Malaria interventions coverage

Source: MICS 2000, DHS 2005, NMCP Rwanda

I. Epidemiological background

Parasite (Plasmodium) types	The main parasite is Plasmodium falciparum (95% of cases); Plasmodium Malariae (4.5%) and Plasmodium Ovale (0.5%).
Main vector (mosquito) types	An. Funestus, An. Gambiae, An. Pharoensis,An. Coustani, An. Paludis, An. Moucheti Moucheti
Total population	9,259,676 (2007)
Population at risk	4,802,025 (2007)
Women aged between 15-45 years of age at risk of malaria	2,737,154 (2006)
Children under five at risk of malaria	3,985,680 (2006)
Number of reported malaria cases	1,416,416 (2005)
Malaria deaths (all ages)	510 (2006)
Deaths among children under five years of age due to malaria (%)	4.6 (2000)
Infant mortality rate (per 1 000 live births)	152 (2005)*

*Source: WHO statistics 2007

II. Current Policy and Strategy

Primary interventions

Case management

The first line treatment is Coartem (artemether/lumefantrine) for uncomplicated malaria. Children in the rural hard to reach areas will access these quality services through the Pro-Poor Equity ITNs distribution Program where the Community Health Volunteers will be distributing Drug packs. Intermittent Preventive Treatment (IPT): The national strategy is that at least 90% of pregnant women will receive IPT and that at least 80% of pregnant women will sleep under impregnated mosquito nets. The national strategic framework has prioritized inclusion of malaria control interventions to target this group through the provision of IPT as prophylaxis, the distribution of highly subsidized ITNs and effective case management.

Prevention

ITNs will be distributed mainly through the Mass Distribution during the Measles Campaign in order to reach high household coverage.

IEC/BCC

All the vector and case management strategies will be supported by ongoing Behavioral Change and Communications’ approaches in order to improve utilization and compliance to ITNs and Drugs respectively. An IEC strategy has been developed in collaboration with the service of education for health at the districts level.

III. Primary interventions

[+] ITNs ownership and use

[+] Malaria cases and deaths

[+] View data

Indicator Name	2001	2002	2003	2004	2005
Malaria Cases	990,893	1,061,062	1,192,472	1,272,098	1,416,716
U5 malaria deaths	730	450	500	420	332
<5 malaria deaths	1,440	960	720	520	400
Total malaria deaths	2,170	1,410	1,220	940	732

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

Challenges Coordination of partners in line with Rwanda RBM strategic plan Antimalarial drug and insecticide resistance Change in mlaria epidemiology due to large scale intervention Some funding not in accordance with country priorities and needs. To overcome these challenges there is a need of: Strengthen malaria treatment and prevention programs by providing good quality medicines to the population Strengthen the capacity of communities to correctly handle uncomplicated cases of malaria Strengthen IEC programs to change behaviours Monitor drug and insecticide resistance Focused IRS Coordination of mlaria control activities Sustainability of malaria Control activities

V. Key RBM Partners in Rwanda

• The Global Fund
• WHO
• UNICEF
• USAID:
  • PMI
  • PSI
  • IntraHealth-Twubakane
  • RTI International (Research Triangle Institute
  • MSH/RPM Plus
  • BASICS
• EIP (IRC-CONCERN-WORLD RELIEF)
• Access-JHPIEGO

For questions, contact Ms Nadia Lasri, RBM Partnership facilitation
Dr James Banda, RBM Partnership facilitation Coordinator,
Dr Corine Karema, National Malaria Control Programme Manager

RESOURCES & LINKS:

National Strategic plan 2005 - 2010
National Malaria Control Programme/ Programme National Intégré de Lutte contre le Paludisme (PNILP)

Surveys:
DHS 2005

Malaria treatment protocols:
WHO Global AMDP database

Malaria contry profiles
WHO/AFRO
PMI

Online publications:
PubMed

Maps:
MARA/ARMA Rwanda maps