Malaria Elimination: A Field Manual for Low and Moderate Endemic Countries
Malaria elimination aims at sustainable interruption of local malaria transmission by mosquitoes despite a continued presence of malaria vector mosquitoes and importation of parasites from abroad through international travel and migration. In areas with intense transmission and extreme poverty, where overall health and development are lagging behind, good malaria control using proven tools, such as case management with efficacious medicines (artemisinin-based combination therapy in the case of Plasmodium falciparum) and vector control with indoor residual spraying and insecticide-treated mosquito nets will considerably contribute to improving public health.
The priorities of a malaria elimination programme are: (i) to identify and treat malaria patients and all people carrying parasites, including those carrying gametocytes, ensuring that they become noninfectious as soon as possible; and (ii) to sustainably reduce human–vector contact and the vectorial capacity of the local Anopheles mosquito populations to prevent new infections from occurring.
The efforts required for malaria elimination are fundamentally different from malaria control. Some tools and approaches are specific to elimination; others take on a much more prominent role than in control efforts. The choice is based on an in-depth knowledge of the local epidemiology of malaria parasites, vectors, and transmission patterns. Their application is targeted through the identification of transmission foci and geographical reconnaissance.
In its early phases, the elimination programme temporarily becomes a specialized vertical programme that focuses on the spatial distribution of malaria, vector control, case-finding, and case investigation. When the goal of elimination is almost reached, the focus shifts back to the general health services, which are key to a good vigilance system.
- Tool Designer Organization:
- Global Malaria Programme, World Health Organization
- Field manual in English
Summary of main features
- This manual has been developed to provide guidance to the increasing number of countries that have decided to eliminate malaria from their territory
- Scope of interventions
- The evolution of the programme, from control to elimination to preventing re-establishment of malaria, is described in detail, along with the important programme reorientations
Malaria elimination aims at sustainable interruption of local malaria transmission by mosquitoes despite a continued presence of malaria vector mosquitoes and importation of parasites from abroad through international travel and migration
- Solid programme management, adequate resources, responsive and comprehensive information systems and geographical access are required to manage and monitor elimination efforts and achieve targets.
The development of an operational plan for malaria elimination requires a comprehensive national effort. Full support from the highest levels of government to smooth coordination between different government ministries such as agriculture, defence, finance, health, and policy and planning is a prerequisite for operational success.
- Effective malaria elimination programmes set realistic targets and follow a comprehensive and funded plan of action, backed up by government commitment at the highest levels.
This document will serve as a tool in the implementation, monitoring and evaluation of malaria elimination programmes.
- Time frame
- To be used when planning for elimination of malaria with realistic timescales that usually stretches over at least 8–10 years
- Potential users
- National governments from endemic countries, partner and donor agencies, and field managers
- Skills required
- Type of software
- Adobe PDF
- User manual available?
- Type and length of training required
- Available languages
- Country applications
- Eastern Mediterranean countries
- Last update and version