Malaria interventions coverage

Source of the data: DHS 2002; NMCP

I. Epidemiological background

Parasite (Plasmodium) types	The main parasites are Plasmodium falciparum and Plasmodium Vivax. The parasite distribution (2005) was P.falciparum (83%) and P.vivax (17%).
Main vector (mosquito) types	The vector is almost exclusively Anopheles arabiensis.
Total population	3,990,36 (2006)
Population at risk	2,673,546 (2006)
67% of the Population lives in areas at risk of malaria: 41 out of the 58 sub-zonas (Sub-regions).
Transmission	Malaria transmission in Eritrea is highly seasonal and unstable: There are two main malaria transmission seasons: September – November (for central, southern, western lowlands) and January – March (for the coastal plains). In brief, malaria is seasonal, focal, and unstable with a risk for malaria epidemics.
Women aged between 15-45 years of age at risk of malaria	528,900 (2006)
Children under five at risk of malaria	432,000 (2006)
Number of reported clinical malaria / fever cases	14,148 (2006)
Child under 5 malaria mortality	9 (2006)
Infant mortality (per 1000)	50 (2005)

Source of the data: WHO statistics 2007

II. Current Policy and Strategy

Primary interventions: Policy

Case management

1st line treatment for uncomplicated falciparum malaria is Artesunate + Amodiaquine (AS+AQ). The 2nd treatment for treatment failures is oral Quinine. The treatment for severe malaria is parenteral Quinine. Treatment of malaria during the pregnancy is Quinine in all trimesters but AS+AQ might be considered when Quinine is not available and when the benefit outweighs the risk. The treatment of malaria in areas where confirmation of malaria either by microscopy or RDTs is NOT possible is CQ+SP.

Prevention

The use of ITNs, Larviciding, Indoor residual spraying in selected villages Malaria prevention during the pregnancy: ITNs are provided freely by the health facilities to all the pregnant women who attend ANC during their 1st clinic visit and also during and after delivery.

Primary interventions: Strategy

Case Management Early detection and prompt treatment Integrated Vector Management: (Environmental Management, Use of ITNs, Larviciding, Indoor residual spraying in selected villages) Epidemic Prevention (forecasting, monitoring of sentinel sites, preparedness) Capacity Building (Training of Health workers, Community Health Agents, Public Health Technicians etc.) Health Promotion Operational Research Monitoring and Evaluation

III. Primary interventions

[+] ITNs

[+] Indoor residual spraying (IRS)

[+] Malaria IPD

[+] View data

Indicators	2000	2001	2002	2003	2004	2005	2006
Number of ITNs distributed	245,000	387,000	472,000	660,000	875,000	982,000	1,063,000
Malaria OPD Cases	109,578	125,746	74,861	65,517	27,783	24,192	10,148
Total <5 IPD	1,300	1,900	1,350	1,550	850	975	775
Total malaria IPD	7,800	8,900	6,800	8,900	4,200	6,900	4,000
U5 malaria deaths	30	45	32	28	6	2	9
Total malaria deaths	85	129	85	70	16	32	25

IV. Challenges and Priority support needs (2008 - 2010)

Challenges The significant reduction of malaria morbidity creates other challenging issues/factors: low immunity of population, tendency to develop severe malaria and prone to malaria epidemics; challenge of sustaining the achievements and successes obtained; creates complacence/relaxation among population, MOH, Partners among others; generally limited infrastructure (transport, laboratory, communications); generally limited trained human resources in the General Health Delivery System; generally limited data base for linking epidemiological, entomological, ecological, and climate-related data to predict epidemics; general concern of sustaining community based interventions (bednet issues, source reduction, case management) ownership and support for community health agents (CHAs) incentives; cross-border malaria concern.

Support needs (TA and Finance) Updating of AMDs Policy, dissemination and training of HWs and CHAs; Procurement of adequate AMDs (ACTs); Procurement of adequate RDTs; Procurement of LLINs, insecticides etc; Improve the early treatment seeking behavior and use of ITNs of the population and particularly of the vulnerable groups (<5, pregnant women, the military & other non immune population) by conducting aggressive HP/BCC activities; Goluj Project and Construction of ware house in Gash Barka (which has already eaten too much time).

V. Key RBM Partners in Ertrea

• National Government Contribution – big and continuous
• GFATM – The second biggest financial support since the end of 2003
• Local associations/NGOs, ministries, communities – big & continuous
• WHO - Technical & Financial since 1995
• UNICEF – Technical & Financial since 1995
• IDA/World Bank – Big Financial & technical support since 1998
• Italian Cooperation/PHARPE – Financial support since 1997
• JICA: Japan International Cooperation Agency – Material support (c. 30,000 LLINs/yr.) since 2003/4

Source: NMCP Eritrea

For questions, contact Ms Nadia Lasri, RBM Partnership facilitation
Dr J. Banda, RBM Partnership facilitation Coordinator,
Dr Tewolde Ghebremeskel , National Malaria Control Programme Manager

RESOURCES & LINKS:

Eritrean Roll Back Malaria Program Five Year Strategic Plan 2005-2009

Five Year (2005-2009) Plan of Action

Malaria treatment protocols:
WHO Global AMDP database

Malaria contry profiles
World Malaria report 2005
WHO/AFRO

Online publications:
PubMed

Maps:
MARA/ARMA Eritrea maps