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
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
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
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.
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).
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
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
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.
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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