Malawi The control of neglected tropical diseases represents a major challenge to those providing healthcare services in the endemic countries. The purpose of this country profile is to provide public health professionals with the most recently available epidemiological information on diseases for which a strategy and tools to implement large-scale preventive chemotherapy exist. This summary outlines the burden of targeted diseases and program implementation outcomes in Malawi. BASIC COUNTRY DATA Total population,86,8 Population years (Pre-SAC),09,03 Population 5 years (SAC),30,7 Population female 5 9 years 3,3,33 Population requiring preventive chemotherapy (PC) Lymphatic filariasis (LF) *,887,8 Schistosomiasis (SCH) *,30,699 Soil-transmitted helminthiasis (STH) * - Pre-SAC,09,03 - SAC,30,7 Onchocerciasis (Oncho),936,9 Trachoma Development status Income status School enrolment data Gross enrolment rate Girls enrolment ratio (gross) * Provisional estimates, to be refined LDC LIC Source: Population data and population requiring PC for STH - United Nations, Population Division, The World Population Prospects - the revision, New York, 009; Population requiring PC for LF - PELF; Population requiring PC for SCH - estimates based on L.Chitsulo et al. / Acta Tropica 77(000)-5; Population requiring PC for Oncho - APOC; Population requiring PC for Trachoma - ; School enrolment data - UNESCO Institute of Statistics, 000 Assessment. United Nations classification; World Bank classification. SITUATION ANALYSIS OF PREVENTIVE CHEMOTHERAPY DISEASES AFRICAN REGION The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which WHO. All rights reserved PCT disease ity status (endemic/nonendemic) Disease distribution (Nationwide/ partial) Mapping status (/in progress/not done) Implementation status (/inprogress/not done) Lymphatic filariasis Nationwide Not done Schistosomiasis Nationwide In progress Soil-transmitted Nationwide In progress helminthiasis Onchocerciasis Partial In progress Trachoma Loa-loa Non-endemic
Maps of infection/disease endemicity Lymphatic filariasis Onchocerciasis ity of LF ity of Oncho Non-endemic Non-endemic 0 5 90 80 70 360 Schistosomiasis S. haematobium 50% and above 0 5 90 80 70 360 Soil-transmitted helminthiasis Prevalence of S.h Less than 0% >=0% and <50% Prevalence of STH Less than 0% >=0% and <50% 0 5 90 80 70 360 Schistosomiasis S. mansoni 50% and above 0 5 90 80 70 360 Prevalence of S.m Less than 0% >=0% and <50% 50% and above Trachoma No data available 0 5 90 80 70 360
Maps of preventive chemotherapy strategy required PC strategy required - ROUND 0 90 80 70 360 5 PC strategy required - ROUND ROUND No implementation MDA ROUND T 0 90 80 70 360 5 MDA (IVM+ALB), MDA (DEC+ALB), MDA3 (IVM), T (ALB or MBD + PZQ), T (PZQ), T3 (ALB or MBD) 3
Preventive chemotherapy implementation PREVENTIVE CHEMOTHERAPY IMPLEMENTATION 006 007 009 00 MDA (IVM + ALB) ROUND MDA (DEC + ALB) MDA3 (IVM) T (ALB or MBD + PZQ) T (PZQ) T3 (ALB or MBD) T (ALB or MBD + PZQ),795,909,89,9 8.9% PreSAC/SAC,93,08,865,73,56,33 8.9% PreSAC,76,87 3,358,86,70,33 33.3% 80.5%,936,9,597,659 8.5% PreSAC/SAC,98,57 ROUND T (PZQ) SAC,785 T3 (ALB or MBD) PreSAC,87,96 - proportion (%) of endemic districts covered with preventive chemotherapy; - proportion (%) of individuals who were treated as per the programme target.
National disease-specific coverage LYMPHATIC FILARIASIS SCHISTOSOMIASIS * 0 8 6 0 SOIL-TRANSMITTED HELMINTHIASIS Pre-SAC **.5.0.5.0 0.5 0.0 ONCHOCERCIASIS **.5.0.5.0 003 00 005 006 007 60% 0% 0% 60% 0% 0% 0% 8% 76% SAC ** Number of individuals received at least one round of annual treatment. 0% 3 0 * SAC 5 3 0 003 00 005 006 007 TRACHOMA No data available.0% 0.8% 0.6% 0.% 0.% 0.0% 60% 0% 0% 0% 0.5 7% 0.0 005 006 007 68% *** Number of people treated via LF programme (MDA) is not included in this chart. National disease-specific coverage - proportion (%) of individuals in the population requiring preventive chemotherapy for the specific disease (see Basic country data on page ) that have been treated. 5
Monitoring decline of disease endemicity (in sentinel sites or periodic surveys) LYMPHATIC FILARIASIS Cumulative number of SS with base line mf>% identified (of total) Percent of the SS (with a baseline of >%) which have Mf prev <% in year No. of IUs where MDA discontinued after meeting epidemiological criteria SOIL-TRANSMITTED HELMINTHIASIS STH prevalence in pre-sac (range) STH prevalence in SAC (range) SCHISTOSOMIASIS S. haematobium prevalence (range) S. mansoni prevalence (range) ONCHOCERCIASIS TF/TI ratio in -9 years old Trachomatous trichiasis males & females > 30 years old Districts achieving Ultimate Intervention Goals, % CHANCE at least TRACHOMA Trachomatous inflammation follicular in -9 years old Trachomatous inflammation intense in -9 years old Trachomatous trichiasis males & females > years old Corneal opacity males & females > years old For more detailed information, please contact: Preventive Chemotherapy and Transmission Control, Department of Control of Neglected Tropical Diseases World Health Organization, 0, avenue Appia, Geneva 7, Switzerland We would also like to be informed as soon as possible if we have made any errors in detailing your activities or if you have any other comments. Thank you for your collaboration. Our contact e-mail is pctdata@who.int 6 World Health Organization 009. All rights reserved. This document is not a formal publication of WHO and does not necessarily represent the decisions or the stated policy of the Organization. The presentation of maps contained herein does not imply the expression of any opinion whatwoever on the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delineation of its frontiers or boundaries.