Hoda Atta - Progress and Challenges in Malaria control and Elimination
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Conferencia: La contribución española en Malaria y los esfuerzos para la eliminación Ciencias de la Vida y de la Materia La Malaria en el mundo: control y eliminación Hoda Atta: Consultora Regional Malaria. Oficina Regional de la OMS para el Mediterráneo Oriental. Egipto. Madrid, 25 de abril de 2012
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Hoda Atta - Progress and Challenges in Malaria control and Elimination
- 1. FUNDACIÓN RAMÓN ARECES La Malaria en el mundo: control y eliminación Hoda Atta Madrid, 25 de abril de 2012
- 2. Progress and Challenges in Malaria control and Elimination in the Eastern Mediterranean Region Dr Hoda Youssef Atta Regional Malaria Advisor WHO / EMRO
- 3. Gaps … Coverage is increasing but…. MIS showed some increase in treatment with ACTs and prevention by long % of HH with at least one LLIN in lasting treated LNs Sudan _N , Sill far below from universal coverage
- 4. Current Malaria Situation in the PV 14% Eastern Mediterranean Region PF , 86% Malaria-free countries Focal transmission/targeting elimination High-burden countries targeting control Non-EMRO countries The Region is mainly a low unstable transmission area 87% of surveys conducted during 1985–2007 showed falciparum prevalence below 86 10% 4 Source: Guerra et al, PLoS
- 5. Reported malaria Morbidity 2000–2010 No of Cases Millions Reported Malaria Cases in EMR-2000-10 10 8 The reported incidence of total 6 malaria cases 9,3 m 4 2000 to in 7,2 in 2010 (28% decrease 2 ) 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Confirmed cases Total reported cases Reported confirmed does not show any Sources: Annual malaria surveillance reports from countries reduction 78.2% % reported confirmed Burden of confirmed cases in 2010 by country cases is carried mainly by 3 countries 11.6% 5.1% 3.3% 1.2% 0.5% 5 Sudan (N&S) Pakistan Yemen Afghanistan Somalia other 5
- 6. Elimination achievements in last decade 1. WHO certified The United Arab Emirates as malaria-free in 2007 2. WHO certified Morocco as malaria-free in 2010 3. Syria eliminated malaria (PV) reported last local case in 2004 , 4. Iraq reported last cases in 2008
- 7. Saudia Arabia reported only 29 local cases - 99% reduction compared to yr 2000 ( mainly PF ) 45,000 40,000 35,000 30,000 25,000 20,000 15,000 10,000 5,000 1941 29 0 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 Iran has a low record of 1847 , 85% reduction compared to yr2000. ( PF,PV ) Trend of Total and Local Cases- Iran (Islamic Republic of ) 25000 Total Reported Cases Local Cases 20000 15000 10000 5000 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
- 8. SPR% from school survey, Tihama area, Yemen Success of the malaria- 25% free initiatives in 21.9% 20% endemic areas 15% 10% 5% 4.5% 0% Khartoum State in Sudan 2001 2002 2003 2004 2005 2006 2007 2008 2009 Recorded malaria cases in Socotra Island (2000–2007) 3000 2333 2500 2000 1500 1000 500 107 158 60 30 4 0 0 0 8 2000 2001 2002 2003 2004 2005 2006 2007 8
- 9. Gaps … Coverage is increasing but…. MIS showed some increase in treatment with ACTs and prevention by long % of HH with at least one LLIN in lasting treated LNs Sudan _N , Sill far below from universal coverage
- 10. Barriers in endemic countries GRAET DOUBT ABOUT Reported Malaria Cases in EMR-2000-10 RELAIBILITY OF REPORTED Millions % MALARIA DATA AND REAL 10 30 MALARIA BURDEN 9 8 25 No of Cases 7 20 -Weakness of diagnostic 6 systems 5 15 4 -43% of facilities surveyed 3 10 in Sudan had functional 2 5 microcopy , 10.5% had 1 0 0 RDT - Weak health information and Total reported cases % confirmation malaria surveillance system 10 10
- 11. Floods in Pakistan Challenges 2010 Climate change and natural disasters. The malaria situation in Pakistan has worsened since the heavy floods in 2010. Complex emergencies duet to political problems, civil Imported malaria unrest, war in many areas in 3500 3264 EMR 3000 2500 2164 Considerable and increasing 2000 1166 1500 1184 population movement (legal and 1000 445343218 illegal) 500 90 85 71 59 23 7 0 Iran… Syrian Arab… Increase in imported malaria with Saudi Arabia Egypt Iraq Jordan Bahrain Oman Kuwait Tunisia UAE Qatar Morocco risk of reintroduction of malaria to countries that eliminated it. Oman reported several outbreaks of local cases in 2007-2011
- 12. Way forward More Political Commitment is needed to be translated into national expenditure Strengthen the capacity of malaria programme managers down to district level for planning and management by regional training courses Support sub-regional initiatives ( e.g., malaria free Arabian peninsula ) , regional networks , inter-regional cooperation More emphasis on T3 – test treat track
Notas del editor
- Malaria is endemic and considered a priority health problem in Seven countries of the Region as follows: the sub-Saharan countries of the Region (Djibouti, Somalia and Sudan, South Sudan ) and Yemen where P. falciparum is predominant, while in Afghanistan and Pakistan both P. falciparum and P. vivax are transmitted. These countries are implementing malaria control interventions. In another two countries (Islamic Republic of Iran and Saudi Arabia) malaria transmission is focal, mainly in the border areas and elimination is targetedThe remaining countries of the region have eliminated malaria either long time ago (Bahrain, Jordan, Kuwait, Lebanon, Libya, Palestine, Qatar, Tunisia, Egypt and United Arab Emirates) or in the past decade (Morocco, Oman, Syria, Iraq). The risk of malaria reintroduction as a result of importation in these countries still exists. Oman had reports of limited outbreaks of indigenous cases as a result of importation; the programme is able to contain such occasion and present reestablishment of local transmission.
- total reported morbidity 7.3 million in 2010, only 28.5% were confirmed parasitologically