I. Epidemiological background

Parasite (Plasmodium) types	Plasmodium falciparum is the predominant malaria type and accounts for 97% of all malaria infections.
Total population	1,116,001 (2006)
Population at risk	1,116,001 (2006)
~ 100% of the Population lives in areas at risk of malaria)
Women aged between 15-45 years of age at risk of malaria	50,220 (2006)
Children under five at risk of malaria	223,200 (2006)
Number of reported clinical malaria / fever cases	204,435 (2006)
Number of Malaria episodes	250,000 (2006)
Malaria deaths (all ages)	10,000 (2006)
Child under 5 mortality (per 1000)	101 (Year 2005)

II. Current Policy and Strategy

Primary interventions: Policy

Case management

The combination therapy of AQ and AS is used as the first line treatment while second line treatment is artemeter plus lumefantrine (Coartem ©). Quinine is used to treat severe malaria and malaria in pregnancy in the first trimester (with AS and AQ being used in the 2nd and 3rd trimesters). SP is used for IPT. The introduction of the new treatment policy and the wide availability of the medicines was one of the main achievements under the GFATM R4. This was necessitated due to the high treatment failure and poor therapeutic efficacy of chloroquine and to a lesser extent with SP and amodiaquine.

Prevention

Implementation of malaria prevention and control in Zanzibar, to date, has focused on: Prevention of infection Early diagnosis and prompt treatment and Malaria in pregnancy. Complementing this, the current strategic plan also includes surveillance and epidemic preparedness. The ZMCP continues to place a major emphasis on the sustained distribution and effective use of ITNs including LLINs. Interventions under this strategy have included free mass re-treatment campaigns of conventional nets, distribution of LLINs at no cost to vulnerable groups and regular monitoring and evaluation of activities. Interaction with the private sector has ensured that conventional nets sold through this medium now have re-treatment kits. Furthermore, there is a growing community awareness on the importance and availability of ITNs/LLINs. Other vector control measures including IRS and larviciding are also outlined in the current prevention strategy. Vector control guidelines are in place to guide the mix of IVM activities.

III. Primary interventions

[+] Total malaria cases (probable and confirmed)

[+] Proportion of malaria confirmed cases

[+] View data

BS Grand Total	BS positive Grand Total	Positivity Rate
2003	106634	43361	40.7%
2004	90177	34574	38.3%
2005	106204	11670	11.0%
2006	87155	2981	3.4%
2007	21742	124	0.6%

BS: Blood Slides
Source: NMCP Zanzibar

[+] OPD Malaria probably cases (confirmed and not confirmed) per 1000 of the population

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

Challenges Financial gap 2009, 2010 on wards M&E and Surveillance in low endemicity Human resources To overcome these challenges there is a need to do resource mobilization: Support to revise GF round 7 proposal Enhance strong partnership in malaria control MOH to develop sustainable mechanism for staff retention in collaboration with partners MOH to increase national investment on malaria Deploy skilled personnel in M&E and surveillance Provision of TA and support when required Assistance needed from Partnership: Study tour for Zanzibar and Eritrea to EMRO (Muscat Oman) to exchange ideas and learn about malaria "elimination techniques".

V. Key RBM Partners in Zanzibar

• The Global Fund
• PMI
• WHO
• UNICEF
• Italian Government
• Research institutions
• Government of Zanzibar
• General community

Source: NMCP Zanzibar

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

RESOURCES & LINKS:

Malaria treatment protocols:
WHO Global AMDP database

Online publications:
PubMed

Maps:
MARA/ARMA Tanzania/Zanzibar maps