Malaria Red Alert Warning, 13/03/99

March and April 1999 Are the High Risk Periods for What is Showing All the Signs of A Severe Malaria Season for Southern Africa.   

Southern Africa Malaria Weekly Surveillance as of 16^th February 1999 Indicates:  There has been an overall increase in malaria transmission within the Southern African Region this malaria season that validates the expected long-range malaria forecasts made in June and October 1998.

Although quality of reporting depends on the timeliness, coverage and completeness of the National Surveillance Systems, this surveillance data is placing many countries in Southern Africa on ‘Red Alert’ for a high risk malaria season.

Malaria Situation in Zimbabwe

18,025 clinical cases and 275 clinical deaths had been reported by end of February (1999) compared with 177,195 clinical cases and 269 clinical deaths by the same period last year (1998)  The focus of the seasonal increase is shifting from eastern Zimbabwe in Mutasa, Chipinge and Mudzi to the North and West such as Hwange, Binga and Gokwe.  Epidemic Hot-Sports exist in Hwange and Chipinge.

Response activities have mainly focused upon field treatment centers, Chloroquine distribution at community level and health education campaigns, field training and redeployment.  Field assessments, such as one recently undertaken in Hwange, Zimbabwe are being initiated to strengthen response efforts and to monitor quality of services.

Malaria Situation in Botswana

8867 clinical cases and 10 clinical deaths had been reported by third week of January, compared with 8142 clinical cases and 9 clinical deaths by the same time last year (1998)  Earlier increases than normal were identified with a higher trend than previous years.  The most affected districts were Okavango, Ngami, Tutume, Botetei, Chobe and Okavango.

Response activities include the re-deployment of staff to health facilities in the affected areas and the issue of emergency epidemic supplies to areas of need.  The main response approach has been through case management at health facilities.

Malaria Situation in South Africa

3826 confirmed cases and 19 confirmed deaths had been reported by the end of February, compared with 4021 confirmed cases and 36 confirmed deaths by the same time last year (1998).  Localised increases have been identified in Murale, Malamulele, Tonga, Ingwavuma districts.

Malaria Situation in Swaziland

2956 confirmed cases and 7 confirmed deaths had been reported from sentinel sites by end of February.  Overall increases reported in Lomasha.  The local health services are managing.

Malaria Situation in Namibia

High risks have been identified in the North and North East of the country.

Actions to Reduce Malaria Vulnerability Undertaken So Far..

	In high risk malaria areas, houses have been sprayed with insecticides
	Bed nets have been impregnated
	Drug supplies have been checked
	Surveillance and field assessment of situation have been conducted in Zimbabwe and Botswana and is planned in Namibia.
	Preparedness activities to improve the response organized in some countries.
	Pro-active response is in place in Botswana and Zimbabwe

Action Taken by WHO – Southern Africa Malaria Control (SAMC)

	Malaria forecasts for the 1998 – 1999 malaria season forecasting high malaria transmission and epidemic risks
	Advocacy and information by identification of high risk countries and districts
	Preventing epidemics through targeting and improving coverage of house spraying and encouraging use of insecticide treated mosquito nets.
	Public information and advocacy through malaria weeks.
	Orientation and training of health staff in malaria epidemics.
	Strengthening coverage and quality of malaria surveillance
	Malaria epidemic preparedness assessments in selected countries and districts.
	Establishing emergency stocks of malaria drugs
	Establishing emergency response support teams

Malaria & Rainfall Forecast for March-April: 1999 Red Alert

	Expected continued seasonal increase with possible epidemics, especially over weeks 11-15, in March
	Potential problem maybe expected within N.Namibia, S.Mozambique and S.Zambia
	Situation anticipated to deteriorate in countries already experiencing problems.

Pro-Active Action Required by Health System and Health Workers “More aggressive preparedness & response for epidemics is required”

	Strengthen weekly surveillance – look for weekly changes in trends and epidemics in high-risk districts.
	Ensure and maintain extra stocks of all necessary malaria drugs and equipment in high risk districts/areas
	Establish temporary malaria camps/satellite clinics to support hard to reach areas
	Utilise extra mobile malaria control teams in high risk districts to pro-actively seek and treat patients.
	Deploy extra staff, radios and transport to high-risk districts
	nform army and civil defense to mobilize additional support
	Mobilization of community and other leaders in areas of risk

Action Now Required By Public

	Urgently protect pregnant women and children (NOW!) who are highly vulnerable to malaria
	Make sure you have mosquito nets treated with insecticides to protect yourself and your family against mosquito bites.
	Use mosquito repellants and wear long clothing to stop the mosquitoes from biting
	Seek malaria treatment early if you show malaria signs and symptoms
	Complete the malaria treatment course for your own improvement
	Do not was or re-plaster walls sprayed with insecticides
	Report any seasonal increase in malaria and epidemics in a localized area

Coordinated Action Required by WHO Multilateral and Bilateral Agencies

	Prepare for emergency technical support, and mobilization of emergency funds to support malaria epidemic response.
	Invest in long term support for malaria control programs

Action Now Required By Press

	Save lives by informing the public on current malaria situation and control
	Save lives by educating the public on how best they can protect themselves
	Avoid triggering panic by sensationalizing a story.  Check your data with the district provincial or national health teams.

“The Health Workers, The Public, The Press and the Bilateral and Multilateral Agencies Must Work Together To Save Lives From Malaria”

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