010

IRS IRS is recommendedDDT is used for IRS

YesYes

––

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 testMalaria diagnosis is free of charge in the public sector

YesYes

1997–

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

NoNoNoNo

2005––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–NoNoYesNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

ALALQNQN–

2003200320032003

Type of RDT used P.f + P.v, P.o, P.m (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AL 2006–2011 0 0 3.2 28 days 12 P. f

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 121

Congo African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

141210

86420

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2005

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

6543210

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1 2001 000

800600400200

0

Death

s

25

25

15

10

5

0

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

4 340 00000

4 340 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, funestus, nili, moucheti, hancocki

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

353025201510

50

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

2007–

IRS IRS is recommendedDDT is used for IRS

YesNo

––

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 testMalaria diagnosis is free of charge in the public sector

YesYes

––

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

NoNoNo

NoNoNoNo

–––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–NoNoYesNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AS+AQAS+AQ

ALQN–

–––––

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+AQAL

2005–20052006–2006

5.62.8

5.62.8

5.62.8

28 days28 days

11

P. fP. f

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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122 | WORLD MALARIA REPORT 2013

Costa Rica Region of the Americas

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

876543210

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

5

4

3

2

1

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

4 0003 5003 0002 5002 0001 5001 000

5000

Indigenous cases (all species) Indigenous cases (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

Number of active fociNumber of people living within active fociNumber of people living in malaria-free areasTotal

12 500

4 800 0004 802 500

100

Parasites and vectors

Major plasmodium species: P. falciparum (14%), P. vivax (57%)Major anopheles species: An.albimanus

Programme phase: Pre-elimination

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

Total cases Imported cases

4 000 3 5003 0002 5002 0001 5001 000

5000

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Among total casesAmong indigenous cases

Malaria cases by source Indigenous malaria cases by species

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20092009

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

NoYes

–1957

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

No–

Yes

NoYes–

Yes

–––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admittedFoci and case investigation undertakenCase reporting from private sector is mandatory

YesYesYesYesYesYesYes

–––––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–CQ+PQ(1d)

––

CQ+PQ(7d);CQ+PQ(14d)

–––––

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days), 0.5 mg/kg (7 days)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 123

Côte d’Ivoire African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

70605040302010

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

10

8

6

4

2

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

900800700600500400300200100

0

Death

s

120100806040200

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

19 800 00000

19 800 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, funestus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

70605040302010

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

––

––

IRS IRS is recommendedDDT is used for IRS

––

––

Larval control Use of larval control – –

IPT IPT used to prevent malaria during pregnancy Yes 2005

Diagnosis Patients of all ages should receive diagnostic testMalaria diagnosis is free of charge in the public sector

––

––

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

–Yes–

––––

–––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–––––

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AS+AQAS+AQ

ALQN–

2003200320032003

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

ALAS+AQ

2005–20092008–2009

00

2.60

7.40

28 days28 days

52

P. fP. f

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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124 | WORLD MALARIA REPORT 2013

Democratic People’s Republic of Korea South-East Asia Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

1210

86420

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

1.41.21.00.80.60.40.20

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

160 000140 000120 000100 000

80 00060 00040 00020 000

0

Indigenous cases (all species) Indigenous cases (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

Number of active fociNumber of people living within active fociNumber of people living in malaria-free areasTotal

14618 700 000

6 070 00024 770 000

7525

Parasites and vectors

Major plasmodium species: P. falciparum (0%), P. vivax (100%)Major anopheles species: An.sinensis

Programme phase: Pre-elimination

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

Total cases Imported cases

160 000140 000120 000100 000

80 00060 00040 00020 000

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Among total casesAmong indigenous cases

Malaria cases by source Indigenous malaria cases by species

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20022002

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

–Yes

–1953

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

––

No

YesNoYesYes

–––

2000–

20002002

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admittedFoci and case investigation undertakenCase reporting from private sector is mandatory

YesNoNoNoNoNoYes

1999–––––

1999

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

––––

CQ+PQ(14d)

–N2006200620062006

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 125

Democratic Republic of the Congo African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

300250200150100

500

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, PMI/ USAID, Other Bilaterals, World Bank, UNICEF,WHO, Other

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2007

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

14121086420

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1 600

1 200

800

400

0

Death

s

45403530252015105

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

63 700 0001 970 000

065 670 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, funestus, nili, moucheti

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

80

60

40

20

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20062008

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20072007

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

NoNoNoYes

2006––

–––

2010

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–YesNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AS+AQAS+AQ

QNQN–

2005200520052005

Type of RDT used P.f + all species (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+AQ 2005–2009 0 3.7 6.9 28 days 7 P. f

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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126 | WORLD MALARIA REPORT 2013

Djibouti Eastern Mediterranean Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

1.41.21.00.80.60.40.2

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Global Fund, World Bank, UNICEF, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: MIS 2009

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

1.0

0.8

0.6

0.4

0.2

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1 4001 2001 000

800600400200

0

Death

s

35302520151050

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

0430 000430 000860 000

05050

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, arabiensis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

6 0005 0004 0003 0002 0001 000

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesNo

2008–

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20072007

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

NoNoNoNo

2007––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

NoNoNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

ALALALQN–

201320132008

––

Type of RDT used P.f only

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 127

Dominican Republic Region of the Americas

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

876543210

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, Other Bilaterals, Other

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

5

4

3

2

1

0

76543210

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1

0.8

0.6

0.4

0.2

0

Death

s

181614121086420

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

442 0008 350 0001 480 000

10 272 000

48114

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. albimanus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Total

case

s

Cases (all species) Cases (P. vivax)

3 5003 0002 5002 0001 5001 000

5000

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20082008

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

19641964

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

No–

Yes

YesNoYesNo

––

1964

1964–––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesYesYesNoNo

–19641964

––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–CQ+PQ(3d)

AS+DCQ; QNCQ+PQ

–––––

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Type of RDT used P.f only

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: <50% decrease in incidence projected 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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128 | WORLD MALARIA REPORT 2013

Ecuador Region of the Americas

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

1210

86420

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, PMI/ USAID

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

876543210

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

120 000100 000

80 00060 00040 00020 000

0

Indigenous cases (all species) Indigenous cases (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

Number of active fociNumber of people living within active fociNumber of people living in malaria-free areasTotal

4232 000

15 300 00015 532 000

199

Parasites and vectors

Major plasmodium species: P. falciparum (14%), P. vivax (86%)Major anopheles species: An.albimanus

Programme phase: Pre-elimination

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

Total cases Imported cases

120 000100 000

80 00060 00040 00020 000

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Among total casesAmong indigenous cases

Malaria cases by source Indigenous malaria cases by species

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

2004–

IRS IRS is recommendedDDT is used for IRS

YesNo

2005–

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 testMalaria diagnosis is free of charge in the public sector

YesYes

19561956

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

NoYesYesYes

2005––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admittedFoci and case investigation undertakenCase reporting from private sector is mandatory

YesYesYesNoNoYesYes

–––––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–ALALQN

CQ+PQ(14d)

–2004200420042004

Dosage of primaquine for radical treatment of P. vivax –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AL 2005–2006 0 0 0 28 days 1 P. f

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 129

El Salvador Region of the Americas

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

4.03.53.02.52.01.51.00.5

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

25

20

15

10

5

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

800700600500400300200100

0

Indigenous cases (all species) Indigenous cases (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

Number of active fociNumber of people living within active fociNumber of people living in malaria-free areasTotal

107 960

6 290 0006 297 960

100

Parasites and vectors

Major plasmodium species: P. falciparum (14%), P. vivax (57%)Major anopheles species: An.albimanus, pseudopunctipennis

Programme phase: Pre-elimination

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

Total cases Imported cases

800700600500400300200100

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Among total casesAmong indigenous cases

Malaria cases by source Indigenous malaria cases by species

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

NoNo

––

IRS IRS is recommendedDDT is used for IRS

YesNo

––

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 testMalaria diagnosis is free of charge in the public sector

YesYes

2010–

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

No–

Yes

YesNoYesNo

–––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admittedFoci and case investigation undertakenCase reporting from private sector is mandatory

YesNoNoYesNoYesNo

–––––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–CQ+PQ

––

CQ+PQ

–––––

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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130 | WORLD MALARIA REPORT 2013

Equatorial Guinea African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

201612

840

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Other

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

9876543210

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

2 5002 0001 5001 000

5000

Death

s

121086420

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

736 00000

736 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, melas

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

908070605040302010

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesNo

––

IRS IRS is recommendedDDT is used for IRS

YesNo

––

Larval control Use of larval control No –

IPT IPT used to prevent malaria during pregnancy – –

Diagnosis Patients of all ages should receive diagnostic testMalaria diagnosis is free of charge in the public sector

YesYes

––

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesNoNo

NoNoNoNo

20102010

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–NoYesYesNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AS+AQAS+AQ

QNQN–

2004200420042004

Type of RDT used P.f only

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+AQ 2006–2011 0 2.8 4.9 28 days 4 P. f

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 131

Eritrea African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

25201510

50

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Global Fund

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

2.5

2.0

1.5

1.0

0.5

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

300250200150100

500

Death

s

3.53.02.52.01.51.00.50

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

4 350 0001 780 000

06 130 000

7129

0

Parasites and vectors

Major plasmodium species: P. falciparum (54%), P. vivax (46%)Major anopheles species: An. gambiae

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

76543210

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20022000

IRS IRS is recommendedDDT is used for IRS

YesYes

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 testMalaria diagnosis is free of charge in the public sector

YesYes

19971997

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

YesNoNoYes

2007––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesNoNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

AS+AQAS+AQ

QNQN

AS+AQ+PQ

20072007200720072007

Dosage of primaquine for radical treatment of P. vivax 0.50 mg/kg (14 days)

Type of RDT used P.f + P.v, P.o, P.m (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+AQ 2006–2010 0 4.55 7.9 28 days 8 P. f

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Page 42: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

132 | WORLD MALARIA REPORT 2013

Ethiopia African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

180160140120100

80604020

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Global Fund

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2005

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

76543210

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

120100

80604020

0

Death

s

5

4

3

2

1

0

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

917 00060 500 00030 300 00091 717 000

16633

Parasites and vectors

Major plasmodium species: P. falciparum (56%), P. vivax (44%)Major anopheles species: An. arabiensis, pharoensis, funestus, nili

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

20

16

12

8

4

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20042004

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

19601960

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

NoNoNoNo

2004––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

NoNoNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

ALALQNQNCQ

–––––

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

QNAL

2006–20062006–2009

100

100.6

103.2

28 days28 days

17

P. fP. f

Impact: 50%–75% decrease in incidence projected 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 133

French Guiana, France Region of the Americas

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

0000000000

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

35302520151050

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

120100

80604020

0

Death

s

6543210

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

208 00035 200

0243 200

8614

0

Parasites and vectors

Major plasmodium species: P. falciparum (36%), P. vivax (64%)Major anopheles species: An. darlingi

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Total

case

s per

1000

Cases (all species) Cases (P. vivax)

25

20

15

10

5

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

NoNo

––

IRS IRS is recommendedDDT is used for IRS

YesNo

––

Larval control Use of larval control – –

IPT IPT used to prevent malaria during pregnancy N/A –

Diagnosis Patients of all ages should receive diagnostic testMalaria diagnosis is free of charge in the public sector

YesYes

––

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

Yes–

No

––––

–––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–––––

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

– AL; AT+PG

AS; QN+DCQ+PQ

–––––

Dosage of primaquine for radical treatment of P. vivax –

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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134 | WORLD MALARIA REPORT 2013

Gabon African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

76543210

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

121086420

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

4 5004 0003 5003 0002 5002 0001 5001 000

5000

Death

s

180160140120100806040200

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

1 630 00000

1 630 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (75%), P. vivax (25%)Major anopheles species: An. funestus, gambiae

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

605040302010

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20032007

IRS IRS is recommendedDDT is used for IRS

NoNo

––

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 testMalaria diagnosis is free of charge in the public sector

YesNo

2009–

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

NoNoNoNo

20032003

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–NoNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AS+AQAS+AQ

ALQN–

2003200320032003

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 135

Gambia African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

1210

86420

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, WHO, Other

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

6050403020100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1 6001 4001 2001 000

800600400200

0

Death

s

35302520151050

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

1 790 00000

1 790 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, arabiensis, melas, pharoensis, funestus, nili

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

180160140120100

80604020

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20001998

IRS IRS is recommendedDDT is used for IRS

YesYes

20082007

Larval control Use of larval control – –

IPT IPT used to prevent malaria during pregnancy Yes 2002

Diagnosis Patients of all ages should receive diagnostic testMalaria diagnosis is free of charge in the public sector

YesYes

20091998

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesNo–

––––

2008––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–––––

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

ALALQNQN–

2005200520052005

Type of RDT used P.f only

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AL 2007–2010 0 2.45 11.9 28 days 4 P. f

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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136 | WORLD MALARIA REPORT 2013

Ghana African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

140120100

80604020

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, PMI/ USAID, Other Bilaterals, UNICEF, WHO, Other

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2003, DHS 2008

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

25

20

15

10

5

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

2 0001 7501 5001 2501 000

750500250

0

Death

s

35302520151050

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

25 400 00000

25 400 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, funestus, arabiensis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

160140120100

80604020

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20042010

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesNo

2008–

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

NoYesNo

NoNoNoYes

–2010

–––

2001

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

noNoNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AS+AQAL; AS+AQ

QNQN–

2004200420042004

Type of RDT used P.f only

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+AQAL

2003–20062003–2007

01.7

4.34

1413.8

28 days28 days

45

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 137

Guatemala Region of the Americas

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

16141210

86420

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Global Fund, PMI/ USAID, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNWith access to an ITN in householdAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

6543210

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1.0

0.8

0.6

0.4

0.0

0

Death

s

5

4

3

2

1

0

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

2 260 0004 600 0008 220 000

14 080 000

8614

0

Parasites and vectors

Major plasmodium species: P. falciparum (36%), P. vivax (64%)Major anopheles species: An. darlingi

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Total

case

s per

1000

Cases (all species) Cases (P. vivax)

60 00050 00040 00030 00020 00010 000

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20062006

IRS IRS is recommendedDDT is used for IRS

YesNo

––

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 testMalaria diagnosis is free of charge in the public sector

YesYes

––

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

Yes–

Yes

YesNoYesNo

–––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesNoNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–CQ+PQ(3d)

–CQ

CQ+PQ(14d)

–––––

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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138 | WORLD MALARIA REPORT 2013

Guinea African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

25201510

50

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, PMI/ USAID, Other Bilaterals, UNICEF, WHO, Other

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2005

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

1.81.61.41.21.00.80.60.40.20

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

800700600500400300200100

0

Death

s

9876543210

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

11 500 00000

11 500 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, funestus, melas, arabiensis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

3025201510

50

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20092009

IRS IRS is recommendedDDT is used for IRS

YesNo

2013–

Larval control Use of larval control No –

IPT IPT used to prevent malaria during pregnancy – –

Diagnosis Patients of all ages should receive diagnostic testMalaria diagnosis is free of charge in the public sector

YesYes

20122012

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

NoNoNoYes

2010––

–––

2009

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–NoNoYesNo

–––

2009–

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AS+AQAS+AQ

QNQN–

–––––

Type of RDT used P.f + all species (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+AQ 2004–2004 1 1 1 28 days 1

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Page 49: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

WORLD MALARIA REPORT 2013 | 139

Guinea-Bissau African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

120100

80604020

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, UNICEF, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

14121086420

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1 6001 4001 2001 000

800600400200

0

Death

s

9080706050403020100

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

1 660 00000

1 660 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, funestus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

50

40

30

20

10

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesNo

2005–

IRS IRS is recommendedDDT is used for IRS

NoNo

––

Larval control Use of larval control No –

IPT IPT used to prevent malaria during pregnancy – –

Diagnosis Patients of all ages should receive diagnostic testMalaria diagnosis is free of charge in the public sector

YesYes

20082008

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

NoYesNo

NoNoNoYes

–––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–NoNo––

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

ALALQNQN–

–––––

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AL 2006–2008 3.6 3.6 3.6 28 days 1 P. f

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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140 | WORLD MALARIA REPORT 2013

Guyana Region of the Americas

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

3.02.52.01.51.00.5

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, PMI/ USAID, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

Source: DHS 2009

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

35302520151050

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1 2001 000

800600400200

0

Death

s

25

20

15

10

5

0

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

278 000461 000

55 700794 700

3558

7

Parasites and vectors

Major plasmodium species: P. falciparum (64%), P. vivax (36%)Major anopheles species: An. darlingi, aquasalis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Total

case

s per

1000

Cases (all species) Cases (P. vivax)

605040302010

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20052005

IRS IRS is recommendedDDT is used for IRS

YesNo

––

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 testMalaria diagnosis is free of charge in the public sector

YesYes

19461946

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesYes

YesNoNoNo

20052004

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

NoNoYesNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AL+PQ(1d)

QN+T–

CQ+PQ(14d)

–20042004

–2004

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: Increase in incidence 2000–2012

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Page 51: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

WORLD MALARIA REPORT 2013 | 141

Haiti Region of the Americas

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

9876543210

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

454035302520151050

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1 2001 000

800600400200

0

Death

s

35302520151050

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

5 390 0004 780 000

010 170 000

5347

0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. albimanus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Total

case

s per

1000

Cases (all species) Cases (P. vivax)

9876543210

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20122012

IRS IRS is recommendedDDT is used for IRS

NoNo

––

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 testMalaria diagnosis is free of charge in the public sector

YesYes

19882011

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

Yes–

Yes

YesNoYesNo

–––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesNoNoYesNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–CQ+PQ(1d)

––

CQ+PQ(14d)

–––––

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Type of RDT used P. f. only

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: Insuffi ciently consistent data to assess trends

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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142 | WORLD MALARIA REPORT 2013

Honduras Region of the Americas

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

3.53.02.52.01.51.0

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, PMI/ USAID, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

4.54.03.53.02.52.01.51.00.50

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1.0

0.8

0.6

0.4

0.2

0

Death

s

5

4

3

2

1

0

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

1 110 0004 670 0002 160 0007 940 000

145927

Parasites and vectors

Major plasmodium species: P. falciparum (9%), P. vivax (91%)Major anopheles species: An. albimanus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Total

case

s per

1000

Cases (all species) Cases (P. vivax)

40 00035 00030 00025 00020 00015 00010 000

5 0000

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20092009

IRS IRS is recommendedDDT is used for IRS

YesNo

––

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 testMalaria diagnosis is free of charge in the public sector

YesYes

––

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

Yes–

Yes

YesNoYesNo

–––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesNoYesNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–CQ+PQ(1d)

SPQN

CQ+PQ(14d)

–––

2011–

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Type of RDT used P.f + P.v specifi c (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

CQ 2008–2009 0 0 0 28 days 1 P.f

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 143

India South-East Asia Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

160120100

80604020

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, World Bank

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

5

4

3

2

1

0

121086420

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

6 0005 0004 0003 0002 0001 000

0

Death

s

1 8001 5001 2009006003000

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

272 000 000829 000 000136 000 000

1 237 000 000

226711

Parasites and vectors

Major plasmodium species: P. falciparum (50%), P. vivax (50%)Major anopheles species: An. culicifacies, fl uviatilis, stephensi, minimus, dirus, annularis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

2.5

2.0

1.5

1.0

0.5

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20012001

IRS IRS is recommendedDDT is used for IRS

YesYes

19531953

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 testMalaria diagnosis is free of charge in the public sector

YesYes

19581953

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesYes

YesNoNoYes

2008––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesYesYesNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

AS+SP+PQAS+SP+PQ

QN+D; QN+TAM; AS; QN

CQ+PQ(14d)

–2004200420042004

Dosage of primaquine for radical treatment of P. vivax –

Type of RDT used P.f only

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+SP 2005–2007 0 0 4 28 days 9

Impact: 50%–75% decrease in incidence projected 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Page 54: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

144 | WORLD MALARIA REPORT 2013

Indonesia South-East Asia Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

5040302010

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, UNICEF, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

Source: DHS 2007. Other Nat.

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity Slide positivity rate

100

80

60

40

20

0

1.81.61.41.21.00.80.60.40.20

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

Death

s

1 000

800

600

400

200

0

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

6 0005 0004 0003 0002 0001 000

0

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

42 000 000109 000 000

93 300 000247 300 000

174439

Parasites and vectors

Major plasmodium species: P. falciparum (55%), P. vivax (45%)Major anopheles species: An. sundaicus, balabacensis, maculatus, farauti, subpictus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

3.0

2.5

2.0

1.5

1.0

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

2006–

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

2007–

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesYes

YesNoNoYes

2004––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesYesYesYesYes

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AS+AQ; DHA-PP+PQ

QN+D+PQAM; AS; QN

AS+AQ; DHA-PP+PQ(14d)

–2008200420042008

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Type of RDT used P.f only, P.f + P.v specifi c (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+AQDHA-PPQ

2003–20062004–2008

02.7

8.84.1

24.14.8

28 days42 days

83

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 145

Iran (Islamic Republic of ) Eastern Mediterranean Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

16141210

86420

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, WHO

IV. Coverage

Source: Other Nat.

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at leas one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

3.02.52.01.51.00.5

0

50

40

30

20

10

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

18 00015 00012 000

9 0006 0003 000

0

Indigenous cases (all species) Indigenous cases (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

Number of active fociNumber of people living within active fociNumber of people living in malaria-free areasTotal

444764 000

75 700 00076 464 000

199

Parasites and vectors

Major plasmodium species: P. falciparum (10%), P. vivax (90%)Major anopheles species: An.stephensi, culicifacies, fl uviatilis, Superpictus

Programme phase: Elimination

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

Total cases Imported cases

25 000

20 000

15 000

10 000

5 000

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Among total casesAmong indigenous cases

Malaria cases by source Indigenous malaria cases by species

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20052005

IRS IRS is recommendedDDT is used for IRS

YesNo

––

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 testMalaria diagnosis is free of charge in the public sector

YesYes

–1949

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

–YesYes

YesNoYesYes

––

1949

1949–

19491949

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admittedFoci and case investigation undertakenCase reporting from private sector is mandatory

YesYesNoNoNoYesYes

19491949

–––

20101949

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AS+SP

ALAS; QN+D

CQ+PQ(14d & 8w)

–20062006

–2005

Dosage of primaquine for radical treatment of P. vivax 0.75 mg/kg (8 weeks)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+SP 2005–2010 0 0 0.5 28 days 8 P. f

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Based on 2011 reported dataBased on 2011 reported data

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146 | WORLD MALARIA REPORT 2013

Kenya African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

120100

80604020

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, PMI/ USAID, Other Bilaterals, World Bank

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2003, DHS 2009

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

181614121086420

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

600500400300200100

0

Death

s

180160140120100806040200

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

15 500 00017 300 00010 400 00043 200 000

364024

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, arabiensis, funestus, merus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

40353025201510

50

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20062010

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesNo

2009–

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYes–

––––

2006––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

NoNoNoNo–

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

ALALQNQN–

2004200420042004

Type of RDT used P.f only

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AL 2002–2008 0 2.65 6.6 28 days 12

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 147

Kyrgyzstan European Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

1.6

1.2

0.8

0.4

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

5

4

3

2

1

0

4 0003 5003 0002 5002 0001 5001 0005000

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

3 0002 5002 0001 5001 000

50

Indigenous cases (all species) Indigenous cases (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

Number of active fociNumber of people living within active fociNumber of people living in malaria-free areasTotal

022 900

5 450 0005 472 000

100

Parasites and vectors

Major plasmodium species: P. falciparum (0%), P. vivax (0%)Major anopheles species: An.superpictus, pulcherrimus, claviger, hyrcanus, messeae

Programme phase: Control (Prevention of re-introduction as of December 2013)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

Total cases Imported cases

3 0002 5002 0001 5001 000

5000

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Among total casesAmong indigenous cases

Malaria cases by source Indigenous malaria cases by species

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20032006

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

–Yes

–2007

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

Yes–

Yes

YesNoYesYes

––

2007

2007–

20072007

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admittedFoci and case investigation undertakenCase reporting from private sector is mandatory

YesNoYesNoNoYesYes

–20072010

––

20072007

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

––––

CQ+PQ(14d)

–––––

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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148 | WORLD MALARIA REPORT 2013

Lao People’s Democratic Republic Western Pacifi c Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

9876543210

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Global Fund, PMI/ USAID, Other Bilaterals, WHO, Other

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

1008060402010

0

10

8

6

4

2

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

25 000

20 000

15 000

10 000

5 000

0

Death

s

400350300250200150500

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

2 390 0001 530 0002 720 0006 640 000

362341

Parasites and vectors

Major plasmodium species: P. falciparum (87%), P. vivax (13%)Major anopheles species: An. dirus, minimus, maculatus, jeyporiensis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

876543210

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20032000

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20032005

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

NoYesNoNo

20052008

–2010

––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesYesNoNoNo

20122012

–––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AL

QN+DAS+AL

CQ+PQ(14d)

–2001200120012001

Dosage of primaquine for radical treatment of P. vivax –

Type of RDT used P.f only, P.f + P.v specifi c (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AL 2005–2013 0 0 8.3 28 days 11 P. f

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 149

Liberia African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

353025201510

50

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, PMI/ USAID, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: MIS, 2009, MIS 2011

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

6050403020100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

6 0005 0004 0003 0002 0001 000

0

Death

s

50

40

30

20

10

0

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

4 190 00000

4 190 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

500

400

300

200

100

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20052008

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20052005

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

NoNoNoYes

2005––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

NoNoNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AS+AQAS+AQ

QNQN–

2004200420042004

Type of RDT used P.f only

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+AQ 2007–2007 0 0 0 28 days 2 P. f

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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150 | WORLD MALARIA REPORT 2013

Madagascar African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

8070605040302010

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, PMI/ USAID, UNICEF, WHO, Other

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2009, MIS 2011

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

5

4

3

2

1

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

8070605040302010

0

Death

s

5

4

3

2

1

0

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

6 690 00015 600 000

022 290 000

3070

0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. funestus, gambiae, arabiensis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

1816141210

86420

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20042009

IRS IRS is recommendedDDT is used for IRS

YesNo

1993–

Larval control Use of larval control No –

IPT IPT used to prevent malaria during pregnancy – –

Diagnosis Patients of all ages should receive diagnostic testMalaria diagnosis is free of charge in the public sector

YesYes

20062006

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

NoNoNoYes

2006––

–––

2008

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–YesNoYesYes

–1993

–2006

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AS+AQAS+AQ

QNQN–

2006200620062006

Type of RDT used P.f + P.v specifi c (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+AQ 2006–2007 0 0 8.7 28 days 10

Impact: <50% decrease in incidence projected 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 151

Malawi African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

605040302010

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2004, DHS 2010

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

25

20

15

10

5

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1 4001 200

1 00800600400200

0

Death

s

706050403020100

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

15 900 00000

15 900 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. funestus, gambiae, arabiensis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

120100

80604020

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20062010

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesNo

2011–

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

NoNoNoYes

20072009

–––

2007

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

NoNoNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

ALAL

AS+AQQN–

2007200720072007

Type of RDT used P.f only

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+AQAL

2005–20052005–2005

07.1

1.87.1

3.67.1

28 days28 days

21

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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152 | WORLD MALARIA REPORT 2013

Malaysia Western Pacifi c Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

5040302010

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

4.03.53.02.52.01.51.00.5

0

250

200

150

100

50

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

14 00012 00010 000

8 0006 0004 0002 000

0

Indigenous cases (all species) Indigenous cases (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

Number of active fociNumber of people living within active fociNumber of people living in malaria-free areasTotal

3 1341 190 000

28 100 00029 290 000

496

Parasites and vectors

Major plasmodium species: P. falciparum (18%), P. vivax (24%)Major anopheles species: An.balabacensis, donaldi, maculatus, sundaicus, fl avirostris

Programme phase: Pre-elimination

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

Total cases Imported cases

14 00012 00010 000

8 0006 0004 0002 000

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Among total casesAmong indigenous cases

Malaria cases by source Indigenous malaria cases by species

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

19951995

IRS IRS is recommendedDDT 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 testMalaria diagnosis is free of charge in the public sector

–Yes

–1967

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

–YesNo

YesYesYesYes

–––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admittedFoci and case investigation undertakenCase reporting from private sector is mandatory

YesNoYesYesYesYesYes

––––––

1975

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AS+MQQN+TQN+T

CQ+PQ(14d)

–N2006200620062006

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 153

Mali African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

3025201510

50

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source:DHS 2006, DHS 2010

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

121086420

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

4 5004 0003 5003 0002 5002 0001 5001 000

5000

Death

s

25

20

15

10

5

0

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

13 400 0001 490 000

014 890 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, funestus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

70605040302010

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesNo

2005–

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20082008

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

NoYesNo

No–

NoYes

–––

–––

2010

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–YesNoYes–

–2008

–1993

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AS+AQAL; AS+AQ

ALQN–

200720072007

––

Type of RDT used P.f only, P.f + all species (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+AQAL

2002–20062004–2008

00

23

7.66

28 days28 days

46

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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154 | WORLD MALARIA REPORT 2013

Mauritania African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

1210

86420

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: MIS 2007

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

1.21.00.80.60.40.20

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

700600500400300200100

0

Death

s

76543210

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

2 240 0001 180 000

380 0003 800 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, arabiensis, pharoensis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

0.90.80.70.60.50.40.30.20.1

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesNo

1998–

IRS IRS is recommendedDDT 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 testMalaria diagnosis is free of charge in the public sector

YesYes

20112009

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

YesYesNoYes

2009––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

––

YesYesYes

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AS+AQAL; AS+AQ

–QN–

–––––

Type of RDT used P.f + P.v specifi c (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: Insuffi ciently consistent data to assess trendsImpact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 155

Mayotte, France African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

0000000

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNWith access to an ITN in householdAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

5

4

3

2

1

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

250

200

150

100

50

0

Indigenous cases (all species) Indigenous cases (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

Number of active fociNumber of people living within active fociNumber of people living in malaria-free areasTotal

13 480

213 000216 480

298

Parasites and vectors

Major plasmodium species: P. falciparum (84%), P. vivax (8%)Major anopheles species: An.Funestus, An.gambiae, s.s.

Programme phase: Elimination

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

Total cases Imported cases

900800700600500400300200100

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Among total casesAmong indigenous cases

Malaria cases by source Indigenous malaria cases by species

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20102010

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

––

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

–YesYesYes

YesYesYesYes

–––

–––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admittedFoci and case investigation undertakenCase reporting from private sector is mandatory

NoYesNoYesYesYesYes

–––––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–ALQN–

CQ+PQ

–––––

Dosage of primaquine for radical treatment of P. vivax

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Page 66: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

156 | WORLD MALARIA REPORT 2013

Mexico Region of the Americas

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

3025201510

50

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

6050403020100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

8 0007 0006 0005 0004 0003 0002 0001 000

0

Indigenous cases (all species) Indigenous cases (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

Number of active fociNumber of people living within active fociNumber of people living in malaria-free areasTotal

714 160 000

117 000 000121 160 000

397

Parasites and vectors

Major plasmodium species: P. falciparum (0%), P. vivax (100%)Major anopheles species: An.pseudopunctipennis, albimanus, punctimacula

Programme phase: Pre-elimination

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

Total cases Imported cases

8 0007 0006 0005 0004 0003 0002 0001 000

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Among total casesAmong indigenous cases

Malaria cases by source Indigenous malaria cases by species

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20122012

IRS IRS is recommendedDDT is used for IRS

NoNo

––

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 testMalaria diagnosis is free of charge in the public sector

YesYes

––

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

No–

Yes

YesNoYesYes

–––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admittedFoci and case investigation undertakenCase reporting from private sector is mandatory

YesYesNoNoNoYesYes

–––––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–CQ+PQ

––

CQ+PQ

–––––

Dosage of primaquine for radical treatment of P. vivax

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 157

Mozambique African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

70605040302010

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

25

20

15

10

5

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

700600500400300200100

0

Death

s

302520151050

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

25 200 00000

25 200 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. funestus, gambiae, arabiensis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

8070605040302010

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

––

IRS IRS is recommendedDDT is used for IRS

YesYes

––

Larval control Use of larval control – –

IPT IPT used to prevent malaria during pregnancy Yes –

Diagnosis Patients of all ages should receive diagnostic testMalaria diagnosis is free of charge in the public sector

YesYes

––

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYes–

––––

–2010

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–––––

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

ALAL–

QN–

20042004

–2004

Type of RDT used P.f only

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AL 2005–2008 0 1.6 3.1 28 days 4

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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158 | WORLD MALARIA REPORT 2013

Myanmar South-East Asia Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

25201510

50

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Global Fund, PMI/ USAID, Other Bilaterals, UNICEF, WHO, Other

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

5

4

3

2

1

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

100 000

80 000

60 000

40 000

20 000

0

Death

s

3 0002 5002 0001 5001 0005000

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

19 500 00012 100 00021 100 00052 700 000

372340

Parasites and vectors

Major plasmodium species: P. falciparum (65%), P. vivax (35%)Major anopheles species: An. minimus, dirus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

10

8

6

4

2

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20032003

IRS IRS is recommendedDDT is used for IRS

YesYes

––

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 testMalaria diagnosis is free of charge in the public sector

YesYes

––

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesNoYes

YesNoNoYes

––

2010

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

NoNoNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AL; AM; AS+MQ; DHA-PPQ; PQ

AS+D; AS+TAM; AS; QN

CQ+PQ(14d)

–2008200820082008

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Type of RDT used P.f + P.v specifi c (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

DHA-PPQAL

2005–20112007–2011

00

0.70

55.9

28 days28 days

1413

P. fP. f

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 159

Namibia African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

76543210

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2007

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

4.54.03.53.02.52.01.51.00.50

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

45 00040 00035 00030 00025 00020 00015 00010 000

5 0000

Death

s

2 000

1 500

1 000

500

0

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

1 510 000113 000633 000

2 256 000

675

28

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. arabiensis, gambiae, funestus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

45 00040 00035 00030 00025 00020 00015 00010 000

5 0000

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesNo

1998–

IRS IRS is recommendedDDT is used for IRS

YesYes

19651965

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20101990

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

YesNoNoYes

2005––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesNoYesNoNo

2012––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

ALALQNQNAL

20062006200620062006

Type of RDT used P.f only, P.f + all species (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Page 70: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

160 | WORLD MALARIA REPORT 2013

Nepal South-East Asia Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

76543210

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Global Fund, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

1.21.00.80.60.40.20

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

3 0002 5002 0001 5001 000

5000

Death

s

454035302520151050

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

1 020 00022 000 000

4 510 00027 530 000

48016

Parasites and vectors

Major plasmodium species: P. falciparum (30%), P. vivax (70%)Major anopheles species: An. fl uviatilis, annularis, maculatus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

14 00012 00010 000

8 0006 0004 0002 000

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20072007

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

19621962

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYes–

––––

2007––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–––––

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

AL+PQAL+PQ

–QN

CQ+PQ(14d)

–2004

–20042004

Dosage of primaquine for radical treatment of P. vivax –

Type of RDT used P.f + P.v specifi c (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AL 2005–2010 0 0 0 28 days 5 P. f

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Page 71: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

WORLD MALARIA REPORT 2013 | 161

Nicaragua Region of the Americas

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

3.02.52.01.51.0

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Global Fund, PMI/ USAID

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

21201918171615

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

250

200

150

100

50

0

Death

s

9876543210

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

77 9002 930 0002 980 0005 987 900

14950

Parasites and vectors

Major plasmodium species: P. falciparum (20%), P. vivax (80%)Major anopheles species: An. albimanus, pseudopunctipennis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Total

case

s per

1000

Cases (all species) Cases (P. vivax)

30 00025 00020 00015 00010 000

5 0000

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20042004

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

––

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

No–

Yes

YesNoYesYes

–––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesYesNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–CQ+PQ

AS+MQ; AS+SPQN+CL

CQ+PQ(7d)

–––––

Dosage of primaquine for radical treatment of P. vivax 0.5 mg/kg (7 days)

Type of RDT used P.f + P.v specifi c (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

CQ 2005–2006 0 0 0 28 days 1 P. f

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Page 72: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

162 | WORLD MALARIA REPORT 2013

Niger African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

3 0002 5002 0001 5001 000

5000

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, PMI/ USAID, World Bank, UNICEF

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2006

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

6050403020100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1 600

1 200

800

400

0

Death

s

302520151050

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

11 800 0005 320 000

380 00017 120 000

6931

0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, funestus, arabiensis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

605040302010

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesNo

2005–

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

––

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

NoYes–

––––

–––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–NoNo––

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

ALALQNQN–

2005200520052005

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AL 2006–2006 4.4 4.4 4.4 28 days 1

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Page 73: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

WORLD MALARIA REPORT 2013 | 163

Nigeria African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

180160140120100

80604020

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2003, DHS 2008, MIS 2010

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

4.03.53.02.52.01.51.00.50

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

600500400300200100

0

Death

s

876543210

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

169 000 00000

169 000 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, funestus, arabiensis, Moucheti, melas, nili

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

4

3

2

1

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20012009

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesNo

2010–

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

NoNoNoNo

20092009

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

NoNoNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AL; AS+AQAL; AS+AQ

QNAM; AS; QN

2004200420042004

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

ALAS+AQ

2002–20072004–2006

00

00

27.8

28 days28 days

55

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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164 | WORLD MALARIA REPORT 2013

Pakistan Eastern Mediterranean Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

16141210

86420

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Global Fund

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

3.53.02.52.01.51.00.50

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

70 00060 00050 00040 00030 00020 00010 000

0

Death

s

300250200150100500

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

51 800 000124 000 000

3 030 000178 030 000

2969

2

Parasites and vectors

Major plasmodium species: P. falciparum (25%), P. vivax (75%)Major anopheles species: An. culicifacies, stephensi

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

2.0

1.6

1.2

0.8

0.4

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20082008

IRS IRS is recommendedDDT 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 testMalaria diagnosis is free of charge in the public sector

YesYes

20111961

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesYes

YesYesNoNo

200920072012

20092009

––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

NoNoNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

CQAS+SP

QNAS; QN

CQ+PQ(14d)

–2007

–20072007

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Type of RDT used P.f + all species (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+SP 2007–2011 0 0 1.5 28 days 7 P. f

Impact: Insuffi ciently consistent data to assess trends

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Based on 2009 reported dataBased on 2009 reported data

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WORLD MALARIA REPORT 2013 | 165

Panama Region of the Americas

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

76543210

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, PMI/ USAID, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

9876543210

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

120100

80604020

0

Death

s

5

4

3

2

1

0

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

167 0002 710 000

928 0003 805 000

47124

Parasites and vectors

Major plasmodium species: P. falciparum (0%), P. vivax (100%)Major anopheles species: An. albimanus, pseudopunctipennis, punctimacula, aquasalis, darlingi

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Total

case

s per

1000

Cases (all species) Cases (P. vivax)

6 0005 0004 0003 0002 0001 000

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

NoNo

––

IRS IRS is recommendedDDT is used for IRS

NoNo

––

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 testMalaria diagnosis is free of charge in the public sector

YesYes

19571957

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

Yes–

Yes

YesNoYesNo

–––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesYesYesNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AL–

MQCQ+PQ(7d);CQ+PQ(14d)

–2012

–––

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: <50% decrease in incidence projected 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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166 | WORLD MALARIA REPORT 2013

Papua New Guinea Western Pacifi c Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

40353025201510

50

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

1008060402010

0

6543210

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

35 00030 00025 00020 00015 00010 000

5 0000

Death

s

8007006005004003002001000

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

6 740 000430 000

07 170 000

9416

0

Parasites and vectors

Major plasmodium species: P. falciparum (89%), P. vivax (11%)Major anopheles species: An. punctulatus, farauti, koliensis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

25

20

15

10

5

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20042005

IRS IRS is recommendedDDT is used for IRS

Yes–

2000–

Larval control Use of larval control – 2010

IPT IPT used to prevent malaria during pregnancy N/A –

Diagnosis Patients of all ages should receive diagnostic testMalaria diagnosis is free of charge in the public sector

YesYes

20102004

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesNo–

––––

2010––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–––––

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AL

DHA-PPQAM; ASAL+PQ

–2008200820082009

Dosage of primaquine for radical treatment of P. vivax –

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

DHA-PPQAL

2005–20072005–2007

122.7

122.7

122.7

42 days28 days

11

P. fP. f

Impact: <50% decrease in incidence projected 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Page 77: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

WORLD MALARIA REPORT 2013 | 167

Paraguay Region of the Americas

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

4.54.03.53.02.52.01.51.00.5

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

706050403020100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

8 0007 0006 0005 0004 0003 0002 0001 000

0

Indigenous cases (all species) Indigenous cases (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

Number of active fociNumber of people living within active fociNumber of people living in malaria-free areasTotal

15497 000

6 190 0006 687 000

793

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An.darlingi, albitarsis

Programme phase: Pre-elimination

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

Total cases Imported cases

8 0007 0006 0005 0004 0003 0002 0001 000

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Among total casesAmong indigenous cases

Malaria cases by source Indigenous malaria cases by species

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

NoNo

––

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

19571957

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

Yes–

No

YesNoYesNo

2005––

1957–

1957–

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admittedFoci and case investigation undertakenCase reporting from private sector is mandatory

YesYesNoYesYesYesNo

19571957

–195719571957

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AL––

CQ+PQ

–––––

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days), 15 mg/kg (14 days adults)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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168 | WORLD MALARIA REPORT 2013

Peru Region of the Americas

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

140120100

80604020

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, PMI/ USAID

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

4035302520151050

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

3 0002 5002 0001 5001 000

5000

Death

s

302520151050

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

1 350 0003 450 000

25 200 00030 000 000

51284

Parasites and vectors

Major plasmodium species: P. falciparum (11%), P. vivax (89%)Major anopheles species: An. darlingi, pseudopunctipennis, albimanus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Total

case

s per

1000

Cases (all species) Cases (P. vivax)

4.03.53.02.52.01.51.0

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

––

IRS IRS is recommendedDDT is used for IRS

YesNo

––

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 testMalaria diagnosis is free of charge in the public sector

YesYes

––

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesYes

NoNoYesYes

–––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesYesYesYesYes

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AS+MQ

––

CQ+PQ

–––––

Dosage of primaquine for radical treatment of P. vivax –

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+MQ 2005–2006 1.1 1.1 1.1 28 days 1 P. f

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Page 79: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

WORLD MALARIA REPORT 2013 | 169

Philippines Western Pacifi c Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

40353025201510

50

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

1008060402010

0

1.0

0.8

0.6

0.4

0.2

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

5 000

4 000

3 000

2 000

1 000

0

Death

s

6005004003002001000

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

6 940 00070 200 00019 600 00096 740 000

77320

Parasites and vectors

Major plasmodium species: P. falciparum (69%), P. vivax (31%)Major anopheles species: An. fl avirostris, maculatus, balabacensis, Litoralis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

60 00050 00040 00030 00020 00010 000

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20062000

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20042003

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesYes

YesYesYesYes

2003–

2006

2007201120102009

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesNoYesNoNo

2009–

2009––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

ALAL+PQQN+TQN+T

CQ+PQ(14d)

20092009200220022002

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

CQAL

2000–20102005–2009

00

00

05.6

28 days28 days

59

P. vP. f

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Page 80: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

170 | WORLD MALARIA REPORT 2013

Republic of Korea Western Pacifi c Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

76543210

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

1.21.00.80.60.40.20

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

4 5004 0003 5003 0002 5002 0001 5001 000

5000

Indigenous cases (all species) Indigenous cases (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

Number of active fociNumber of people living within active fociNumber of people living in malaria-free areasTotal

223 760 000

45 200 00048 960 000

892

Parasites and vectors

Major plasmodium species: P. falciparum (7%), P. vivax (93%)Major anopheles species: An.sinensis

Programme phase: Elimination

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

Total cases Imported cases

4 5004 0003 5003 0002 5002 0001 5001 000

5000

80

60

40

20

0

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Among total casesAmong indigenous cases

Malaria cases by source Indigenous malaria cases by species

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

2001–

IRS IRS is recommendedDDT 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 testMalaria diagnosis is free of charge in the public sector

–Yes

–2001

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

–––

YesNoNoYes

–––

2001––

2011

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admittedFoci and case investigation undertakenCase reporting from private sector is mandatory

NoNoNoNoYesYesYes

–––––

20011963

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

CQ–––

CQ+PQ(14d)

–N2006200620062006

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days), 0.25 mg base/kg

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 171

Rwanda African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

4540353025201510

50

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2005, DHS 2008, DHS 2010

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

302520151050

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

2 000

1 600

1 200

800

400

0

Death

s

6050403020100

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

11 500 00000

11 500 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, funestus, arabiensis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

8070605040302010

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesNo

2004–

IRS IRS is recommendedDDT is used for IRS

YesNo

2009–

Larval control Use of larval control – –

IPT IPT used to prevent malaria during pregnancy No –

Diagnosis Patients of all ages should receive diagnostic testMalaria diagnosis is free of charge in the public sector

YesNo

2009–

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

NoYes–

––––

–––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–––––

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

ALALQN

AM; QN–

2005200520052005

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AL 2004–2007 0 1.5 6.9 28 days 3

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Page 82: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

172 | WORLD MALARIA REPORT 2013

Sao Tome and Principe African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

543210

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, Other Bilaterals, World Bank, UNICEF, WHO, Other

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2009

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

120100806040200

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

12 00010 000

8 0006 0004 0002 000

0

Death

s

250

200

150

100

50

0

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

188 00000

188 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

400

300

200

100

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesNo

2005–

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20012008

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

Yes––

––––

2009––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–YesNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AS+AQAS+AQ

ALQN–

2004200420042004

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Page 83: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

world malaria report 2013 | 173

Saudi Arabia Eastern Mediterranean Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

353025201510

50

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

5

4

3

2

1

0

35302520151050

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Con�

rmed

case

s

5 000

4 000

3 000

2 000

1 000

0

Indigenous cases (all species) Indigenous cases (P. vivax)

Sources of financing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profilePopulation (UN Population Division) 2012 %

Number of active fociNumber of people living within active fociNumber of people living in malaria-free areasTotal

682 300 000

26 000 00028 300 000

892

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An.arabiensis, sergentii, funestus, bacroftii, albimanus, balabacensis

Programme phase: Elimination

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Con�

rmed

case

s

Total cases Imported cases

7 0006 0005 0004 0003 0002 0001 000

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Among total casesAmong indigenous cases

Malaria cases by source Indigenous malaria cases by species

II. Intervention policies and strategies

Intervention Policies/strategiesYes/ No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

19801980

IRS IRS is recommendedDDT is used for IRS

YesNo

––

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 testMalaria diagnosis is free of charge in the public sector

YesYes

–1963

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

–YesYes

NoYesNoYes

––

1985

–1985

–1990

Intervention Policies/strategiesYes/ No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admittedFoci and case investigation undertakenCase reporting from private sector is mandatory

YesYesNoNoNoYesYes

19801980

–––

19901990

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfirmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AS+SP

ALAS; AM; QN

CQ+PQ(14d)

–––––

Dosage of primaquine for radical treatment of P. vivax –

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insu�cient data

0

Confirmed cases per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insu�cient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases due to P. falciparum

Based on 2011 reported dataBased on 2011 reported data

Egypt

Sudan

Iraq Islamic Republic of Iran

Oman

Yemen

RedSea

Egypt

Sudan

Iraq Islamic Republic of Iran

Oman

Yemen

RedSea

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174 | WORLD MALARIA REPORT 2013

Senegal African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

40353025201510

50

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Global Fund

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2005, MIS 2006, MIS 2009, DHS 2011

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

6543210

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

250

200

150

100

50

0

Death

s

181614121086420

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

13 200 000549 000

013 749 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, arabiensis, funestus, pharoensis, melas

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

3025201510

50

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

19981998

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20072007

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

NoNoNoYes

20102010

–––

2006

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–YesNoNoNo

–2012

–––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AS+AQAL; AS+AQ

–QN–

20052005

–2005

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+AQAL

2002–20082002–2008

00

00.85

0.53.2

28 days28 days

76

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Page 85: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

WORLD MALARIA REPORT 2013 | 175

Sierra Leone African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

16141210

86420

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, UNICEF, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2008

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

454035302520151050

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1 600

1 200

800

400

0

Death

s

160140120100806040200

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

5 980 00000

5 980 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, funestus, melas

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

300250200150100

500

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

Yes–

2010–

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20102008

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYes–

–––

Yes

2010––

–––

2005

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–––––

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AS+AQAL; AS+AQ

QNAM; QN

2004200420042004

Type of RDT used P.f only

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+AQ 2004–2004 27 27 27 28 days 1

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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176 | WORLD MALARIA REPORT 2013

Solomon Islands Western Pacifi c Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

1086420

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, Other Bilaterals, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

1008060402010

0

80706050403020100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

2 000

1 600

1 200

800

400

0

Death

s

80706050403020100

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

544 0000

5 500549 500

9901

Parasites and vectors

Major plasmodium species: P. falciparum (64%), P. vivax (36%)Major anopheles species: An. farauti, punctulatus, koliensis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

250

200

150

100

50

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20091996

IRS IRS is recommendedDDT is used for IRS

YesNo

––

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 testMalaria diagnosis is free of charge in the public sector

YesYes

19682007

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

YesYesNoNo

20082009

20092009

––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

––

YesNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

ALALQN

AS; ALAL+PQ(14d)

20092009200220022002

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Type of RDT used P.f + all species (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

ALAL

2008–20132008–2013

04

05.1

6.331.6

28 days28 days

33

P. fP. v

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 177

Somalia Eastern Mediterranean Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

141210

86420

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Global Fund, Other Bilaterals, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

2.5

2.0

1.5

1.0

0.5

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

10 000

8 000

6 000

4 000

2 000

0

Death

s

9080706050403020100

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

7 140 0003 060 000

010 200 000

7030

0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. arabiensis, funestus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

4.54.03.53.02.52.01.51.00.5

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20052005

IRS IRS is recommendedDDT is used for IRS

YesNo

2004–

Larval control Use of larval control No –

IPT IPT used to prevent malaria during pregnancy – –

Diagnosis Patients of all ages should receive diagnostic testMalaria diagnosis is free of charge in the public sector

YesYes

20062006

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesNoNo

NoNoNoNo

2006––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesNoNoNoNo

2006––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AS+SPAS+SP

QNAS; QN

CQ+PQ(14d)

20062006200620062006

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+SP 2005–2006 0 0.5 1 28 days 2 P. f

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Based on 2011 reported dataBased on 2011 reported data

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178 | WORLD MALARIA REPORT 2013

South Africa African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

605040302010

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

876543210

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

3 0002 5002 0001 5001 000

500 0

Death

s

450400350300250200150100500

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

2 100 0003 140 000

47 100 00052 340 000

46

90

Parasites and vectors

Major plasmodium species: P. falciparum (99%), P. vivax (1%)Major anopheles species: An. arabiensis, funestus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

30 00025 00020 00015 00010 000

5 0000

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

NoNo

––

IRS IRS is recommendedDDT is used for IRS

YesYes

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 testMalaria diagnosis is free of charge in the public sector

YesYes

–1997

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

NoNoNoNo

2001––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesYesNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

–AL; QN+CL; QN+D

AS; QNQN

AL+PQ; CQ+PQ

–200120012001

Type of RDT used P.f only

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AL 2007–2007 0 2.6 5.2 28 days 2 P. f

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 179

South Sudan* Eastern Mediterranean Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

605040302010

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, PMI/ USAID, UNICEF, WHO, Other

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

2.5

2.0

1.5

1.0

0.5

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

10 000

8 000

6 000

4 000

2 000

0

Death

s

1 4001 2001 0008006004002000

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

10 800 00000

10 800 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (95%), P. vivax (5%)Major anopheles species: An. gambiae, arabiensis, funestus, nili

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

100

80

60

40

20

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20082008

IRS IRS is recommendedDDT 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 testMalaria diagnosis is free of charge in the public sector

NoYes

–2005

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

NoNoNoNo

20062012

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

NoNoNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AS+AQAS+AQ

ALAM; AS; QNAS+AQ+PQ

2006200620062004

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+AQAL

2003–20052004–2004

12.8

3.052.8

5.12.8

28 days28 days

21

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

* In May 2013 South Sudan was reassigned to the Who African Region (WHA resolution 66.21 http://apps.who.int/gb/ebwha/pdf_fi les/WHA66/A66_R21-en.pdf ). Nonetheless, since most data in this report precede 2013, South Sudan is placed in Eastern Mediterranean Region

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180 | WORLD MALARIA REPORT 2013

Sri Lanka South-East Asia Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

1086420

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

141210

86420

454035302520151050

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

250 000

200 000

150 000

100 000

50 000

0

Indigenous cases (all species) Indigenous cases (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

Number of active fociNumber of people living within active fociNumber of people living in malaria-free areasTotal

17501 000

20 600 00021 101 000

298

Parasites and vectors

Major plasmodium species: P. falciparum (17%), P. vivax (83%)Major anopheles species: An.culicifacies, subpictus, annularis, varuna

Programme phase: Elimination

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

Total cases Imported cases

250 000

200 000

150 000

100 000

50 000

0

80

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Among total casesAmong indigenous cases

Malaria cases by source Indigenous malaria cases by species

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

19922004

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

–Yes

–1911

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

–YesYes

YesYesYesYes

–––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admittedFoci and case investigation undertakenCase reporting from private sector is mandatory

YesYesYesYesNoYesYes

–––

2008–

19582008

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AL+PQ

–QN

CQ+PQ(14d)

–N2006200620062006

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 181

Sudan Eastern Mediterranean Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

908070605040302010

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, UNICEF, WHO, Other

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: MIS 2009, MIS 2012.

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

9876543210

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

180 000150 000120 000

90 00060 00030 000

0

Death

s

3 0002 5002 0001 5001 0005000

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

30 900 0006 320 000

037 220 000

8317

0

Parasites and vectors

Major plasmodium species: P. falciparum (95%), P. vivax (5%)Major anopheles species: An. arabiensis, funestus, gambiae, nili, pharoensis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

353025201510

50

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20052010

IRS IRS is recommendedDDT is used for IRS

YesNo

1956–

Larval control Use of larval control – –

IPT IPT used to prevent malaria during pregnancy No –

Diagnosis Patients of all ages should receive diagnostic testMalaria diagnosis is free of charge in the public sector

YesNo

2009–

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

YesNoNoNo

20052004

2005–––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

NoNoNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

AS+SPAS+SP

ALAM; QN

AL

20042004200620062004

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+SPAL

2005–20102005–2010

00

20

5.34.5

28 days28 days

811

P. fP. f

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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182 | WORLD MALARIA REPORT 2013

Suriname Region of the Americas

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

1.00.80.60.40.2

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Global Fund

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

100

80

60

40

20

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

400350300250200150100

500

Death

s

302520151050

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

83 9000

451 000534 900

160

84

Parasites and vectors

Major plasmodium species: P. falciparum (43%), P. vivax (57%)Major anopheles species: An. darlingi

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Total

case

s per

1000

Cases (all species) Cases (P. vivax)

40353025201510

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20062006

IRS IRS is recommendedDDT is used for IRS

NoNo

––

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 testMalaria diagnosis is free of charge in the public sector

YesYes

19551955

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesYes

YesNoNoNo

–––

2004–––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesNoYesNoNo

2000–

2000––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AL+PQAS+MQ

ASCQ+PQ(14d)

–20042004

–2004

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AL 2005–2011 0 2.35 4.7 28 days 2 P. f

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Based on 2010 reported dataBased on 2010 reported data

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WORLD MALARIA REPORT 2013 | 183

Swaziland African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

3.53.02.52.01.51.00.5

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2007

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

9876543210

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

2 000

1 600

1 200

800

400

0

Death

s

706050403020100

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

0345 000886 000

1 231 000

02872

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. arabiensis, gambiae, funestus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

1 6001 4001 2001 000

800600400200

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20022010

IRS IRS is recommendedDDT is used for IRS

YesYes

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20102010

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesNoYes

NoNoNoYes

2010–

2010

–––

2010

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesYesYesNoNo

20122010

–––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

–ALQNQN–

–20092009

––

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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184 | WORLD MALARIA REPORT 2013

Tajikistan European Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

4.54.03.53.02.52.01.51.00.5

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

10

8

6

4

2

0

160140120100806040200

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

25 00020 00015 00010 000

8 0006 0004 0002 000

0

Indigenous cases (all species) Indigenous cases (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

Number of active fociNumber of people living within active fociNumber of people living in malaria-free areasTotal

222 150 0005 860 0008 010 000

2773

Parasites and vectors

Major plasmodium species: P. falciparum (0%), P. vivax (100%)Major anopheles species: An.superpictus, pulcherrimus

Programme phase: Elimination

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

Total cases Imported cases

25 000

20 000

15 000

10 000

5 000

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Among total casesAmong indigenous cases

Malaria cases by source Indigenous malaria cases by species

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20062006

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

–1997

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesYes

YesNoYesYes

––

2004

1997–

20041997

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admittedFoci and case investigation undertakenCase reporting from private sector is mandatory

NoYesNoYesNoYesYes

–2004

–1997

–20042000

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–ALQNAN

CQ+PQ(14d)

–––––

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 185

Thailand South-East Asia Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

3025201510

50

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, WHO, Other

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

141210

86420

1614121086420

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

18 00016 00014 00012 00010 000

8 0006 0004 0002 000

0

Death

s

7006005004003002001000

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

5 340 00028 000 00033 400 00066 740 000

84250

Parasites and vectors

Major plasmodium species: P. falciparum (40%), P. vivax (60%)Major anopheles species: An. dirus, minimus, maculatus, sundaicus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

1.41.21.00.80.60.40.2

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

19921992

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

19911953

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesYes

YesNoYesNo

1995–

1995

1965–

2008–

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesNoYesNoNo

1958–

1958––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AS+MQQN+DAS; QN

CQ+PQ(14d)

–2004

–20042004

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+QM 2001–2009 0 0.5 10.4 28 days 20

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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186 | WORLD MALARIA REPORT 2013

Democratic Republic of Timor-Leste South-East Asia Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

9876543210

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, WHO, Other

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

Source: DHS 2010

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

1008060402010

0

25

20

15

10

5

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

2 000

1 600

1 200

800

400

0

Death

s

80706050403020100

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

858 000256 000

01 114 000

7723

0

Parasites and vectors

Major plasmodium species: P. falciparum (56%), P. vivax (44%)Major anopheles species: An. subpictus, barbirostris

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

605040302010

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20052008

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20072000

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesNoNo

YesNoNoNo

2007––

2006–––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesYesNoNoNo

20122009

–––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AL

QN+DAM; AS; QN

CQ+PQ(14d)

–––––

Dosage of primaquine for radical treatment of P. vivax 0.50 mg/kg (14 days)

Type of RDT used P.f + all species (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 187

Togo African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

181512

9630

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, Other Bilaterals, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

20

16

12

8

4

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1 000

800

600

400

200

0

Death

s

50

40

30

20

10

0

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

6 640 00000

6 640 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, funestus, melas, arabiensis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

120100

80604020

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20042011

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesNo

2010–

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

NoNoNo

No––

Yes

–––

–––

2009

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–NoNoYesNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AL; AS+AQAL; AS+AQ

–QN–

–––––

Type of RDT used P.f only

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+AQAL

2005–20092005–2009

00

00.7

64.4

28 days28 days

88

P. fP. f

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Page 98: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

188 | WORLD MALARIA REPORT 2013

Turkey European Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

5040302010

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

10

8

6

4

2

0

12 00010 0008 0006 0004 0002 0000

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

12 00010 000

8 0006 0004 0002 000

0

Indigenous cases (all species) Indigenous cases (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

Number of active fociNumber of people living within active fociNumber of people living in malaria-free areasTotal

12 500

74 000 00074 002 500

100

Parasites and vectors

Major plasmodium species: P. falciparum (0%), P. vivax (0%)Major anopheles species: An.sacharovi, superpictus

Programme phase: Elimination

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

Total cases Imported cases

14 00012 00010 000

8 0006 0004 0002 000

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Among total casesAmong indigenous cases

Malaria cases by source Indigenous malaria cases by species

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

NoNo

––

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

–Yes

–1926

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

––

No

YesNoYesNo

––

1926

––

2007–

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admittedFoci and case investigation undertakenCase reporting from private sector is mandatory

NoYesNoNoNoYesYes

–2010

–––

19831930

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

––––

CQ+PQ(14d)

–––––

Dosage of primaquine for radical treatment of P. vivax 0.50 mg/kg (14 days)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 189

Uganda African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

250200150100

500

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2006, MIS 2009, DHS 2011

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

181614121086420

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

2 500

2 000

1 500

1 000

500

0

Death

s

302520151050

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

32 700 0003 630 000

036 330 000

9010

0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, funestus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

8070605040302010

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20062013

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

19972006

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

NoNoNoYes

20062005

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

NoNoNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

ALALQNQN–

2004200420042004

Type of RDT used P.f only

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AL 2002–2008 0 2.3 8.9 28 days 8

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Page 100: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

190 | WORLD MALARIA REPORT 2013

United Republic of Ta nzania (Mainland) African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

250200150100

500

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, PMI/ USAID, Other Bilaterals, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2005, DHS 2008, DHS 2010

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

25

20

15

10

5

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

2 500

2 000

1 500

1 000

500

0

Death

s

6050403020100

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

33 900 00012 500 000

046 400 000

7327

0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, arabiensis, funestus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

8070605040302010

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

NoNo

––

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesNo

2009–

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

Yes–

No

NoNoNoYes

–––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–––

NoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

ALALQNQN–

2004200420042004

Type of RDT used P.f + all species (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AL 2002–2008 0 2.85 8.6 28 days 8

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 191

United Republic of Ta nzania (Zanzibar) African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

8

6

4

2

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, PMI/ USAID, Other Bilaterals, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

40

30

20

10

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1 000

800

600

400

200

0

Death

s

4035302520151050

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

1 410 00000

1 410 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

20

16

12

8

4

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20052008

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20072004

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

NoNoNoYes

20032012

–––

2003

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesYesYesNoNo

200820112011

––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

AS+AQAS+AQ

QNQN–

2004200420042004

Type of RDT used P.f + all species (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AL 2006–2007 0 0 0 42 days 1 P. f

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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192 | WORLD MALARIA REPORT 2013

Uzbekistan European Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

2.52.01.51.00.5

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

1.0

0.8

0.6

0.4

0.2

0

4 0003 5003 0002 5002 0001 5001 0005000

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

70605040302010

0

Indigenous cases (all species) Indigenous cases (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

Number of active fociNumber of people living within active fociNumber of people living in malaria-free areasTotal

00

28 500 00028 500 000

100

Parasites and vectors

Major plasmodium species: P. falciparum (0%), P. vivax (0%)Major anopheles species: An.superpictus, pulcherrimus, hyrcanus, claviger

Programme phase: Control (Prevention of re-introduction as of December 2013)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Confi

rmed

case

s

Total cases Imported cases

140120100

80604020

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Among total casesAmong indigenous cases

Malaria cases by source Indigenous malaria cases by species

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20052005

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

–Yes

–1925

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

––

Yes

YesNoYesYes

––

1939

1939–

19391939

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admittedFoci and case investigation undertakenCase reporting from private sector is mandatory

YesYesYesYesYesYesYes

1925192519391939

–19251925

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

––––

CQ+PQ (14d)

–––––

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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WORLD MALARIA REPORT 2013 | 193

Vanuatu Western Pacifi c Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

6543210

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

Source: Other Nat.

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

1008060402010

0

35302520151050

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1 2001 000

800600400200

0

Death

s

1614121086420

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

245 0000

2 470247 470

9901

Parasites and vectors

Major plasmodium species: P. falciparum (32%), P. vivax (68%)Major anopheles species: An. farauti

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

18 00015 00012 000

9 0006 0003 000

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20081990

IRS IRS is recommendedDDT is used for IRS

NoNo

––

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 testMalaria diagnosis is free of charge in the public sector

YesNo

2009–

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesNoNo

YesYesNoNo

2009––

20092009

––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

NoNoNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–ALQNQN

AL+PQ(14d)

20092009200220022002

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Type of RDT used P.f + all species (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AL 2011–2012 0 0 0 28 days 1 P. v

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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194 | WORLD MALARIA REPORT 2013

Venezuela (Bolivarian Republic of ) Region of the Americas

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

605040302010

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costs

No data reported for 2012

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

10

8

6

4

2

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

1.0

0.8

0.6

0.4

0.2

0

Death

s

454035302520151050

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

779 0004 850 000

24 300 00029 929 000

31681

Parasites and vectors

Major plasmodium species: P. falciparum (25%), P. vivax (75%)Major anopheles species: An. darlingi, aquasalis, nuneztovari, braziliensis, albitarsis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Total

case

s per

1000

Cases (all species) Cases (P. vivax)

2.0

1.6

1.2

0.8

0.4

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20052005

IRS IRS is recommendedDDT is used for IRS

YesNo

––

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 testMalaria diagnosis is free of charge in the public sector

YesYes

19361936

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesYes

YesNoYesNo

2004––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesYesNoNoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–AL+MQ+PQ

QN+CL; QN+D; QN+TAM; QN

CQ+PQ(14d)

–2004200420042004

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

Impact: Increase in incidence 2000–2012

Insufficient data

0

Confirmed cases

per 1000 population

0–0.1

1.0–10

0.1–1.0

10–50

50–100

≥100

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Page 105: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

WORLD MALARIA REPORT 2013 | 195

Viet Nam Western Pacifi c Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

141210

86420

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, WHO

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

At high risk protected with ITNsAll ages who slept under an ITNHouseholds with at least one ITNAt high risk protected with IRS

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

1008060402010

0

14121086420

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

70 00060 00050 00040 00030 00020 00010 000

0

Death

s

160140120100806040200

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

15 900 00018 100 00056 800 00090 800 000

182063

Parasites and vectors

Major plasmodium species: P. falciparum (63%), P. vivax (37%)Major anopheles species: An. minimus, dirus, sundaicus, maculatus, sinensis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

1.0

0.8

0.6

0.4

0.2

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

19921992

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

19581958

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesYes

YesNoYesYes

2003–

2003

1960––

1980

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesYesNoNoNo

19581958

–––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

–DHA-PPQ

AS+MQ; QNAS; QN

CQ+PQ(14d)

20092009200220022002

Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Type of RDT used P.f + P.v specifi c (Combo)

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

DHA-PPQ 2001–2010 0 0 6.1 28 days 14

Impact: On track for >75% decrease in incidence 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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196 | WORLD MALARIA REPORT 2013

Yemen Eastern Mediterranean Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

1816141210

86420

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, Other Bilaterals, Other

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNHouseholds with at least one ITNAt risk protected with IRS

Source: MIS 2009

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

76543210

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

3 5003 0002 5002 0001 5001 000

5000

Death

s

100

80

60

40

20

0

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

10 300 0005 350 0008 180 000

23 830 000

432234

Parasites and vectors

Major plasmodium species: P. falciparum (99%), P. vivax (1%)Major anopheles species: An. arabiensis, culicifacies, sergentii

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

5

4

3

2

1

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20022009

IRS IRS is recommendedDDT is used for IRS

YesNo

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20012002

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYes–

Yes–––

20092009

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–––––

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivax

AS+SPAS+SP

ALAM; QN

CQ+PQ(14d)

2009200920092009

–Dosage of primaquine for radical treatment of P. vivax 0.25 mg/kg (14 days)

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AS+SP 2007–2011 0 0 1.5 28 days 6 P. f

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

Based on 2011 reported dataBased on 2011 reported data

Page 107: Country profi les - who.int · 92 | WORLD MALARIA REPORT 2013 This section describes the methods used for preparing country profi les. These methods also apply to other sections

WORLD MALARIA REPORT 2013 | 197

Zambia African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

70605040302010

0

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, PMI/ USAID, World Bank, UNICEF, WHO, Other

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2002, DHS 2007

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

40

30

20

10

0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

3 5003 0002 5002 0001 5001 000

5000

Death

s

100

80

60

40

20

0

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

13 900 00000

13 900 000

10000

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. gambiae, funestus, arabiensis

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

20

16

12

8

4

0

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

––

IRS IRS is recommendedDDT is used for IRS

YesYes

––

Larval control Use of larval control – –

IPT IPT used to prevent malaria during pregnancy Yes –

Diagnosis Patients of all ages should receive diagnostic testMalaria diagnosis is free of charge in the public sector

YesYes

––

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

NoNoNoYes

20032003

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

–––

NoNo

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

ALALQNQN–

2002200220022002

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AL 2005–2009 0 0 6.7 28 days 7 P. f

Impact: 50%–75% decrease in incidence projected 2000–2015

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum

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198 | WORLD MALARIA REPORT 2013

Zimbabwe African Region

III. Financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Government Global Fund World Bank USAID/PMI WHO/UNICEF Others

Contr

ibutio

n (US

$m)

353025201510

50

Insecticides & spray materials

ITNs

Diagnostic testing

Antimalarial medicines

Monitoring and evaluation

Human resources & technical assistance

Management and other costsFunding source(s): Government, Global Fund, PMI/ USAID, Other Bilaterals, UNICEF, Other

IV. Coverage

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Popu

lation

(%)

With access to an ITN (model)All ages who slept under an ITNWith access to an ITN (survey)At risk protected with IRS

Source: DHS 2006, MIS 2009, DHS 2011

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s (%

)

Suspected cases testedP. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine

Cases potentially treated with any antimalarial

V. Impact

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Posit

ivity

rate (

%)

ABER

(%)

ABER (Micr. & RDT) RDT positivity rate Slide positivity rate

100

80

60

40

20

0

121086420

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Admi

ssion

s

400

300

200

100

0

Death

s

181614121086420

Admissions (all species)Deaths (all species)

Admissions (P. vivax)Deaths (P. vivax)

Sources of fi nancing Expenditure by intervention in 2012

Coverage of ITNs and IRS Cases tested and potentially treated (public sector)

Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax

I. Epidemiological profi lePopulation (UN Population Division) 2012 %

High transmission (>1 case per 1000 population)Low transmission (0–1 cases per 1000 population)Malaria-free (0 cases)Total

6 510 0000

6 510 00013 020 000

500

50

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)Major anopheles species: An. arabiensis, gambiae, funestus

Programme phase: Control

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s per

1000

Cases (all species) Cases (P. vivax)

3025201510

50

0

20

40

60

80

100

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Case

s due

to P.

vivax

(%)

Confi rmed cases (per 1000) Malaria admissions and deaths (100 000)

II. Intervention policies and strategies

Intervention Policies/strategiesYes/No

Year adopted

ITN ITNs/LLINs distributed free of chargeITNs/LLINs distributed to all age groups

YesYes

20092009

IRS IRS is recommendedDDT is used for IRS

YesYes

19472004

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 testMalaria diagnosis is free of charge in the public sector

YesYes

20082008

Treatment ACT is free for all ages in public sectorArtemisinin-based monotherapies withdrawnSingle dose of primaquine (0.25 mg base/kg) is used as gametocidal medicine for P. falciparumPrimaquine is used for radical treatment of P. vivaxG6PD test is a requirement before treatment with primaquineDirectly observed treatment with primaquine is undertakenSystem for monitoring of adverse reaction to antimalarials exists

YesYesNo

NoNoNoYes

2008––

––––

Intervention Policies/strategiesYes/No

Year adopted

Surveillance ACD for case investigation (reactive)ACD at community level of febrile cases (pro-active)Mass screening is undertakenUncomplicated P. falciparum cases routinely admittedUncomplicated P. vivax cases routinely admitted

YesYesYesYesYes

–––––

Antimalaria treatment policy MedicineYear

adopted

First-line treatment of unconfi rmed malariaFirst-line treatment of P. falciparumFor treatment failure of P. falciparumTreatment of severe malariaTreatment of P. vivaxDosage of primaquine for radical treatment of P. vivax

ALALQNQN–

2004200420042004

Type of RDT used –

Therapeutic effi cacy tests (clinical and parasitological failure, %)

Medicine Year Min Median Max Follow-up No. of studies Species

AL 2006–2008 0 0.95 8.1 28 days 12 P. f

Impact: Insuffi ciently consistent data to assess trends

Insufficient data0

0–0.1

0.1–1.0

1.0–10

Confirmed cases

per 1000 population/

Parasite prevalence

(PP)

PP>750

Insufficient data

no cases

Very low PP

0–20

20–40

40–60

60–80

80–100

Proportion of cases

due to P. falciparum


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