Country profiles

Afghanistan68
Algeria69
Angola70
Argentina71
Azerbaijan72
Bangladesh73
Belize74
Benin75
Bhutan76
Bolivia (Plurinational State of )
77
Botswana78
Brazil79
Burkina Faso
80
Burundi81
Cabo Verde
82
Cambodia83
Cameroon84
Central African Republic
85
Chad86
China87
Colombia88
Comoros89
Congo90
Costa Rica
91
Cte dIvoire
92
Democratic Peoples Republic of Korea
93
Democratic Republic of the Congo
94
Djibouti95
Dominican Republic
96
Ecuador97
El Salvador
98
Equatorial Guinea
99
Eritrea100
Ethiopia101
French Guiana, France
102
Gabon103
Gambia104
Ghana105
Guatemala106
Guinea107
Guinea-Bissau108
Guyana109
Haiti110
Honduras111
India112
Indonesia113
Iran (Islamic Republic of )
114
Kenya115
Lao Peoples Democratic Republic
116

Liberia117
Madagascar118
Malawi119
Malaysia120
Mali121
Mauritania122
Mayotte, France
123
Mexico124
Mozambique125
Myanmar126
Namibia127
Nepal128
Nicaragua129
Niger130
Nigeria131
Pakistan132
Panama133
Papua New Guinea
134
Paraguay135
Peru136
Philippines137
Republic of Korea
138
Rwanda139
Sao Tome and Principe
140
Saudi Arabia
141
Senegal142
Sierra Leone
143
Solomon Islands
144
Somalia145
South Africa
146
South Sudan
147
Sri Lanka
148
Sudan149
Suriname150
Swaziland151
Tajikistan152
Thailand153
Timor-Leste154
Togo155
Turkey156
Uganda157
United Republic of Tanzania (Mainland)
158
United Republic of Tanzania (Zanzibar)
159
Vanuatu160
Venezuela (Bolivarian Republic of )
161
Viet Nam
162
Yemen163
Zambia164
Zimbabwe165

Afghanistan

Eastern Mediterranean Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

8220000
14900000
7460000
30580000

27
49
24

Major plasmodium species: P. falciparum (5%), P. vivax (95%)

Major anopheles species:
An. stephensi, An. superpictus, An. hyrcanus, An. pulcherrimus, An. culicifacies, An. fluviatilis
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
39263
24

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2010
2010

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2012

Larval control Use of larval control recommended

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
No
No
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2000
2000

Treatment

ACT is free for all ages in public sector

Yes 2003
Artemisinin-based monotherapies withdrawn
Yes 2003
Single dose of primaquine is used as gametocidal medicine for P. falciparum No
Primaquine is used for radical treatment of P. vivax
Yes 2010
G6PD test is a requirement before treatment with primaquine
Yes 2010
Directly observed treatment with primaquine is undertaken
Yes 2011
System for monitoring of adverse reactions to antimalarials exists
No

2012

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

CQ

AS+SP+PQ
2014
QN
AM; AS; QN

CQ+PQ(8w)

0.75 mg/kg (8 weeks)

Type of RDT used

P.f + P.v, P.o, P.m (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AS+SP 20052013
0 0 1 28 days 8
P. falciparum
CQ
20072009
0
0
0
28 days
4
P. vivax

World Bank

(%)

Cases (%)

Cases tested and treated in public sector

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

Management and other costs

Survey source: Other nat.

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

20
16
12
8
4
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

100
80
60
40
20
0

6000
4800
3600
2400
1200
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Reporting completeness

Suspected cases tested

Survey source: Other nat.
<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Funding source(s): Global

Fund, WHO

Others

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Survey source: Other nat.
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

WHO/UNICEF

Tests (%)

Population (%)

IV. Coverage

USAID/PMI

Cases (P. vivax)

Malaria admissions and deaths

5
4
3
2
1
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Aber (microscopy
& RDT)
Cases
(p.vivax) points
68 | WORLD MALARIA
REPORT
2014
Cases (p.vivax)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

50
40
30
20
10
0

Deaths

Global Fund

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

20
16
12
8
4
0

ABER (%)

Contribution (US$m)

III. Financing

Algeria

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
Number of active foci
Number of people living within active foci
Number of people living in malaria-free areas
Total

2013

0

39200000
39200000

100

Parasites and vectors

Major plasmodium species: P. falciparum (88%), P. vivax (13%)
Major anopheles species:
An. multicolor, An. labranchiae, An. sergentii, An. hispaniola
Programme phase:

Elimination

Total confirmed cases, 2013:

Total deaths, 2013:

603
3

Indigenous cases, 2013:

Indigenous deaths, 2013:

0
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

No
No

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1980

Yes

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Foci and case investigation undertaken

Case reporting from private sector is mandatory

Yes
No
No
Yes
Yes
Yes
Yes

Yes

1968

Larval control Use of larval control recommended

IPT

IPT used to prevent malaria during pregnancy

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Treatment

ACT is free for all ages in public sector

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

Yes

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

Global Fund

World Bank

WHO/UNICEF

Follow-up No. of studies

Species

Others

Cases tested

Cases (%)

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases tracked

(%)

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtreated
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

100
80
60
40
20
0

Suspected cases tested points

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

ACTs distributed vs reported P. falciparum cases

ACTs as % of all antimalarials received by <5 (survey)

Cases investigated

ACTs as % of all antimalarials received by <5 (survey)

Malaria
test positivity
and ABER
Antimalarials
distributedrate
vs reported
cases

Primaquine distributed vs reported P.vivax cases

ACTs distributed vs reported P.falciparum cases points
ACTs distributed vs reported P.falciparum cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Slide positivity rate

RDT positivity rate

Foci investigated

Number of malaria cases

20
16
12
8
4
0

Cases

Population (%)
Cases (%)

USAID/PMI

ITN and IRS coverage

Others

Positivity rate (%)

Max

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

At high risk protected with ITNs

Households with at least one ITN

6.0
4.8
3.6
2.4
1.2
0

Median

Financing by intervention in 2013

Sources of financing

IV. Coverage

100
80
60
40
20
0

Min

No data reported for 2013

Government
100
80
60
40
20
0

Year

ABER (%)

Contribution (US$m)

100
80
60
40
20
0

CQ

0.25 mg/kg (14 days)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

III. Financing

1968

1000
800
600
400
200
0

Reporting completeness
Foci investigated
Cases investigated points
Cases investigated
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Total cases
Indigenous cases (P. falciparum)

Imported cases
Indigenous cases (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Aberpositivity
(microscopy
RDT)
RDT
rate&points
RDT positivity rate
Slide positivity points
Slide positivity rate

WORLD MALARIA REPORT 2014 | 69

Imported cases points
Imported cases
Indigenous (P.vivax) points

Angola

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

PF-RATIO

>75

4060

6080

PP

2013

%
100
0
0

2040

>75

4060

6080
80100
Based on 2012 reported data

80100

I. Epidemiological profile
21500000
0
0
21500000

No cases

1.010

2040

Based on 2012 reported data

High transmission (> 1 case per 1000 population)

Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

1.010

Population

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. gambiae, An. funestus, An. nili
Programme phase:

Control

Reported confirmed cases: 1999868

Reported deaths:
7300

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
No

2001
2010

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2003

Larval control Use of larval control recommended

Yes

2009

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
No
No

IPT

IPT used to prevent malaria during pregnancy

Yes

2005

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2010
2006

Treatment

ACT is free for all ages in public sector

Yes 2006
Artemisinin-based monotherapies withdrawn
No

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
Yes 2006
G6PD test is a requirement before treatment with primaquine
Yes

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2006
AL
2006
QN 2006
AS; QN

0.25 mg/kg (14 days)

Type of RDT used

P.f + P.v specific (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20132013 2.7
6.5
10.3
28 days
2
P. falciparum
DHA-PPQ
20132013
0
0
0
28 days
2
P. falciparum

Cases tested and treated in public sector

Survey source: MIS 2007, MIS 2011

Cases per 1000

100
80
60
40
20
0

2500
2000
1500
1000
500
0

Survey source: MIS 2007, MIS 2011

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

100
80
60
40
20
0

Management and other costs

Survey source: MIS 2007, MIS 2011

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS

Funding source(s): Global Fund,

USAID/PMI, UNICEF

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

(%)

WHO/UNICEF

Cases (P. vivax)

Suspected cases tested

Survey source: MIS 2011
<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

20
16
12
8
4
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Cases (p.vivax) points
70 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

300
240
180
120
60
0

Deaths

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

With access to an ITN (model)

With access to an ITN (survey)

100
80
60
40
20
0

USAID/PMI

Tests (%)

Population (%)

IV. Coverage

World Bank

Cases (%)

Global Fund

Pie chart includes 44%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

120
96
72
48
24
0

ABER (%)

Contribution (US$m)

III. Financing

Argentina

Region of the Americas

EURO / PAHO
Confirmed cases
API 1000 population
per

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

Represents foci (active or non-active)

I. Epidemiological profile
Population
Number of active foci
Number of people living within active foci
Number of people living in malaria-free areas
Total

2013

0
0
41400000
41400000

0
100

Parasites and vectors

Major plasmodium species: P. falciparum (0%), P. vivax (0%)
Major anopheles species:
An. pseudopunctipennis, An. darlingi
Programme phase:

Elimination

Total confirmed cases, 2013:

Total deaths, 2013:

4
0

Indigenous cases, 2013:

Indigenous deaths, 2013:

0
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

No
No

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2013

Larval control Use of larval control recommended

No

IPT

IPT used to prevent malaria during pregnancy

N/A

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Foci and case investigation undertaken

Case reporting from private sector is mandatory

Yes
No
Yes
Yes
No
Yes
Yes

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1980

Treatment

ACT is free for all ages in public sector

Yes

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

Yes

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

Global Fund

World Bank

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013
Insecticide & spraying materials

Cases tracked
100
80
60
40
20
0

Suspected cases tested points

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

Primaquine distributed vs reported P. vivax cases

Cases investigated

Primaquine distributed vs reported P.vivax cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Pie chart includes 100%

of total contributions

Management and other costs

Suspected cases tested

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtreated
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

(%)

Cases (%)
Positivity rate (%)

100
80
60
40
20
0

Malaria
test positivity
and ABER
Antimalarials
distributedrate
vs reported
cases

ABER (microscopy & RDT)

Species

Cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Follow-up No. of studies

Funding source(s): Government

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Antimalarials distributed vs reported cases

Max

Others

ITN and IRS coverage

10
8
6
4
2
0

WHO/UNICEF

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

USAID/PMI

Cases (%)

100
80
60
40
20
0

Median

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

RDT positivity rate

Foci investigated

Number of malaria cases

10
8
6
4
2
0

Cases

Population (%)

IV. Coverage

Min

Financing by intervention in 2013

Sources of financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government

Year

ABER (%)

Contribution (US$m)

3.0
2.4
1.8
1.2
0.6
0

AL+PQ

CQ+PQ

0.25 mg/kg (14 days)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

III. Financing

500
400
300
200
100
0

Reporting completeness
Foci investigated
Cases investigated points
Cases investigated
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Total cases
Indigenous cases (P. falciparum)

Imported cases
Indigenous cases (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Aberpositivity
(microscopy
RDT)
RDT
rate&points
RDT positivity rate
Slide positivity points
Slide positivity rate

WORLD MALARIA REPORT 2014 | 71

Imported cases points
Imported cases
Indigenous (P.vivax) points

Azerbaijan

EURO / PAHO
Confirmed cases
API 1000 population
per

European Region

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

I. Epidemiological profile
Population
Number of active foci
Number of people living within active foci
Number of people living in malaria-free areas
Total

2013

6
12600
9400000
9412600

0
100

Parasites and vectors

Major plasmodium species: P. falciparum (0%), P. vivax (0%)
Major anopheles species:
An. sacharovi, An. maculipennis
Programme phase:

Elimination

Total confirmed cases, 2013:

Total deaths, 2013:

4
0

Indigenous cases, 2013:

Indigenous deaths, 2013:

0
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
No

2009

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1930

Larval control Use of larval control recommended

Yes

1930

IPT

IPT used to prevent malaria during pregnancy

N/A

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Foci and case investigation undertaken

Case reporting from private sector is mandatory

Yes
Yes
No
Yes
Yes
Yes
Yes

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1930

Treatment

ACT is free for all ages in public sector

Yes 2009
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
Yes 1956
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

Yes 1956
System for monitoring of adverse reactions to antimalarials exists
Yes 1956

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

Global Fund

World Bank

100
80
60
40
20
0

Cases (%)

Monitoring and evaluation

Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013
Insecticide & spraying materials

Suspected cases tested points

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

ACTs distributed vs reported P. falciparum cases

ACTs as % of all antimalarials received by <5 (survey)

Cases investigated

ACTs as % of all antimalarials received by <5 (survey)

Primaquine distributed vs reported P.vivax cases
ACTs distributed vs reported P.falciparum cases points
ACTs distributed vs reported P.falciparum cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Funding source(s): Government,

Global Fund, USAID/PMI, WHO,
Other (bilateral)

Human Resources & technical Assistance

Malaria
test positivity
and ABER
Antimalarials
distributedrate
vs reported
cases

ABER (microscopy & RDT)

Pie chart includes 100%

of total contributions

Cases tracked

(%)

Cases (%)
Positivity rate (%)

0.30
0.24
0.18
0.12
0.06
0

RDT positivity rate

2000
1600
1200
800
400
0

Reporting completeness
Foci investigated
Cases investigated points
Cases investigated
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Total cases
Indigenous cases (P. falciparum)

Aber (microscopy & RDT)

Slide positivity points
Slide positivity rate

Foci investigated

Number of malaria cases

300
240
180
120
60
0

Impact: Achieved >75% decrease in case incidence in 2013

RDT positivity rate points
72 | WORLD MALARIA
REPORT 2014
RDT positivity rate

Species

Management and other costs

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtreated
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v cases

Follow-up No. of studies

Cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Max

Others

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

WHO/UNICEF

ITN and IRS coverage

Others

Cases

Population (%)

100
80
60
40
20
0

USAID/PMI

Median

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government

Min

Financing by intervention in 2013

Sources of financing

IV. Coverage

Year

ABER (%)

Contribution (US$m)

10
8
6
4
2
0

AS+SP
2008
AS+SP
2008
QN+CL 2008
AS; QN
2008
CQ+PQ(14d)

0.25 mg/kg (14 days)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

III. Financing

1930
1930

1998
1998
1930
2008

Imported cases points

Imported cases
Indigenous (P.vivax) points

Imported cases
Indigenous cases (P. vivax)

Bangladesh

South-East Asia Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Insufficient data
0

Insufficient data
No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

>75

4060

6080

No cases

1.010
PP

2040

Based on 2012 reported data

2040

>75

4060

6080
80100
Based on 2012 reported data

80100

I. Epidemiological profile
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Insufficient data

Insufficient data
0

PF-RATIO

1.010

Population

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

2013

Parasites and vectors

4170000
12100000
140400000
156670000

3
8
90

Major plasmodium species: P. falciparum (87%), P. vivax (13%)

Major anopheles species:
An. dirus, An. minimus, An. philippinensis, An. sundaicus, An. albimanus, An. annularis
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

3864
15

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2008
2008

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2008

Larval control Use of larval control recommended

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
No
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2008
2008

Treatment

ACT is free for all ages in public sector

Yes 2008
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
Yes 2008
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes 2008

2008
2008

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2004
QN+D; QN+T
2004
AM; QN
2004
CQ+PQ(14d)
2004
0.25 mg/kg (14 days)

Type of RDT used

P.f + P.v specific (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20062014
0
0
11.1
28 days
10
P. falciparum
QN+D
20082009
0
0
0
28 days
1
P. falciparum

World Bank

(%)

100
80
60
40
20
0

Cases (%)

Cases tested and treated in public sector

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

Management and other costs

Survey source: DHS 2011

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

Test positivity
100
80
60
40
20
0

6000
4800
3600
2400
1200
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

% fever cases <5 seeking treatment at public HF (survey)

1.0
0.8
0.6
0.4
0.2
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS
Survey source: DHS 2000, DHS 2004, DHS 2007, DHS 2011

V. Impact

Reporting completeness

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
Antimalarials
vs reported
points2010 2011 2012 2013
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Funding source(s): Global

Fund, WHO

Others

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

WHO/UNICEF

Tests (%)

Population (%)

IV. Coverage

USAID/PMI

Cases (P. vivax)

Malaria admissions and deaths

5
4
3
2
1
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

600
480
360
240
120
0

Deaths

Global Fund

Pie chart includes 66%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

20
16
12
8
4
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
2014 | 73
Deaths (P.vivax)
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Belize

Region of the Americas

EURO / PAHO
Confirmed cases
API 1000 population
per

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

Represents foci (active or non-active)

I. Epidemiological profile
Population
Number of active foci
Number of people living within active foci
Number of people living in malaria-free areas
Total

2013

6
4540
327000
331540

1
99

Parasites and vectors

Major plasmodium species: P. falciparum (0%), P. vivax (100%)
Major anopheles species:
An. albimanus, An. darlingi
Programme phase:

Pre-elimination

Total confirmed cases, 2013:

Total deaths, 2013:

26
0

Indigenous cases, 2013:

Indigenous deaths, 2013:

20
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2009
2009

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

Larval control Use of larval control recommended

Yes

IPT

IPT used to prevent malaria during pregnancy

N/A

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Foci and case investigation undertaken

Case reporting from private sector is mandatory

Yes
No
Yes
No
No
Yes
Yes

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

Year
Antimalaria treatment policy
Medicine
adopted

Treatment

ACT is free for all ages in public sector

Yes 2010
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

Yes

System for monitoring of adverse reactions to antimalarials exists

No

First-line treatment of unconfirmed malaria

First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

Global Fund

World Bank

Funding source(s): Government,

USAID/PMI, WHO

Monitoring and evaluation

Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013
Insecticide & spraying materials

Cases tracked
100
80
60
40
20
0

Suspected cases tested points

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

Primaquine distributed vs reported P. vivax cases

Cases investigated

Primaquine distributed vs reported P.vivax cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Pie chart includes 100%

of total contributions

Human Resources & technical Assistance

Malaria
test positivity
and ABER
Antimalarials
distributedrate
vs reported
cases

ABER (microscopy & RDT)

RDT positivity rate

2000
1600
1200
800
400
0

Reporting completeness
Foci investigated
Cases investigated points
Cases investigated
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Total cases
Indigenous cases (P. falciparum)

Aber (microscopy & RDT)

Slide positivity points
Slide positivity rate

Foci investigated

Number of malaria cases

15
12
9
6
3
0

Impact: Achieved >75% decrease in case incidence in 2013

RDT positivity rate points
74 | WORLD MALARIA
REPORT 2014
RDT positivity rate

Species

Management and other costs

Suspected cases tested

(%)

Cases (%)
Positivity rate (%)

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtreated
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Follow-up No. of studies

Cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Antimalarials distributed vs reported cases

Max

Others

ITN and IRS coverage

10
8
6
4
2
0

WHO/UNICEF

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

USAID/PMI

Cases (%)

100
80
60
40
20
0

Median

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

Cases

Population (%)

IV. Coverage

Min

Financing by intervention in 2013

Sources of financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government

Year

ABER (%)

Contribution (US$m)

0.30
0.24
0.18
0.12
0.06
0

CQ+PQ (1d)

QN

CQ+PQ(14d)

0.25 mg/kg (14 days)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

III. Financing

Imported cases points

Imported cases
Indigenous (P.vivax) points

Imported cases
Indigenous cases (P. vivax)

Benin

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

10300000
0
0
10300000

100
0
0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. gambiae, An. funestus, An. melas
Programme phase:

Control

Reported confirmed cases: 1078834

Reported deaths:
2288

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
No

2007

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2006

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
No
Yes
No

Larval control Use of larval control recommended

No

IPT

IPT used to prevent malaria during pregnancy

Yes

2005

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2011
2008

Treatment

ACT is free for all ages in public sector

No

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes 2005

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2004
AL
2004
QN 2004
AS; QN

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20052011
0
0.75
6.5
28 days
6
P. falciparum

No data reported for 2013

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

WHO/UNICEF

Cases tested and treated in public sector

Survey source: DHS 2006, DHS 2012

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

Antimalarials distributed vs reported cases

ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases

Test positivity
100
80
60
40
20
0

1000
800
600
400
200
0

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Survey source: DHS 2006, DHS 2012

Suspected cases tested

<5 with fever with finger/heel stick (survey)

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2001, DHS 2006, DHS 2012

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

120
96
72
48
24
0

Others

Tests (%)

Population (%)
(%)

100
80
60
40
20
0

USAID/PMI

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

With access to an ITN (model)

With access to an ITN (survey)

World Bank

ITN and IRS coverage

Others

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

15
12
9
6
3
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

25
20
15
10
5
0

Deaths

Global Fund

IV. Coverage

Cases (%)

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

50
40
30
20
10
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
2014 | 75
Deaths (P.vivax)
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Bhutan

South-East Asia Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Insufficient data
0

Insufficient data
No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

>75

4060

6080

PP

235000
519000
754000

31
69

2040

>75

4060

6080
80100
Based on 2012 reported data

80100

I. Epidemiological profile
2013

No cases

1.010

2040

Based on 2012 reported data

Number of active foci

Number of people living within active foci
Number of people living in malaria-free areas
Total

Insufficient data

Insufficient data
0

PF-RATIO

1.010

Population

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Parasites and vectors

Major plasmodium species: P. falciparum (59%), P. vivax (41%)
Major anopheles species:
An. culicifacies, An. maculatus, An. philippiensis, An. annularis
Programme phase:

Pre-elimination

Total confirmed cases, 2013:

Total deaths, 2013:

45
0

Indigenous cases, 2013:

Indigenous deaths, 2013:

15
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2006
2006

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1964

Larval control Use of larval control recommended

No

IPT

IPT used to prevent malaria during pregnancy

N/A

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Foci and case investigation undertaken

Case reporting from private sector is mandatory

Yes
No
Yes
Yes
Yes
Yes
No

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1964
1964

Treatment

ACT is free for all ages in public sector

Yes 2006
Artemisinin-based monotherapies withdrawn
Yes

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes 2012
Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes 2012

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

Global Fund

World Bank

WHO/UNICEF

Follow-up No. of studies

Species

Others

Cases tested

Cases (%)

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases tracked

(%)

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtreated
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

100
80
60
40
20
0

Suspected cases tested points

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

ACTs distributed vs reported P. falciparum cases

ACTs as % of all antimalarials received by <5 (survey)

Cases investigated

ACTs as % of all antimalarials received by <5 (survey)

Malaria
test positivity
and ABER
Antimalarials
distributedrate
vs reported
cases

Primaquine distributed vs reported P.vivax cases

ACTs distributed vs reported P.falciparum cases points
ACTs distributed vs reported P.falciparum cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Slide positivity rate

RDT positivity rate

8000
6400
4800
3200
1600
0

Reporting completeness
Foci investigated
Cases investigated points
Cases investigated
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Total cases
Indigenous cases (P. falciparum)

Impact: Achieved >75% decrease in case incidence in 2013

RDT positivity rate points
76 | WORLD MALARIA
REPORT 2014
RDT positivity rate
Aber (microscopy & RDT)
Slide positivity points
Slide positivity rate

Foci investigated

Number of malaria cases

20
16
12
8
4
0

Cases

Population (%)
Cases (%)

USAID/PMI

ITN and IRS coverage

Others

Positivity rate (%)

Max

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

At high risk protected with ITNs

Households with at least one ITN

10
8
6
4
2
0

Median

Financing by intervention in 2013

Sources of financing

IV. Coverage

100
80
60
40
20
0

Min

No data reported for 2013

Government
100
80
60
40
20
0

Year

AL
20052011
0
0
0
28 days
23
P. falciparum
CQ
20052011
0
0
0
28 days
22
P. vivax

ABER (%)

Contribution (US$m)

2.0
1.6
1.2
0.8
0.4
0

AL
2006
QN 2006
AM; QN
2006
CQ+PQ(14d)
2006
0.25 mg/kg (14 days)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

III. Financing

2013

2011
2012
2012
2012

Imported cases points

Imported cases
Indigenous (P.vivax) points

Imported cases
Indigenous cases (P. vivax)

Bolivia (Plurinational State of )

EURO / PAHO
Confirmed cases
API 1000 population
per

Region of the Americas

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

512000
3250000
6900000
10662000

5
31
65

Major plasmodium species: P. falciparum (16%), P. vivax (84%)

Major anopheles species:
An. darlingi, An. pseudopunctipennis
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

7342
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2008
2005

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1959

Larval control Use of larval control recommended

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
No
Yes
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2000
1996

Treatment

ACT is free for all ages in public sector

Yes 2003
Artemisinin-based monotherapies withdrawn
Yes

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
Yes 1998
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

No

1998

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+MQ+PQ
2001
QN+CL
QN
2001
CQ+PQ(7d)
2001
0.50 mg/kg (7 days)

Type of RDT used

P.f + P.v specific (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

CQ
20062011
0
7.8
10
28 days
4
P. vivax

World Bank

Cases per 1000

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

100
80
60
40
20
0

Suspected cases tested

Primaquine distributed vs reported P.v. cases points
Primaquine distributed vs reported P.v. cases
Antimalarials distributed vs reported cases points
Antimalarials distributed vs reported cases
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v. cases

Insecticide & spraying materials

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

5
4
3
2
1
0

Management and other costs

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high
risk protected with IRS
Survey source: DHS 2003, DHS 2008

Tests (%)

(%)

Cases tested and treated in public sector

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Funding source(s): Government,

Global Fund

Others

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

WHO/UNICEF

Cases (%)

Population (%)

IV. Coverage

USAID/PMI

Cases (P. vivax)

RDT positivity rate

Malaria admissions and deaths

10
8
6
4
2
0

300
240
180
120
60
0

Slide positivity rate points

Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

15
12
9
6
3
0

Deaths

Global Fund

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

5
4
3
2
1
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
2014 | 77
Deaths (P.vivax)
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Botswana

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

364000
950000
707000
2021000

18
47
35

Major plasmodium species: P. falciparum (100%), P. vivax (0%)

Major anopheles species:
An. arabiensis, An. gambiae
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

456
7

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2009
1997

IRS

IRS is recommended
DDT is authorized for IRS

Yes
Yes

1950
1950

Larval control Use of larval control recommended

Yes

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
No
No
No

IPT

IPT used to prevent malaria during pregnancy

No

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2010
1995

Treatment

ACT is free for all ages in public sector

Yes 2007
Artemisinin-based monotherapies withdrawn
Yes

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes

2012
2012
2012

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2007
AL
2007
QN 2007
QN
2007

Type of RDT used

P.f only

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

Cases (%)

Cases tested and treated in public sector

Cases per 1000

80
64
48
32
16
0

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity
100
80
60
40
20
0

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Management and other costs

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

5
4
3
2
1
0

Funding source(s): Government

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

(%)

WHO/UNICEF

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

With access to an ITN (model)

With access to an ITN (survey)

100
80
60
40
20
0

USAID/PMI

Tests (%)

Population (%)

IV. Coverage

World Bank

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

120
96
72
48
24
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Cases (p.vivax) points
78 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

2.5
2.0
1.5
1.0
0.5
0

Deaths

Global Fund

Pie chart includes 84%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

5
4
3
2
1
0

ABER (%)

Contribution (US$m)

III. Financing

Brazil

Region of the Americas

EURO / PAHO
Confirmed cases
API 1000 population
per

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

4610000
36100000
159700000
200410000

2
18
80

Major plasmodium species: P. falciparum (18%), P. vivax (82%)

Major anopheles species:
An. darlingi, An. albitarsis, An. aquasalis
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
178 546
41

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2007
2007

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1945

Larval control Use of larval control recommended

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
Yes
Yes
Yes

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1972
1972

Treatment

ACT is free for all ages in public sector

Yes 2006
Artemisinin-based monotherapies withdrawn
Yes 2010
Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes 2011
Primaquine is used for radical treatment of P. vivax
Yes 1972
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

World Bank

USAID/PMI

WHO/UNICEF

Cases (%)

100
80
60
40
20
0

2
3
2

Species
P. falciparum
P. falciparum
P. vivax

Pie chart includes <1%

of total contributions

Management and other costs

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v. cases

Insecticide & spraying materials

Tests (%)

Test positivity
100
80
60
40
20
0

Suspected cases tested

Primaquine distributed vs reported P.v. cases points
Primaquine distributed vs reported P.v. cases
Antimalarials distributed vs reported cases points
Antimalarials distributed vs reported cases
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (P. vivax)

RDT positivity rate

Malaria admissions and deaths

10
8
6
4
2
0

Admissions

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

Cases (all species)

28 days
42 days
28 days

Funding source(s): USAID/PMI

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Follow-up No. of studies

Cases tested and treated in public sector

% fever cases <5 seeking treatment at public HF (survey)

Cases per 1000

0
0
5.2

Others

ABER (%)

Contribution (US$m)
Population (%)
(%)

5
4
3
2
1
0

Max

0
0
3.25

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Median

0
0
1.3

Financing by intervention in 2013

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

Min

15 000
12 000
9000
6000
3000
0

Slide positivity rate points

Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

250
200
150
100
50
0

Deaths

Global Fund

IV. Coverage
100
80
60
40
20
0

Year
20052007
20052007
20052008

Sources of financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government

P.f + all species (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

AL
AS+MQ
CQ+PQ

120
96
72
48
24
0

AL+PQ(1d); AS+MQ+PQ(1d)
2012
QN+D+PQ
AM+CL; AS+CL; QN+CL

CQ+PQ(7d)
2006
0.50 mg/kg (7 days)

Type of RDT used

Medicine

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: On track for 75% decrease in case incidence 20002015

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
2014 | 79
Deaths (P.vivax)
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Burkina Faso

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

16900000
0
0
16900000

100
0
0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. gambiae, An. funestus, An. arabiensis
Programme phase:

Control

Reported confirmed cases: 3769051

Reported deaths:
6294

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2007
1998

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2006

Larval control Use of larval control recommended

Yes

2012

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
Yes
No

IPT

IPT used to prevent malaria during pregnancy

Yes

2005

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2009
2009

Treatment

ACT is free for all ages in public sector

No

Artemisinin-based monotherapies withdrawn

Yes 2009
Single dose of primaquine is used as gametocidal medicine for P. falciparum No
Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes 2009

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL; AS+AQ
2005
AL; AS+AQ
2005
QN
AS; QN

Type of RDT used

P.f only

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20052012
0
6.15
12.5
28 days
9
P. falciparum
AS+AQ
20062012
0
5.05
21.5
28 days
6
P. falciparum

WHO/UNICEF

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

Cases tested and treated in public sector

Survey source: DHS 2003, DHS 2010

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

3000
2400
1800
1200
600
0

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Survey source: DHS 2010

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity
100
80
60
40
20
0

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Management and other costs

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2003, MICS 2006, DHS 2010

% fever cases <5 seeking treatment at public HF (survey)

250
200
150
100
50
0

Others

Tests (%)

Population (%)
(%)

100
80
60
40
20
0

USAID/PMI

ITN and IRS coverage

Others

With access to an ITN (model)

With access to an ITN (survey)

World Bank

Funding source(s): Government,

Global Fund, USAID/PMI, World
Bank, WHO, UNICEF, Other
(bilateral), Other (all types)

Cases (P. vivax)

Suspected cases tested

Survey source: DHS 2010
<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

30
24
18
12
6
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Cases (p.vivax) points
80 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

60
48
36
24
12
0

Deaths

Global Fund

Cases (%)

Government

Pie chart includes 54%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

IV. Coverage
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

120
96
72
48
24
0

ABER (%)

Contribution (US$m)

III. Financing

Burundi

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

2440000
5490000
2240000
10170000

24
54
22

Major plasmodium species: P. falciparum (100%), P. vivax (0%)

Major anopheles species:
An. gambiae, An. funestus, An. arabiensis
Programme phase:

Control

Reported confirmed cases: 4141387

Reported deaths:
3411

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
No

2004

IRS

IRS is recommended
DDT is authorized for IRS

Yes

2009

Larval control Use of larval control recommended

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
No
Yes
No

IPT

IPT used to prevent malaria during pregnancy

No

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
No

2012

Treatment

ACT is free for all ages in public sector

Yes 2009
Artemisinin-based monotherapies withdrawn
No

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

No

2010

2003

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+AQ
2003
AS+AQ
2003
QN 2003
AS; QN

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AS+AQ
20052006 2.9
5.2
7.5
28 days
2
P. falciparum

No data reported for 2013

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

WHO/UNICEF

Cases tested and treated in public sector

Survey source: DHS 2010, MIS 2012, DHS 2013

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

Antimalarials distributed vs reported cases

ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases

Test positivity
100
80
60
40
20
0

1500
1200
900
600
300
0

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Survey source: MICS 2005, DHS 2010, MIS 2012, DHS 2013

Suspected cases tested

<5 with fever with finger/heel stick (survey)

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: MICS 2005, DHS 2010, MIS 2012, DHS 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

500
400
300
200
100
0

Others

Tests (%)

Population (%)
(%)

100
80
60
40
20
0

USAID/PMI

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

With access to an ITN (model)

With access to an ITN (survey)

World Bank

ITN and IRS coverage

Others

Cases (P. vivax)

Suspected cases tested

Survey source: MIS 2012
<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

100
80
60
40
20
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

35
28
21
14
7
0

Deaths

Global Fund

IV. Coverage

Cases (%)

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

35
28
21
14
7
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
2014 | 81
Deaths (P.vivax)
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Cabo Verde

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
Number of active foci
Number of people living within active foci
Number of people living in malaria-free areas
Total

2013

2
299000
200000
499000

60
40

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. arabiensis
Programme phase:

Pre-elimination

Total confirmed cases, 2013:

Total deaths, 2013:

46
0

Indigenous cases, 2013:

Indigenous deaths, 2013:

22
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

No
No

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1998

Larval control Use of larval control recommended

Yes

IPT

IPT used to prevent malaria during pregnancy

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Foci and case investigation undertaken

Case reporting from private sector is mandatory

Yes
Yes
No
Yes

Yes
Yes

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1998
1975

Treatment

ACT is free for all ages in public sector

Yes 2008
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine

Directly observed treatment with primaquine is undertaken

Yes

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

Global Fund

World Bank

100
80
60
40
20
0

Funding source(s): Government,

Global Fund, USAID/PMI, WHO

Monitoring and evaluation

Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013
Insecticide & spraying materials

Suspected cases tested points

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

ACTs distributed vs reported P. falciparum cases

ACTs as % of all antimalarials received by <5 (survey)

Cases investigated

ACTs as % of all antimalarials received by <5 (survey)

Primaquine distributed vs reported P.vivax cases
ACTs distributed vs reported P.falciparum cases points
ACTs distributed vs reported P.falciparum cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Pie chart includes 100%

of total contributions

Human Resources & technical Assistance

Malaria
test positivity
and ABER
Antimalarials
distributedrate
vs reported
cases

ABER (microscopy & RDT)

RDT positivity rate

Slide positivity points

Slide positivity rate

Foci investigated

Number of malaria cases

25
20
15
10
5
0

200
160
120
80
40
0

Reporting completeness
Foci investigated
Cases investigated points
Cases investigated
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Total cases
Indigenous cases (P. falciparum)

Impact: Achieved >75% decrease in case incidence in 2013

Aberpositivity
(microscopy
RDT)
RDT
rate&points
82 | WORLD MALARIA
REPORT
2014
RDT positivity rate

Species

Cases tracked

(%)

Cases (%)
Positivity rate (%)

2.5
2.0
1.5
1.0
0.5
0

Follow-up No. of studies

Management and other costs

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtreated
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v cases

Max

Cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Median

Others

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

WHO/UNICEF

Cases (%)

100
80
60
40
20
0

Min

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

Cases

Population (%)

IV. Coverage

USAID/PMI

Year

Financing by intervention in 2013

Sources of financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government

ABER (%)

Contribution (US$m)

25
20
15
10
5
0

AL
2007
AL
2007
QN
QN

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

III. Financing

Imported cases points

Imported cases
Indigenous (P.vivax) points

Imported cases
Indigenous cases (P. vivax)

Cambodia

Western Pacific Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

6660000
1360000
7110000
15130000

44
9
47

Major plasmodium species: P. falciparum (55%), P. vivax (45%)

Major anopheles species:
An. dirus, An. minimus, An. maculatus, An. sundaicus
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
21309
12

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2000
2000

IRS

IRS is recommended
DDT is authorized for IRS

No
No

Larval control Use of larval control recommended

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
No
Yes
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2000
2000

Treatment

ACT is free for all ages in public sector

Yes 2000
Artemisinin-based monotherapies withdrawn
Yes 2011
Single dose of primaquine is used as gametocidal medicine for P. falciparum No
Primaquine is used for radical treatment of P. vivax
Yes 2013
G6PD test is a requirement before treatment with primaquine
Yes 2012
Directly observed treatment with primaquine is undertaken
No

System for monitoring of adverse reactions to antimalarials exists

Yes 2010

World Bank

Min

Median

Max

20052011
20082014
20102014

0
0
0

3.15
5.9
0

19.4
37.5
3.3

WHO/UNICEF

14
21
6

Species
P. falciparum
P. falciparum
P. vivax

Pie chart includes 100%

of total contributions

Funding source(s): Government,

Global Fund, USAID/PMI, WHO

Cases tested and treated in public sector

100
80
60
40
20
0

Management and other costs

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines

Survey source: DHS 2005, DHS 2010

Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS
Survey source: DHS 2000, DHS 2005, DHS 2010

Test positivity
100
80
60
40
20
0

20 000
16 000
12 000
8000
4000
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

42 days
42 days
28 days

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Follow-up No. of studies

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

Cases (%)

Survey source: DHS 2005

V. Impact
Cases per 1000

Year

AS+MQ
DHA-PPQ
DHA-PPQ

Tests (%)

Population (%)
(%)

USAID/PMI

% fever cases <5 seeking treatment at public HF (survey)

7.5
6.0
4.5
3.0
1.5
0

Medicine

Financing by intervention in 2013

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

P.f + P.v specific (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Cases (P. vivax)

Malaria admissions and deaths

5
4
3
2
1
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

800
640
480
320
160
0

Deaths

Global Fund

AS+MQ; DHA-PPQ+PQ
2000
QN+T 2000
AM; QN

DHA-PPQ
2011
0.25 mg/kg (14 days)

Type of RDT used

Sources of financing

IV. Coverage

First-line treatment of unconfirmed malaria

First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Year
Antimalaria treatment policy
Medicine
adopted

Admissions

50
40
30
20
10
0

ABER (%)

Contribution (US$m)

III. Financing

2010

2010

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Increase in case incidence 2000-2015

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
2014 | 83
Deaths (P.vivax)
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Cameroon

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

PF-RATIO

>75

4060

6080

No cases

1.010
PP

2040

Based on 2012 reported data

2040

>75

4060

6080
80100
Based on 2012 reported data

80100

I. Epidemiological profile
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

1.010

Population

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

2013

Parasites and vectors

15800000
6450000
0
22250000

71
29
0

Major plasmodium species: P. falciparum (100%), P. vivax (0%)

Major anopheles species:
An. gambiae, An. arabiensis, An. funestus, An. moucheti, An. nili
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
26651
4349

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
No

2004

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2007

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
No

Larval control Use of larval control recommended

No

IPT

IPT used to prevent malaria during pregnancy

Yes

2004

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
No

2011

Treatment

ACT is free for all ages in public sector

No

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine

Directly observed treatment with primaquine is undertaken

System for monitoring of adverse reactions to antimalarials exists

Yes 2004

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+AQ
2004
AS+AQ
2004
QN 2004
AS; AM; QN
2014

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

(%)

100
80
60
40
20
0

WHO/UNICEF

Cases tested and treated in public sector

Survey source: DHS 2004, DHS 2011

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

2500
2000
1500
1000
500
0

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity
100
80
60
40
20
0

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Management and other costs

Survey source: MICS 2006, DHS 2011

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2004, MICS 2006, DHS 2011

% fever cases <5 seeking treatment at public HF (survey)

20
16
12
8
4
0

Funding source(s): WHO

Others

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

25
20
15
10
5
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
84 | WORLD MALARIA
REPORT
2014
Cases (p.vivax)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

40
32
24
16
8
0

Deaths

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

With access to an ITN (model)

With access to an ITN (survey)

USAID/PMI

Tests (%)

Population (%)

IV. Coverage

World Bank

Cases (%)

Global Fund

Pie chart includes 3%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

80
64
48
32
16
0

ABER (%)

Contribution (US$m)

III. Financing

Central African Republic

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

PF-RATIO

>75

4060

6080

PP

2013

%
100
0
0

2040

>75

4060

6080
80100
Based on 2012 reported data

80100

I. Epidemiological profile
4620000
0
0
4620000

No cases

1.010

2040

Based on 2012 reported data

High transmission (> 1 case per 1000 population)

Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

1.010

Population

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. gambiae, An. funestus, An. arabiensis
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
116300
1026

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2006
2010

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2012

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No

Larval control Use of larval control recommended

IPT

IPT used to prevent malaria during pregnancy

Yes

2004

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
No

Treatment

ACT is free for all ages in public sector

Yes 2010
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2005
AL

QN
AS; AM; QN

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20082010
0
3.8
7.6
28 days
2
P. falciparum
AS+AQ
20082010
0
3.4
6.8
28 days
2
P. falciparum

Cases (%)

Cases tested and treated in public sector

Cases per 1000

100
80
60
40
20
0

2000
1600
1200
800
400
0

Survey source: MICS 2006

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Management and other costs

Survey source: MICS 2006

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

30
24
18
12
6
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Funding source(s): Government,

Global Fund, WHO, UNICEF

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

(%)

WHO/UNICEF

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

With access to an ITN (model)

With access to an ITN (survey)

100
80
60
40
20
0

USAID/PMI

Tests (%)

Population (%)

IV. Coverage

World Bank

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

5
4
3
2
1
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

35
28
21
14
7
0

Deaths

Global Fund

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

10
8
6
4
2
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
2014 | 85
Deaths (P.vivax)
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Chad

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

PF-RATIO

>75

4060

6080

No cases

1.010
PP

2040

Based on 2012 reported data

2040

>75

4060

6080
80100
Based on 2012 reported data

80100

I. Epidemiological profile
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

1.010

Population

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

2013

Parasites and vectors

10300000
2440000
128000
12868000

80
19
1

Major plasmodium species: P. falciparum (100%), P. vivax (0%)

Major anopheles species:
An. arabiensis, An. funestus, An. pharoensis, An. nili
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
754565
1881

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
No

2010

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No

Yes

Larval control Use of larval control recommended

No

IPT

IPT used to prevent malaria during pregnancy

Yes

2004

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

Treatment

ACT is free for all ages in public sector

Yes

Artemisinin-based monotherapies withdrawn

No

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL; AS+AQ

AL; AS+AQ

QN
AS; QN
2014

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AS+AQ
20092011
0
0
1.8
28 days
3
P. falciparum

No data reported for 2013

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Global Fund

WHO/UNICEF

Cases tested and treated in public sector

Cases (%)

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS

Cases per 1000

ACTs as % of all antimalarials received by <5 (survey)

350
280
210
140
70
0

Survey source: DHS 2004

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Antimalarials distributed vs reported cases

ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases

Test positivity
100
80
60
40
20
0

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

<5 with fever with finger/heel stick (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

60
48
36
24
12
0

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

(%)

USAID/PMI

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

With access to an ITN (model)

With access to an ITN (survey)

100
80
60
40
20
0

World Bank

ITN and IRS coverage

Others

Tests (%)

Population (%)

IV. Coverage

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

5
4
3
2
1
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Cases (p.vivax) points
86 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

15
12
9
6
3
0

Deaths

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

1250
1000
750
500
250
0

ABER (%)

Contribution (US$m)

III. Financing

China

Western Pacific Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Insufficient data
0

Insufficient data
No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

>75

4060

6080

No cases

1.010
PP

2040

Based on 2011 reported data

2040

>75

4060

6080
80100
Based on 2011 reported data

80100

I. Epidemiological profile
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Insufficient data

Insufficient data
0

PF-RATIO

1.010

Population

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

2013

Parasites and vectors

197000
579300000
806100000
1385597000

0
42
58

Major plasmodium species: P. falciparum (73%), P. vivax (23%)

Major anopheles species:
An. sinensis, An. anthropophagus, An. dirus, An. minimus
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

4086
23

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2003
2000

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2000

Larval control Use of larval control recommended

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
Yes
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
No

2000

Treatment

ACT is free for all ages in public sector

Yes 2006
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
Yes 1970
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

Yes 1970
System for monitoring of adverse reactions to antimalarials exists
Yes 1970

World Bank

USAID/PMI

Min

Median

Max

20122012
20082013
20082010

0
0
0

1.15
0
0

2.3
4.3
0

WHO/UNICEF

2
11
2

Species
P. falciparum
P. vivax
P. vivax

Pie chart includes 100%

of total contributions

Funding source(s): Government

Cases (%)

Cases tested and treated in public sector

100
80
60
40
20
0

Management and other costs

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

Test positivity
100
80
60
40
20
0

5
4
3
2
1
0

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

42 days
28 days
28 days

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Follow-up No. of studies

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

All ages who slept under an ITN (survey)

At high risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

Cases per 1000

Year

DHA-PPQ
CQ
CQ+PQ

Tests (%)

Population (%)
(%)

0.05
0.04
0.03
0.02
0.01
0

Medicine

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Therapeutic efficacy tests (clinical and parasitological failure, %)

Financing by intervention in 2013

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

At high risk protected with ITNs

Households with at least one ITN

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
Antimalarials
vs reported
points2010 2011 2012 2013
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths

2.0
1.6
1.2
0.8
0.4
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

60
48
36
24
12
0

Deaths

Global Fund

ART+NQ; ART-PPQ; AS+AQ; DHA-PPQ 2009

AM; AS; PYR

2009
CQ+PQ(8d)
2006
QN

Type of RDT used

Sources of financing

IV. Coverage

100
80
60
40
20
0

First-line treatment of unconfirmed malaria

First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Year
Antimalaria treatment policy
Medicine
adopted

Admissions

60
48
36
24
12
0

ABER (%)

Contribution (US$m)

III. Financing

2000
2000
1970

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
2014 | 87
Deaths (P.vivax)
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Colombia

Region of the Americas

EURO / PAHO
Confirmed cases
API 1000 population
per

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

7150000
3720000
37400000
48270000

15
8
78

Major plasmodium species: P. falciparum (34%), P. vivax (66%)

Major anopheles species:
An. darlingi, An. albimanus, An. nunestovari, An. neivai, An. punctimacula, An. pseudopunctipennis
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

51722
10

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2005
2005

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1958

Larval control Use of larval control recommended

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
No
No
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1984
1958

Treatment

ACT is free for all ages in public sector

Yes 2008
Artemisinin-based monotherapies withdrawn
No

Single dose of primaquine is used as gametocidal medicine for P. falciparum No 2008

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

World Bank

USAID/PMI

WHO/UNICEF

3
2

Pie chart includes 73%

of total contributions

Funding source(s): Government,

Global Fund, AMI/RAVREDA

Cases (%)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Tests (%)

100
80
60
40
20
0

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v. cases

Insecticide & spraying materials

Suspected cases tested

Primaquine distributed vs reported P.v. cases points
Primaquine distributed vs reported P.v. cases
Antimalarials distributed vs reported cases points
Antimalarials distributed vs reported cases
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (P. vivax)

RDT positivity rate

Malaria admissions and deaths

10
8
6
4
2
0

800
640
480
320
160
0

Slide positivity rate points

Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: On track for 75% decrease in case incidence 20002015

Cases (p.vivax) points
88 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Species
P. falciparum
P. vivax

Test positivity

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

28 days
28 days

Management and other costs

Suspected cases tested

Admissions

Cases per 1000

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS
Survey source: DHS 2000, DHS 2005, DHS 2010

ABER (microscopy & RDT)

Follow-up No. of studies

Cases tested and treated in public sector

% fever cases <5 seeking treatment at public HF (survey)

7.5
6.0
4.5
3.0
1.5
0

1
0

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Max

0.6
0

Others

ABER (%)

Contribution (US$m)
Population (%)
(%)

100
80
60
40
20
0

Median

0
0

Financing by intervention in 2013

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

Min

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

60
48
36
24
12
0

Deaths

Global Fund

IV. Coverage
100
80
60
40
20
0

Year
20072009
20062011

Sources of financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government

P.f + P.v specific (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

AL
CQ+PQ

35
28
21
14
7
0

AL
2006
QN(3d)+CL(5d) 2004
AS

CQ+PQ(14d)
1960s
0.25 mg/kg (14 days)

Type of RDT used

Medicine

III. Financing

1998

Comoros

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

PF-RATIO

>75

4060

6080

No cases

1.010
PP

2040

Based on 2012 reported data

2040

>75

4060

6080
80100
Based on 2012 reported data

80100

I. Epidemiological profile
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

1.010

Population

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

2013

Parasites and vectors

691000
44100
0
735100

94
6
0

Major plasmodium species: P. falciparum (99%), P. vivax (0%)

Major anopheles species:
An. gambiae, An. funestus
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

53156
15

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2005
2010

IRS

IRS is recommended
DDT is authorized for IRS

Yes
Yes

2010

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
No
Yes
Yes
No

Larval control Use of larval control recommended

No

IPT

IPT used to prevent malaria during pregnancy

Yes

2004

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1997
2011

Treatment

ACT is free for all ages in public sector

Yes 2010
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

No

2013

2010

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2003
AL
2003
QN 2003
QN
2003

Type of RDT used

P.f + P.v, P.o, P.m (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20062013
0
0
3.2
28 days
16
P. falciparum

Survey source: DHS 2012

Cases tested and treated in public sector

Cases (%)

Survey source: DHS 2012

Cases per 1000

3500
2800
2100
1400
700
0

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity
100
80
60
40
20
0

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Management and other costs

Survey source: DHS 2012

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

100
80
60
40
20
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Funding source(s): Government,

Global Fund, WHO, UNICEF

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

(%)

WHO/UNICEF

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

With access to an ITN (model)

With access to an ITN (survey)

100
80
60
40
20
0

USAID/PMI

Tests (%)

Population (%)

IV. Coverage

World Bank

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
Antimalarials
vs reported
points2010 2011 2012 2013
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

500
400
300
200
100
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

20
16
12
8
4
0

Deaths

Global Fund

Pie chart includes 66%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

5
4
3
2
1
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
2014 | 89
Deaths (P.vivax)
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Congo

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

4450000
0
0
4450000

100
0
0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. gambiae, An. funestus, An. nili, An. moucheti
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
43232
2870

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2011
2011

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2007

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
No
No

Larval control Use of larval control recommended

No

IPT

IPT used to prevent malaria during pregnancy

Yes

2006

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
No

Treatment

ACT is free for all ages in public sector

No

Artemisinin-based monotherapies withdrawn

Yes 2007
Single dose of primaquine is used as gametocidal medicine for P. falciparum No
Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+AQ

AS+AQ

AL
QN

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20062014
0
2.8
3.6
28 days
3
P. falciparum
AS+AQ
20052014
0
2.7
5.6
28 days
3
P. falciparum

No data reported for 2013

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

WHO/UNICEF

Cases tested and treated in public sector

Survey source: DHS 2005, DHS 2012

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

Antimalarials distributed vs reported cases

ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases

Test positivity
100
80
60
40
20
0

1200
960
720
480
240
0

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Survey source: DHS 2005, DHS 2012

Suspected cases tested

<5 with fever with finger/heel stick (survey)

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2005, DHS 2012

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

35
28
21
14
7
0

Others

Tests (%)

Population (%)
(%)

100
80
60
40
20
0

USAID/PMI

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

With access to an ITN (model)

With access to an ITN (survey)

World Bank

ITN and IRS coverage

Others

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

200
160
120
80
40
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Cases (p.vivax) points
90 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

80
64
48
32
16
0

Deaths

Global Fund

IV. Coverage

Cases (%)

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

15
12
9
6
3
0

ABER (%)

Contribution (US$m)

III. Financing

Costa Rica

Region of the Americas

EURO / PAHO
Confirmed cases
API 1000 population
per

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

Represents foci (active or non-active)

I. Epidemiological profile
Population
Number of active foci
Number of people living within active foci
Number of people living in malaria-free areas
Total

2013

1
2500
4870000
4872500

0
100

Parasites and vectors

Major plasmodium species: P. falciparum (0%), P. vivax (100%)
Major anopheles species:
An. albimanus
Programme phase:

Elimination

Total confirmed cases, 2013:

Total deaths, 2013:

6
0

Indigenous cases, 2013:

Indigenous deaths, 2013:

2
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2009
2009

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1957

Larval control Use of larval control recommended

No

IPT

IPT used to prevent malaria during pregnancy

N/A

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Foci and case investigation undertaken

Case reporting from private sector is mandatory

Yes
Yes
No
Yes
Yes
Yes
Yes

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1957

Treatment

ACT is free for all ages in public sector

No

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

Yes

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

Global Fund

World Bank

WHO/UNICEF

Follow-up No. of studies

Species

Others

Cases tested

Cases (%)

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases tracked

(%)

Antimalarials distributed vs reported cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtreated
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

100
80
60
40
20
0

Suspected cases tested points

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

Primaquine distributed vs reported P. vivax cases

Cases investigated

Primaquine distributed vs reported P.vivax cases

Malaria
test positivity
and ABER
Antimalarials
distributedrate
vs reported
cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Slide positivity rate

RDT positivity rate

Foci investigated

Number of malaria cases

5
4
3
2
1
0

Cases

Population (%)
Cases (%)

USAID/PMI

ITN and IRS coverage

Others

Positivity rate (%)

Max

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

At high risk protected with ITNs

Households with at least one ITN

30
24
18
12
6
0

Median

Financing by intervention in 2013

Sources of financing

IV. Coverage

100
80
60
40
20
0

Min

No data reported for 2013

Government
100
80
60
40
20
0

Year

ABER (%)

Contribution (US$m)

8.0
6.4
4.8
3.2
1.6
0

CQ+PQ(1d)

CQ+PQ
QN

CQ+PQ(7d); CQ+PQ(14d)

0.25 mg/kg (14 days); 0.5mg/kg (7 days)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

III. Financing

4000
3200
2400
1600
800
0

Reporting completeness
Foci investigated
Cases investigated points
Cases investigated
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Total cases
Indigenous cases (P. falciparum)

Imported cases
Indigenous cases (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Aberpositivity
(microscopy
RDT)
RDT
rate&points
RDT positivity rate
Slide positivity points
Slide positivity rate

WORLD MALARIA REPORT 2014 | 91

Imported cases points
Imported cases
Indigenous (P.vivax) points

Cte dIvoire

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

20300000
0
0
20300000

100
0
0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. gambiae, An. funestus
Programme phase:

Control

Reported confirmed cases: 2506953

Reported deaths:
3261

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
No

2008

IRS

IRS is recommended
DDT is authorized for IRS

Yes
Yes

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No


Yes
No

Larval control Use of larval control recommended

IPT

IPT used to prevent malaria during pregnancy

Yes

2005

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes

2012

Treatment

ACT is free for all ages in public sector

Yes

Artemisinin-based monotherapies withdrawn

Yes 2007
Single dose of primaquine is used as gametocidal medicine for P. falciparum No
Primaquine is used for radical treatment of P. vivax

G6PD test is a requirement before treatment with primaquine

Directly observed treatment with primaquine is undertaken

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+AQ
2003
AS+AQ
2003
AL 2003
QN
2003

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20052009
0
2.6
7.4
28 days
9
P. falciparum
AS+AQ
20072009
0
0
1.3
28 days
4
P. falciparum

No data reported for 2013

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

WHO/UNICEF

Cases tested and treated in public sector

Survey source: DHS 2005, DHS 2012

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

Antimalarials distributed vs reported cases

ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases

Test positivity
100
80
60
40
20
0

800
640
480
320
160
0

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Survey source: MICS 2006, DHS 2012

Suspected cases tested

<5 with fever with finger/heel stick (survey)

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: MICS 2006, DHS 2012

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

150
120
90
60
30
0

Others

Tests (%)

Population (%)
(%)

100
80
60
40
20
0

USAID/PMI

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

With access to an ITN (model)

With access to an ITN (survey)

World Bank

ITN and IRS coverage

Others

Cases (P. vivax)

Suspected cases tested

Survey source: DHS 2012
<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

20
16
12
8
4
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Cases (p.vivax) points
92 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

100
80
60
40
20
0

Deaths

Global Fund

IV. Coverage

Cases (%)

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

100
80
60
40
20
0

ABER (%)

Contribution (US$m)

III. Financing

Democratic Peoples Republic of KoreaSouth-East Asia Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
Number of active foci
Number of people living within active foci
Number of people living in malaria-free areas
Total

2013

2252
13100000
11800000
24900000

53
47

Parasites and vectors

Major plasmodium species: P. falciparum (0%), P. vivax (100%)
Major anopheles species:
An. sinensis
Programme phase:

Pre-elimination

Total confirmed cases, 2013:

Total deaths, 2013:

14407
0

Indigenous cases, 2013:

Indigenous deaths, 2013:

14407
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2002
2002

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2007

Larval control Use of larval control recommended

Yes

2002

IPT

IPT used to prevent malaria during pregnancy

N/A

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Foci and case investigation undertaken

Case reporting from private sector is mandatory

No
Yes
No
No
No
No
No

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1953

Treatment

ACT is free for all ages in public sector

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
Yes 2000
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

Yes 2000
System for monitoring of adverse reactions to antimalarials exists
Yes 2002

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

Global Fund

World Bank

100
80
60
40
20
0

Cases (%)

Monitoring and evaluation

Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013
Insecticide & spraying materials

Suspected cases tested points

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

ACTs distributed vs reported P. falciparum cases

ACTs as % of all antimalarials received by <5 (survey)

Cases investigated

ACTs as % of all antimalarials received by <5 (survey)

Primaquine distributed vs reported P.vivax cases
ACTs distributed vs reported P.falciparum cases points
ACTs distributed vs reported P.falciparum cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Funding source(s): Government,

Global Fund, USAID/PMI, WHO,
Other (bilateral)

Human Resources & technical Assistance

Malaria
test positivity
and ABER
Antimalarials
distributedrate
vs reported
cases

ABER (microscopy & RDT)

Pie chart includes 100%

of total contributions

Cases tracked

(%)

Cases (%)
Positivity rate (%)

100
80
60
40
20
0

Species

Management and other costs

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtreated
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v cases

Follow-up No. of studies

Cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Max

Others

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

WHO/UNICEF

ITN and IRS coverage

Others

RDT positivity rate

Foci investigated

Number of malaria cases

10
8
6
4
2
0

150 000
120 000
90 000
60 000
30 000
0

Cases

Population (%)

100
80
60
40
20
0

USAID/PMI

Median

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government

Min

Financing by intervention in 2013

Sources of financing

IV. Coverage

Year

ABER (%)

Contribution (US$m)

15
12
9
6
3
0

CQ+PQ(14d)

0.25 mg/kg (14 days)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

III. Financing

1999

Reporting completeness
Foci investigated
Cases investigated points
Cases investigated
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Total cases
Indigenous cases (P. falciparum)

Imported cases
Indigenous cases (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Aberpositivity
(microscopy
RDT)
RDT
rate&points
RDT positivity rate
Slide positivity points
Slide positivity rate

WORLD MALARIA REPORT 2014 | 93

Imported cases points
Imported cases
Indigenous (P.vivax) points

Democratic Republic of the Congo

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

African Region

OTHERS

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

65500000
2030000
0
67530000

97
3
0

Major plasmodium species: P. falciparum (100%), P. vivax (0%)

Major anopheles species:
An. gambiae, An. funestus, An. nili, An. moucheti
Programme phase:

Control

Reported confirmed cases: 6715223

Reported deaths:
30918

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2008
2008

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2007

Larval control Use of larval control recommended

Yes

1998

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
No
No
No

IPT

IPT used to prevent malaria during pregnancy

Yes

2004

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2007
2007

Treatment

ACT is free for all ages in public sector

Yes 2006
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes 2010

2010

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+AQ
2005
AS+AQ
2005
QN 2005
AS; QN

Type of RDT used

P.f + all species (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20052013
0
2.4
9.2
28 days
10
P. falciparum
AS+AQ
20052012
0
4.2
6.9
28 days
8
P. falciparum

No data reported for 2013

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

WHO/UNICEF

Cases tested and treated in public sector

Survey source: DHS 2007, DHS 2013

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

Antimalarials distributed vs reported cases

ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases

Test positivity
100
80
60
40
20
0

1500
1200
900
600
300
0

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Survey source: DHS 2007, MICS 2010, DHS 2013

Suspected cases tested

<5 with fever with finger/heel stick (survey)

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2007, MICS 2010, DHS 2013/2014

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

100
80
60
40
20
0

Others

Tests (%)

Population (%)
(%)

100
80
60
40
20
0

USAID/PMI

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

With access to an ITN (model)

With access to an ITN (survey)

World Bank

ITN and IRS coverage

Others

Cases (P. vivax)

Suspected cases tested

Survey source: DHS 2013/2014
<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

20
16
12
8
4
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Cases (p.vivax) points
94 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

50
40
30
20
10
0

Deaths

Global Fund

IV. Coverage

Cases (%)

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

600
480
360
240
120
0

ABER (%)

Contribution (US$m)

III. Financing

Djibouti

Eastern Mediterranean Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Insufficient data
0

Insufficient data
No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

>75

4060

6080

No cases

1.010
PP

2040

Based on 2012 reported data

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Insufficient data

Insufficient data
0

PF-RATIO

1.010

Population

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

2013

Parasites and vectors

0
436000
436000
872000

0
50
50

Major plasmodium species: P. falciparum (100%), P. vivax (0%)

Major anopheles species:
An. gambiae, An. arabiensis
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

1684
17

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2008

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2006

Larval control Use of larval control recommended

Yes

2008

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2007
2007

Treatment

ACT is free for all ages in public sector

Yes 2007
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes 2014
Primaquine is used for radical treatment of P. vivax
Yes 2014
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2014
AL+PQ
2014
AS+AQ 2014
QN

CQ+PQ (14d)

0.25 mg/kg (14 days)

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

(%)

100
80
60
40
20
0

WHO/UNICEF

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

Cases tested and treated in public sector

Cases (%)

Survey source: Other nat.

Cases per 1000

Management and other costs

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

Test positivity
100
80
60
40
20
0

1500
1200
900
600
300
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

% fever cases <5 seeking treatment at public HF (survey)

10
8
6
4
2
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: MICS 2006; Other nat.

V. Impact

Reporting completeness

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Funding source(s): WHO, UNICEF,

Other (all types)

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

With access to an ITN (model)

With access to an ITN (survey)

USAID/PMI

Tests (%)

Population (%)

IV. Coverage

World Bank

Cases (P. vivax)

Malaria admissions and deaths

2.0
1.6
1.2
0.8
0.4
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

30
24
18
12
6
0

Deaths

Global Fund

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

2.0
1.6
1.2
0.8
0.4
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
2014 | 95
Deaths (P.vivax)
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Dominican Republic

Region of the Americas

EURO / PAHO
Confirmed cases
API 1000 population
per

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

447000
8460000
1500000
10407000

4
81
14

Major plasmodium species: P. falciparum (99%), P. vivax (1%)

Major anopheles species:
An. albimanus
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

579
5

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2008
2008

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1946

Larval control Use of larval control recommended

Yes

1964

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
Yes
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1964
1964

Treatment

ACT is free for all ages in public sector

No

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes 1964
Primaquine is used for radical treatment of P. vivax
Yes 1964
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

Yes

System for monitoring of adverse reactions to antimalarials exists

No

1964
1964
1964

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

CQ+PQ(1d)

CQ; QN

CQ; QN

CQ+PQ(14d)

0.25 mg/kg (14 days)

Type of RDT used

P.f only

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

Global Fund

World Bank

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Human Resources & technical Assistance

Survey source: DHS 2007

Monitoring and evaluation

Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v. cases

Insecticide & spraying materials

Tests (%)

Test positivity
100
80
60
40
20
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (P. vivax)

Suspected cases tested

Primaquine distributed vs reported P.v. cases points
Primaquine distributed vs reported P.v. cases
Antimalarials distributed vs reported cases points
Antimalarials distributed vs reported cases
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

Cases (all species)

Management and other costs

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS
Survey source: DHS 2002, DHS 2007

V. Impact
Cases per 1000

Cases tested and treated in public sector

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

% fever cases <5 seeking treatment at public HF (survey)

0.5
0.4
0.3
0.2
0.1
0

Others

Cases (%)

Population (%)
(%)

100
80
60
40
20
0

WHO/UNICEF

ITN and IRS coverage

Others

At high risk protected with ITNs

Households with at least one ITN

USAID/PMI

Funding source(s): Government,

Global Fund, WHO, Other
(all types)

RDT positivity rate

Malaria admissions and deaths

7.5
6.0
4.5
3.0
1.5
0

15
12
9
6
3
0

Slide positivity rate points

Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: On track for 50%-75% decrease in case incidence 2000-2015

Cases (p.vivax) points
96 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

20
16
12
8
4
0

Deaths

Government

Pie chart includes 87%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

IV. Coverage
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

8.0
6.4
4.8
3.2
1.6
0

ABER (%)

Contribution (US$m)

III. Financing

Ecuador

Region of the Americas

EURO / PAHO
Confirmed cases
API 1000 population
per

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

I. Epidemiological profile
Population
Number of active foci
Number of people living within active foci
Number of people living in malaria-free areas
Total

2013

3
265000
15500000
15765000

2
98

Parasites and vectors

Major plasmodium species: P. falciparum (43%), P. vivax (57%)
Major anopheles species:
An. albimanus, An. punctimacula, An. pseudopunctipennis
Programme phase:

Pre-elimination

Total confirmed cases, 2013:

Total deaths, 2013:

378
0

Indigenous cases, 2013:

Indigenous deaths, 2013:

368
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2004

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2005

Larval control Use of larval control recommended

Yes

IPT

IPT used to prevent malaria during pregnancy

N/A

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Foci and case investigation undertaken

Case reporting from private sector is mandatory

Yes
Yes
No
No
No
Yes
No

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1956
1956

Treatment

ACT is free for all ages in public sector

Yes 2005
Artemisinin-based monotherapies withdrawn
Yes

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

Yes

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

Global Fund

World Bank

Funding source(s): Government,

Global Fund, Other (bilateral),
Other (all types)

Cases (%)

Monitoring and evaluation

Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013
Insecticide & spraying materials

Cases tracked
100
80
60
40
20
0

Suspected cases tested points

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

Primaquine distributed vs reported P. vivax cases

Cases investigated

Primaquine distributed vs reported P.vivax cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Pie chart includes 76%

of total contributions

Human Resources & technical Assistance

Malaria
test positivity
and ABER
Antimalarials
distributedrate
vs reported
cases

ABER (microscopy & RDT)

Species

Management and other costs

Suspected cases tested

(%)

Cases (%)
Positivity rate (%)

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Follow-up No. of studies

Cases tested

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtreated
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

Antimalarials distributed vs reported cases

Max

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

25
20
15
10
5
0

WHO/UNICEF

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

USAID/PMI

ITN and IRS coverage

Others

RDT positivity rate

Foci investigated

Number of malaria cases

10
8
6
4
2
0

120 000
96 000
72 000
48 000
24 000
0

Cases

Population (%)

100
80
60
40
20
0

Median

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government

Min

Financing by intervention in 2013

Sources of financing

IV. Coverage

Year

AL
20052006
0
0
0
28 days
1
P. falciparum

ABER (%)

Contribution (US$m)

10
8
6
4
2
0

AL+PQ
2012
QN+CL 2004
QN
2004
CQ+PQ(14d)
2004
0.50 mg/kg (7 days)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

III. Financing

Reporting completeness
Foci investigated
Cases investigated points
Cases investigated
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Total cases
Indigenous cases (P. falciparum)

Imported cases
Indigenous cases (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Aberpositivity
(microscopy
RDT)
RDT
rate&points
RDT positivity rate
Slide positivity points
Slide positivity rate

WORLD MALARIA REPORT 2014 | 97

Imported cases points
Imported cases
Indigenous (P.vivax) points

El Salvador

Region of the Americas

EURO / PAHO
Confirmed cases
API 1000 population
per

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

Represents foci (active or non-active)

I. Epidemiological profile
Population
Number of active foci
Number of people living within active foci
Number of people living in malaria-free areas
Total

2013

2
54900
6290000
6344900

1
99

Parasites and vectors

Major plasmodium species: P. falciparum (0%), P. vivax (100%)
Major anopheles species:
An. albimanus, An. pseudopunctipennis
Programme phase:

Pre-elimination

Total confirmed cases, 2013:

Total deaths, 2013:

7
0

Indigenous cases, 2013:

Indigenous deaths, 2013:

6
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2013

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

Larval control Use of larval control recommended

Yes

IPT

IPT used to prevent malaria during pregnancy

N/A

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Foci and case investigation undertaken

Case reporting from private sector is mandatory

Yes
Yes
No
No
No
Yes
No

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2010

Treatment

ACT is free for all ages in public sector

No

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

Yes

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

Global Fund

World Bank

Funding source(s): Government,

WHO

Monitoring and evaluation

Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013
Insecticide & spraying materials

Cases tracked
100
80
60
40
20
0

Suspected cases tested points

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

Primaquine distributed vs reported P. vivax cases

Cases investigated

Primaquine distributed vs reported P.vivax cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Pie chart includes 100%

of total contributions

Human Resources & technical Assistance

Malaria
test positivity
and ABER
Antimalarials
distributedrate
vs reported
cases

ABER (microscopy & RDT)

RDT positivity rate

Slide positivity points

Slide positivity rate

Foci investigated

Number of malaria cases

25
20
15
10
5
0

800
640
480
320
160
0

Reporting completeness
Foci investigated
Cases investigated points
Cases investigated
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Total cases
Indigenous cases (P. falciparum)

Impact: Achieved >75% decrease in case incidence in 2013

Aberpositivity
(microscopy
RDT)
RDT
rate&points
98 | WORLD MALARIA
REPORT
2014
RDT positivity rate

Species

Management and other costs

Suspected cases tested

(%)

Cases (%)
Positivity rate (%)

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtreated
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Follow-up No. of studies

Cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Antimalarials distributed vs reported cases

Max

Others

ITN and IRS coverage

0.35
0.28
0.21
0.14
0.07
0

WHO/UNICEF

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

USAID/PMI

Cases (%)

100
80
60
40
20
0

Median

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

Cases

Population (%)

IV. Coverage

Min

Financing by intervention in 2013

Sources of financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government

Year

ABER (%)

Contribution (US$m)

4.0
3.2
2.4
1.6
0.8
0

CQ+PQ(1d)

AL
QN
2012
CQ+PQ(14d)

0.25 mg/kg (14 days)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

III. Financing

Imported cases points

Imported cases
Indigenous (P.vivax) points

Imported cases
Indigenous cases (P. vivax)

Equatorial Guinea

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

PF-RATIO

>75

4060

6080

PP

2013

%
100
0
0

2040

>75

4060

6080
80100
Based on 2012 reported data

80100

I. Epidemiological profile
757000
0
0
757000

No cases

1.010

2040

Based on 2012 reported data

High transmission (> 1 case per 1000 population)

Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

1.010

Population

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. gambiae, An. melas
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
13129
66

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
No

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

Larval control Use of larval control recommended

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
Yes
Yes
No

IPT

IPT used to prevent malaria during pregnancy

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

Treatment

ACT is free for all ages in public sector

Yes

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
Yes

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+AQ
2004
AS+AQ
2004
QN 2004
AS

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AS+AQ
20062011
0
2.3
5
28 days
5
P. falciparum

Cases (%)

Cases tested and treated in public sector

Cases per 1000

Management and other costs

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

80
64
48
32
16
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS

100
80
60
40
20
0

2000
1600
1200
800
400
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Reporting completeness

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Funding source(s): Government,

Other (all types)

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

(%)

WHO/UNICEF

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

With access to an ITN (model)

With access to an ITN (survey)

100
80
60
40
20
0

USAID/PMI

Tests (%)

Population (%)

IV. Coverage

World Bank

Cases (P. vivax)

Malaria admissions and deaths

10
8
6
4
2
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

15
12
9
6
3
0

Deaths

Global Fund

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

20
16
12
8
4
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
2014 | 99
Deaths (P.vivax)
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Eritrea

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

4500000
1840000
0
6340000

71
29
0

Major plasmodium species: P. falciparum (60%), P. vivax (39%)

Major anopheles species:
An. arabiensis
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
21317
6

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2002
2002

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1995

Larval control Use of larval control recommended

Yes

1995

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
No
No
No
No

IPT

IPT used to prevent malaria during pregnancy

No

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1997
1997

Treatment

ACT is free for all ages in public sector

Yes 2007
Artemisinin-based monotherapies withdrawn
Yes

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
Yes 2002
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes 2013

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+AQ
2007
AS+AQ
2007
QN 2002
QN
2002
AS+AQ+PQ
2007
0.25 mg/kg (14 days)

Type of RDT used

P.f + P.v specific (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AS+AQ
20062012
0
2.25
9.3
28 days
16
P. falciparum

Cases (%)

Cases tested and treated in public sector

Cases per 1000

100
80
60
40
20
0

300
240
180
120
60
0

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Management and other costs

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

10
8
6
4
2
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Funding source(s): Global Fund,

Other (all types)

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

(%)

WHO/UNICEF

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

With access to an ITN (model)

With access to an ITN (survey)

100
80
60
40
20
0

USAID/PMI

Tests (%)

Population (%)

IV. Coverage

World Bank

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

2.0
1.6
1.2
0.8
0.4
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Cases (p.vivax) points
100 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

5
4
3
2
1
0

Deaths

Global Fund

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

20
16
12
8
4
0

ABER (%)

Contribution (US$m)

III. Financing

Ethiopia

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

PF-RATIO

>75

4060

6080

No cases

1.010
PP

2040

Based on 2012 reported data

2040

>75

4060

6080
80100
Based on 2012 reported data

80100

I. Epidemiological profile
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

1.010

Population

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

2013

Parasites and vectors

941000
62100000
31100000
94141000

1
66
33

Major plasmodium species: P. falciparum (64%), P. vivax (36%)

Major anopheles species:
An. arabiensis, An. pharoensis, An. funestus, An. nili
Programme phase:

Control

Reported confirmed cases: 2645454

Reported deaths:
358

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2004
2004

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1960

Larval control Use of larval control recommended

Yes

1960

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
No
No

IPT

IPT used to prevent malaria during pregnancy

No

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1960
1960

Treatment

ACT is free for all ages in public sector

Yes 2004
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

World Bank

USAID/PMI

WHO/UNICEF

Cases (%)

Survey source: DHS 2005

100
80
60
40
20
0

Tests (%)

100
80
60
40
20
0

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

28 days
28 days
28 days

15
1
4

Species
P. falciparum
P. falciparum
P. vivax

Pie chart includes 77%

of total contributions

Funding source(s): Global Fund,

USAID/PMI

Management and other costs

Survey source: DHS 2011

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity
100
80
60
40
20
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Follow-up No. of studies

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2000, DHS 2005, DHS 2011

Admissions

Cases per 1000

7.5
10
13.7

Cases tested and treated in public sector

% fever cases <5 seeking treatment at public HF (survey)

30
24
18
12
6
0

Max

1
10
7.05

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Median

0
10
3.8

Others

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

15
12
9
6
3
0

ABER (%)

Contribution (US$m)
Population (%)
(%)

100
80
60
40
20
0

Min

Financing by intervention in 2013

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

With access to an ITN (model)

With access to an ITN (survey)

Year
20062012
20062006
20062010

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

5
4
3
2
1
0

Deaths

Global Fund

IV. Coverage
100
80
60
40
20
0

Sources of financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government

Therapeutic efficacy tests (clinical and parasitological failure, %)

AL
QN
CQ

200
160
120
80
40
0

AL
2004
AL
2004
QN 2004
AS; AM; QN
2012
CQ
1960

Type of RDT used

Medicine

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: On track for 50%-75% decrease in case incidence 2000-2015

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 101
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

French Guiana, France

Region of the Americas

EURO / PAHO
Confirmed cases
API 1000 population
per

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

213000
36100
0
249100

86
14
0

Major plasmodium species: P. falciparum (31%), P. vivax (68%)

Major anopheles species:
An. darlingi
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

875
3

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2012
2012

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

Larval control Use of larval control recommended

Yes

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

Treatment

ACT is free for all ages in public sector

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine

Directly observed treatment with primaquine is undertaken

System for monitoring of adverse reactions to antimalarials exists

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL; AT+PG

AS; QN+D

CQ+PQ

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

No data reported for 2013

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Global Fund

World Bank

Cases tested and treated in public sector

Cases per 1000

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

Tests (%)

100
80
60
40
20
0

Suspected cases tested

Primaquine distributed vs reported P.v. cases points
Primaquine distributed vs reported P.v. cases
Antimalarials distributed vs reported cases points
Antimalarials distributed vs reported cases
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v. cases

Test positivity

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

25
20
15
10
5
0

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

(%)

WHO/UNICEF

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

USAID/PMI

ITN and IRS coverage

Others

Cases (%)

Population (%)

IV. Coverage

Cases (P. vivax)

RDT positivity rate

Malaria admissions and deaths

30
24
18
12
6
0

120
96
72
48
24
0

Slide positivity rate points

Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Cases (p.vivax) points
102 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

5
4
3
2
1
0

Deaths

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

0.60
0.48
0.36
0.24
0.12
0

ABER (%)

Contribution (US$m)

III. Financing

P.f + P.v, P.o, P.m (Combo)

Gabon

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

1670000
0
0
1670000

100
0
0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. funestus, An. gambiae, An. funestus
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
28982
273

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

No
Yes

2007

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2013

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
No

Larval control Use of larval control recommended

No

IPT

IPT used to prevent malaria during pregnancy

Yes

2003

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
No

2009

Treatment

ACT is free for all ages in public sector

Yes 2003
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+AQ
2003
AS+AQ
2003
AL 2003
AS; AM; QN

Type of RDT used

P.f + P.v, P.o, P.m (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

(%)

100
80
60
40
20
0

WHO/UNICEF

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

Cases tested and treated in public sector

Cases (%)

Survey source: DHS 2012

Cases per 1000

100
80
60
40
20
0

4000
3200
2400
1600
800
0

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Survey source: DHS 2012

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Management and other costs

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

60
48
36
24
12
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2000, DHS 2012

V. Impact

Funding source(s): Government,

Other (bilateral)

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

With access to an ITN (model)

With access to an ITN (survey)

USAID/PMI

Tests (%)

Population (%)

IV. Coverage

World Bank

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

15
12
9
6
3
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

200
160
120
80
40
0

Deaths

Global Fund

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

10
8
6
4
2
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 103
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Gambia

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

1850000
0
0
1850000

100
0
0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. gambiae, An. arabiensis, An. melas, An. pharoensis, An. funestus, An. nili
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
240792
262

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2000
1998

IRS

IRS is recommended
DDT is authorized for IRS

Yes
Yes

2008
2007

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Larval control Use of larval control recommended

IPT

IPT used to prevent malaria during pregnancy

Yes

2002

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2009
1998

Treatment

ACT is free for all ages in public sector

Yes 2008
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum

Primaquine is used for radical treatment of P. vivax

G6PD test is a requirement before treatment with primaquine

Directly observed treatment with primaquine is undertaken

System for monitoring of adverse reactions to antimalarials exists

Yes/ Year
No adopted

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2005
AL
2005
QN 2005
QN
2005

Type of RDT used

P.f only

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20072013
0
1.6
11.9
28 days
7
P. falciparum

Cases (%)

Cases tested and treated in public sector

Survey source: MICS 2006

Cases per 1000

1500
1200
900
600
300
0

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity
100
80
60
40
20
0

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Management and other costs

Survey source: MICS 2006

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

200
160
120
80
40
0

Funding source(s): Global Fund

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

(%)

WHO/UNICEF

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

With access to an ITN (model)

With access to an ITN (survey)

100
80
60
40
20
0

USAID/PMI

Tests (%)

Population (%)

IV. Coverage

World Bank

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

50
40
30
20
10
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Cases (p.vivax) points
104 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

30
24
18
12
6
0

Deaths

Global Fund

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

10
8
6
4
2
0

ABER (%)

Contribution (US$m)

III. Financing

Ghana

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

25900000
0
0
25900000

100
0
0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. gambiae, An. funestus, An. arabiensis
Programme phase:

Control

Reported confirmed cases: 1639451

Reported deaths:
2506

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2004
2010

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2005

Larval control Use of larval control recommended

Yes

1999

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
No
No

IPT

IPT used to prevent malaria during pregnancy

Yes

2003

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
No

2008

Treatment

ACT is free for all ages in public sector

No

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes 2001

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

World Bank

USAID/PMI

WHO/UNICEF

Survey source: DHS 2003, DHS 2008

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Species
P. falciparum
P. falciparum

Pie chart includes 100%

of total contributions

Funding source(s): Government,

Global Fund, USAID/PMI, WHO,
Other (bilateral), Other (all types)

Management and other costs

Survey source: MICS 2006, DHS 2008

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity
100
80
60
40
20
0

2000
1600
1200
800
400
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

11
12

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

Tests (%)

Cases per 1000

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2003, MICS 2006, DHS 2008

ABER (microscopy & RDT)

28 days
28 days

Cases tested and treated in public sector

% fever cases <5 seeking treatment at public HF (survey)

150
120
90
60
30
0

Follow-up No. of studies

Others

Cases (%)

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

V. Impact

13.8
14

ITN and IRS coverage

Others

Admissions

(%)

100
80
60
40
20
0

Max

0
3.15

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

25
20
15
10
5
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

35
28
21
14
7
0

Deaths

Global Fund

With access to an ITN (model)

With access to an ITN (survey)

Median

0
0

Financing by intervention in 2013

ABER (%)

Contribution (US$m)
Population (%)

100
80
60
40
20
0

Min

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government

Year
20052011
20052011

Sources of financing

IV. Coverage

P.f only

Therapeutic efficacy tests (clinical and parasitological failure, %)

AL
AS+AQ

120
96
72
48
24
0

AS+AQ
2004
AL; AS+AQ
2004
QN 2004
AS; AM; QN

Type of RDT used

Medicine

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 105
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Guatemala

Region of the Americas

EURO / PAHO
Confirmed cases
API 1000 population
per

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

2320000
4720000
8430000
15470000

15
31
54

Major plasmodium species: P. falciparum (2%), P. vivax (98%)

Major anopheles species:
An. albimanus, An. pseudopunctipennis, An. darlingi
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

6214
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2006
2006

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

Larval control Use of larval control recommended

Yes

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
No
No
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

Treatment

ACT is free for all ages in public sector

Yes

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

CQ+PQ(3d)

CQ

CQ+PQ(14d)

0.25 mg/kg (14 days)

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

World Bank

Cases per 1000

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

100
80
60
40
20
0

Suspected cases tested

Primaquine distributed vs reported P.v. cases points
Primaquine distributed vs reported P.v. cases
Antimalarials distributed vs reported cases points
Antimalarials distributed vs reported cases
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v. cases

Insecticide & spraying materials

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

5
4
3
2
1
0

Management and other costs

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

Tests (%)

(%)

Cases tested and treated in public sector

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Funding source(s): Government,

USAID/PMI

Others

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

WHO/UNICEF

Cases (%)

Population (%)

IV. Coverage

USAID/PMI

Cases (P. vivax)

RDT positivity rate

Malaria admissions and deaths

5
4
3
2
1
0

5
4
3
2
1
0

Slide positivity rate points

Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Cases (p.vivax) points
106 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

5
4
3
2
1
0

Deaths

Global Fund

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

15
12
9
6
3
0

ABER (%)

Contribution (US$m)

III. Financing

Guinea

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

11700000
0
0
11700000

100
0
0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. gambiae, An. funestus, An. melas, An. arabiensis
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
211257
108

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2009
2009

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2013

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
Yes
No

Larval control Use of larval control recommended

No

IPT

IPT used to prevent malaria during pregnancy

Yes

2005

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2012
2012

Treatment

ACT is free for all ages in public sector

Yes 2010
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes 2009

2009

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+AQ

AS+AQ

QN
AS

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

WHO/UNICEF

Cases tested and treated in public sector

Survey source: DHS 2005, DHS 2012

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

800
640
480
320
160
0

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity
100
80
60
40
20
0

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Management and other costs

Survey source: DHS 2012

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk
protected with IRS
Survey source: DHS 2005, DHS 2012

% fever cases <5 seeking treatment at public HF (survey)

30
24
18
12
6
0

Others

Tests (%)

Population (%)

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

(%)

USAID/PMI

ITN and IRS coverage

Others

With access to an ITN (model)

With access to an ITN (survey)

100
80
60
40
20
0

World Bank

Funding source(s): Government,

USAID/PMI, WHO, UNICEF, Other
(all types)

Cases (P. vivax)

Suspected cases tested

Survey source: DHS 2012
<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

2.0
1.6
1.2
0.8
0.4
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

10
8
6
4
2
0

Deaths

Global Fund

Cases (%)

Government

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

IV. Coverage
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

30
24
18
12
6
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 107
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Guinea-Bissau

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

1700000
0
0
1700000

100
0
0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. gambiae, An. funestus
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
54584
418

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
No

2005

IRS

IRS is recommended
DDT is authorized for IRS

No
No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No

Larval control Use of larval control recommended

No

IPT

IPT used to prevent malaria during pregnancy

Yes

2005

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2008
2008

Treatment

ACT is free for all ages in public sector

No

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL

AL

QN
AS; QN

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20062008 3.6
3.6
3.6
28 days
1
P. falciparum

Cases (%)

Cases tested and treated in public sector

Cases per 1000

100
80
60
40
20
0

1500
1200
900
600
300
0

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Management and other costs

Survey source: MICS 2006

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

50
40
30
20
10
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected
with IRS
Survey source: MICS 2006

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Funding source(s): Government,

Global Fund, WHO, UNICEF

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

(%)

WHO/UNICEF

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

With access to an ITN (model)

With access to an ITN (survey)

100
80
60
40
20
0

USAID/PMI

Tests (%)

Population (%)

IV. Coverage

World Bank

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

15
12
9
6
3
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Cases (p.vivax) points
108 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

100
80
60
40
20
0

Deaths

Global Fund

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

120
96
72
48
24
0

ABER (%)

Contribution (US$m)

III. Financing

Guyana

Region of the Americas

EURO / PAHO
Confirmed cases
API 1000 population
per

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

280000
464000
56000
800000

35
58
7

Major plasmodium species: P. falciparum (55%), P. vivax (44%)

Major anopheles species:
An. darlingi, An. aquasalis
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

31479
3

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2005
2005

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

Larval control Use of larval control recommended

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
Yes
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1946
1946

Treatment

ACT is free for all ages in public sector

Yes 2005
Artemisinin-based monotherapies withdrawn
Yes

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL+PQ(1d)
2004
QN+T 2004
AM

CQ+PQ(14d)
2004
0.25 mg/kg (14 days)

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

CQ
20062006 32.4
32.4
32.4
28 days
1
P. vivax

Population (%)

IV. Coverage

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

Survey source: DHS 2005, DHS 2009

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high
risk protected with IRS
Survey source: DHS 2005, DHS 2009

100
80
60
40
20
0

Monitoring and evaluation

Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v. cases

Insecticide & spraying materials

Cases (P. vivax)

Suspected cases tested

Primaquine distributed vs reported P.v. cases points
Primaquine distributed vs reported P.v. cases
Antimalarials distributed vs reported cases points
Antimalarials distributed vs reported cases
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Test positivity

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

ABER (microscopy & RDT)

Management and other costs

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact
Cases per 1000

Cases tested and treated in public sector

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

Funding source(s): Global Fund,

USAID/PMI, WHO

Others

Tests (%)

(%)

60
48
36
24
12
0

WHO/UNICEF

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

USAID/PMI

RDT positivity rate

Malaria admissions and deaths

35
28
21
14
7
0

1200
960
720
480
240
0

Slide positivity rate points

Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

50
40
30
20
10
0

Deaths

World Bank

Cases (%)

Global Fund

Pie chart includes 51%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

2.5
2.0
1.5
1.0
0.5
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Increase in case incidence 2000-2015

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 109
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Haiti

Region of the Americas

EURO / PAHO
Confirmed cases
API 1000 population
per

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

5470000
4850000
0
10320000

53
47
0

Major plasmodium species: P. falciparum (100%), P. vivax (0%)

Major anopheles species:
An. albimanus
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

20586
10

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2012
2012

IRS

IRS is recommended
DDT is authorized for IRS

No
No

Larval control Use of larval control recommended

Yes

2011

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
No
No
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1988
2011

Treatment

ACT is free for all ages in public sector

Yes

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

CQ+PQ(1d)

MQ; SP

QN

CQ+PQ(14d)

0.25 mg/kg (14 days)

Type of RDT used

P.f + all species (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

World Bank

% fever cases <5 seeking treatment at public HF (survey)

Cases per 1000

10
8
6
4
2
0

Management and other costs

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

100
80
60
40
20
0

Suspected cases tested

Primaquine distributed vs reported P.v. cases points
Primaquine distributed vs reported P.v. cases
Antimalarials distributed vs reported cases points
Antimalarials distributed vs reported cases
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Parasite prevalence (survey)

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Cases (P. vivax)

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v. cases

Insecticide & spraying materials

Test positivity

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS Survey source: DHS 2000, DHS 2006, DHS 2012
Tests (%)

(%)

Cases tested and treated in public sector

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Funding source(s): Government,

Global Fund, Other (all types)

Others

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Survey source: DHS 2012, Other nat.
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

WHO/UNICEF

Cases (%)

Population (%)

IV. Coverage

USAID/PMI

Slide positivity rate

RDT positivity rate

Malaria admissions and deaths

40
32
24
16
8
0

1200
960
720
480
240
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Cases (p.vivax) points
110 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

120
96
72
48
24
0

Deaths

Global Fund

Pie chart includes 93%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

10
8
6
4
2
0

ABER (%)

Contribution (US$m)

III. Financing

Honduras

Region of the Americas

EURO / PAHO
Confirmed cases
API 1000 population
per

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

1130000
4760000
2200000
8090000

14
59
27

Major plasmodium species: P. falciparum (21%), P. vivax (79%)

Major anopheles species:
An. albimanus, An. pseudopunctipennis, An. darlingi, An. cruzii, An. argyritarsis
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

5428
1

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2009
2009

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

Larval control Use of larval control recommended

Yes

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
Yes
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

Treatment

ACT is free for all ages in public sector

Yes

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

CQ+PQ(1d)

SP 2011
QN

CQ+PQ(14d)

0.25 mg/kg (14 days)

Type of RDT used

P.f + P.v specific (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

CQ
20082009
0
0
0
28 days
1
P. falciparum

Global Fund

World Bank

Cases (%)

Population (%)

Cases tested and treated in public sector

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

Management and other costs

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high
risk protected with IRS
Survey source: DHS 2006, DHS 2012

Tests (%)

100
80
60
40
20
0

Suspected cases tested

Primaquine distributed vs reported P.v. cases points
Primaquine distributed vs reported P.v. cases
Antimalarials distributed vs reported cases points
Antimalarials distributed vs reported cases
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v. cases

Insecticide & spraying materials

Test positivity

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

7.5
6.0
4.5
3.0
1.5
0

Others

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

(%)

WHO/UNICEF

ITN and IRS coverage

Others

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

USAID/PMI

Funding source(s): Government,

Global Fund, USAID/PMI, WHO,
Other (bilateral)

Cases (P. vivax)

RDT positivity rate

Malaria admissions and deaths

5
4
3
2
1
0

5
4
3
2
1
0

Slide positivity rate points

Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

5
4
3
2
1
0

Deaths

Government

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

IV. Coverage
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

3.0
2.4
1.8
1.2
0.6
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
2014 | 111
Deaths (P.vivax)
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

India

South-East Asia Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Insufficient data
0

Insufficient data
No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

>75

4060

6080

No cases

1.010
PP

2040

Based on 2011 reported data

2040

>75

4060

6080
80100
Based on 2011 reported data

80100

I. Epidemiological profile
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Insufficient data

Insufficient data
0

PF-RATIO

1.010

Population

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

2013

Parasites and vectors

275500000
838900000
137700000
1252100000

22
67
11

Major plasmodium species: P. falciparum (53%), P. vivax (47%)

Major anopheles species:
An. culicifacies, An. fluviatilis, An. stephensi, An. minimus, An. dirus, An. annularis
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
881730
440

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2001
2001

IRS

IRS is recommended
DDT is authorized for IRS

Yes
Yes

1953
1953

Larval control Use of larval control recommended

Yes

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
No
Yes
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1958
1953

Treatment

ACT is free for all ages in public sector

Yes 2006
Artemisinin-based monotherapies withdrawn
Yes

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
Yes

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

CQ
2007
AS+SP+PQ
2007
QN+D; QN+T

AM; AS; QN
2007
CQ+PQ(14d)
2007
0.25 mg/kg (14 days)

Type of RDT used

P.f + P.v specific (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

World Bank

(%)

Cases (%)

Cases tested and treated in public sector

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Survey source: DHS 2006

Cases per 1000

Management and other costs

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

2.0
1.6
1.2
0.8
0.4
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

100
80
60
40
20
0

5
4
3
2
1
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Reporting completeness

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Funding source(s): Government,

Global Fund, World Bank

Others

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

WHO/UNICEF

Tests (%)

Population (%)

IV. Coverage

USAID/PMI

Cases (P. vivax)

Malaria admissions and deaths

15
12
9
6
3
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: On track for 50%-75% decrease in case incidence 2000-2015

Cases (p.vivax) points
112 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

2000
1600
1200
800
400
0

Deaths

Global Fund

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

150
120
90
60
30
0

ABER (%)

Contribution (US$m)

III. Financing

Indonesia

South-East Asia Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Insufficient data
0

Insufficient data
No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

>75

4060

6080

No cases

1.010
PP

2040

Based on 2012 reported data

2040

>75

4060

6080
80100
Based on 2012 reported data

80100

I. Epidemiological profile
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Insufficient data

Insufficient data
0

PF-RATIO

1.010

Population

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

2013

Parasites and vectors

42500000
109900000
97400000
249800000

17
44
39

Major plasmodium species: P. falciparum (56%), P. vivax (44%)

Major anopheles species:
An. sundaicus, An. balabacensis, An. maculatus, An. farauti, An. subpictus, An. subpictus
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
343527
45

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2006
2004

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1959

Larval control Use of larval control recommended

Yes

1990

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
Yes
Yes
Yes

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2007
1959

Treatment

ACT is free for all ages in public sector

Yes 2004
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+AQ; DHA-PP+PQ
2008
QN+D+PQ 2004
AM; AS; QN
2004
AS+AQ; DHA-PP+PQ(14d)
2008
0.25 mg/kg (14 days)

Type of RDT used

P.f + P.v specific (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

World Bank

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

(%)

Survey source: DHS 2003,
DHS 2007, DHS 2012

Cases tested and treated in public sector

Cases (%)

Survey source: DHS 2007

Cases per 1000

Management and other costs

Survey source: DHS 2012

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

2.0
1.6
1.2
0.8
0.4
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

100
80
60
40
20
0

5
4
3
2
1
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Reporting completeness

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Funding source(s): Global Fund,

WHO, UNICEF

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

WHO/UNICEF

Tests (%)

Population (%)

IV. Coverage

USAID/PMI

Cases (P. vivax)

Malaria admissions and deaths

2.0
1.6
1.2
0.8
0.4
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

1000
800
600
400
200
0

Deaths

Global Fund

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

50
40
30
20
10
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
2014 | 113
Deaths (P.vivax)
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Iran (Islamic Republic of )

Eastern Mediterranean Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Insufficient data
0

Insufficient data
No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

>75

4060

6080

PP

282
746000
76700000
77446000

1
99

2040

>75

4060

6080
80100
Based on 2012 reported data

80100

I. Epidemiological profile
2013

No cases

1.010

2040

Based on 2012 reported data

Number of active foci

Number of people living within active foci
Number of people living in malaria-free areas
Total

Insufficient data

Insufficient data
0

PF-RATIO

1.010

Population

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Parasites and vectors

Major plasmodium species: P. falciparum (18%), P. vivax (82%)
Major anopheles species:
An. stephensi, An. culicifacies, An. fluviatilis, An. superpictus
Programme phase:

Elimination

Total confirmed cases, 2013:

Total deaths, 2013:

1373
2

Indigenous cases, 2013:

Indigenous deaths, 2013:

479
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2005
2005

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

Larval control Use of larval control recommended

Yes

1949

IPT

IPT used to prevent malaria during pregnancy

N/A

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Foci and case investigation undertaken

Case reporting from private sector is mandatory

Yes
Yes
No
No
No
Yes
Yes

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1949

Treatment

ACT is free for all ages in public sector

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes 1949
Primaquine is used for radical treatment of P. vivax
Yes 1949
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

Yes 1949
System for monitoring of adverse reactions to antimalarials exists
Yes 1949

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

Global Fund

World Bank

100
80
60
40
20
0

Cases (%)

Monitoring and evaluation

Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013
Insecticide & spraying materials

Suspected cases tested points

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

ACTs distributed vs reported P. falciparum cases

ACTs as % of all antimalarials received by <5 (survey)

Cases investigated

ACTs as % of all antimalarials received by <5 (survey)

Primaquine distributed vs reported P.vivax cases
ACTs distributed vs reported P.falciparum cases points
ACTs distributed vs reported P.falciparum cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Funding source(s): Government,

Global Fund, USAID/PMI, WHO,
Other (bilateral)

Human Resources & technical Assistance

Malaria
test positivity
and ABER
Antimalarials
distributedrate
vs reported
cases

ABER (microscopy & RDT)

Pie chart includes 100%

of total contributions

Cases tracked

(%)

Cases (%)
Positivity rate (%)

2.0
1.6
1.2
0.8
0.4
0

RDT positivity rate

25 000
20 000
15 000
10 000
5000
0

Reporting completeness
Foci investigated
Cases investigated points
Cases investigated
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Total cases
Indigenous cases (P. falciparum)

Aber (microscopy & RDT)

Slide positivity points
Slide positivity rate

Foci investigated

Number of malaria cases

300
240
180
120
60
0

Impact: Achieved >75% decrease in case incidence in 2013

RDT positivity rate points
114 | WORLD MALARIA
REPORT 2014
RDT positivity rate

Species

Management and other costs

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtreated
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v cases

Follow-up No. of studies

Cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Max

Others

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

WHO/UNICEF

ITN and IRS coverage

Others

Cases

Population (%)

100
80
60
40
20
0

USAID/PMI

Median

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government

Min

Financing by intervention in 2013

Sources of financing

IV. Coverage

Year

AS+SP 20052012
0 0 1 28 days 15
P. falciparum
CQ+PQ
20082011
0
0
0
28 days
4
P. vivax

ABER (%)

Contribution (US$m)

15
12
9
6
3
0

AS+SP; AS+SP+PQ
2010
AL; AL+PQ
2010
AS; QN+D

CQ+PQ(14d & 8w)

0.75 mg/kg (8 weeks)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

III. Financing

1949
1949

2010
1949

Imported cases points

Imported cases
Indigenous (P.vivax) points

Imported cases
Indigenous cases (P. vivax)

Kenya

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

16000000
17700000
10600000
44300000

36
40
24

Major plasmodium species: P. falciparum (100%), P. vivax (0%)

Major anopheles species:
An. gambiae, An. arabiensis, An. funestus, An. merus
Programme phase:

Control

Reported confirmed cases: 2335286

Reported deaths:
360

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2006
2010

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2003

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
No

Larval control Use of larval control recommended

No

IPT

IPT used to prevent malaria during pregnancy

Yes

2001

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2009

Treatment

ACT is free for all ages in public sector

Yes 2006
Artemisinin-based monotherapies withdrawn
Yes

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax

G6PD test is a requirement before treatment with primaquine

Directly observed treatment with primaquine is undertaken

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2004
AL
2004
QN 2004
AS; AM; QN
2012

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20052011
0
1.65
6.6
28 days
16
P. falciparum

Cases tested and treated in public sector

Survey source: DHS 2003, DHS 2009

Cases per 1000

100
80
60
40
20
0

600
480
360
240
120
0

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Management and other costs

Survey source: DHS 2009

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

60
48
36
24
12
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk
protected with IRS
Survey source: DHS 2003, DHS 2009

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Funding source(s): Government,

Global Fund, USAID/PMI

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

(%)

WHO/UNICEF

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
Antimalarials
vs reported
points2010 2011 2012 2013
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

25
20
15
10
5
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

200
160
120
80
40
0

Deaths

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

With access to an ITN (model)

With access to an ITN (survey)

100
80
60
40
20
0

USAID/PMI

Tests (%)

Population (%)

IV. Coverage

World Bank

Cases (%)

Global Fund

Pie chart includes 54%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

150
120
90
60
30
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
2014 | 115
Deaths (P.vivax)
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Lao Peoples Democratic Republic

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Western Pacific Region

OTHERS

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

2440000
1560000
2780000
6780000

36
23
41

Major plasmodium species: P. falciparum (73%), P. vivax (27%)

Major anopheles species:
An. dirus, An. minimus, An. maculatus, An. jeyporiensis
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
38131
28

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2003
2000

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2010

Larval control Use of larval control recommended

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
No
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2003
2005

Treatment

ACT is free for all ages in public sector

Yes 2005
Artemisinin-based monotherapies withdrawn
Yes 2007
Single dose of primaquine is used as gametocidal medicine for P. falciparum No
Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
Yes 2010
Directly observed treatment with primaquine is undertaken
No

System for monitoring of adverse reactions to antimalarials exists

No

2012
2012

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2001
QN+D
2001
CQ+PQ(14d) 2001
CQ+PQ(14d)
2001
AL

Type of RDT used

P.f + P.v specific (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20052013
0
1.2
18.1
28 days
12
P. falciparum

World Bank

(%)

Cases (%)

Cases tested and treated in public sector

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

Management and other costs

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

10
8
6
4
2
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

100
80
60
40
20
0

25 000
20 000
15 000
10 000
5000
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Reporting completeness

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
Antimalarials
vs reported
points2010 2011 2012 2013
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Funding source(s): Government,

Global Fund, USAID/PMI, WHO

Others

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

WHO/UNICEF

Tests (%)

Population (%)

IV. Coverage

USAID/PMI

Cases (P. vivax)

Malaria admissions and deaths

10
8
6
4
2
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Increase in case incidence 2000-2015

Cases (p.vivax) points
116 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

350
280
210
140
70
0

Deaths

Global Fund

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

10
8
6
4
2
0

ABER (%)

Contribution (US$m)

III. Financing

Liberia

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

4290000
0
0
4290000

100
0
0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. gambiae
Programme phase:

Control

Reported confirmed cases: 1244220

Reported deaths:
1191

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2005
2008

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2009

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
No
No

Larval control Use of larval control recommended

No

IPT

IPT used to prevent malaria during pregnancy

Yes

2005

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2005
2005

Treatment

ACT is free for all ages in public sector

Yes 2005
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+AQ
2004
AS+AQ
2004
QN 2004
AS; AM; QN
2014

Type of RDT used

P.f only

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AS+AQ
20072009
0
0
1
28 days
3
P. falciparum

WHO/UNICEF

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

Cases tested and treated in public sector

Survey source: MIS 2009, MIS 2011, DHS 2013

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

35 000
28 000
21 000
14 000
7000
0

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Management and other costs

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity
100
80
60
40
20
0

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Survey source: DHS 2007, MIS 2009, MIS 2011,

DHS 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2007, MIS 2009, MIS 2011, DHS 2013

% fever cases <5 seeking treatment at public HF (survey)

500
400
300
200
100
0

Others

Tests (%)

Population (%)
(%)

100
80
60
40
20
0

USAID/PMI

ITN and IRS coverage

Others

With access to an ITN (model)

With access to an ITN (survey)

World Bank

Funding source(s): Government,

Global Fund, USAID/PMI, WHO,
UNICEF

Cases (P. vivax)

Suspected cases tested

Survey source: MIS 2009, MIS 2011
<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

60
48
36
24
12
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

50
40
30
20
10
0

Deaths

Global Fund

Cases (%)

Government

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

IV. Coverage
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

30
24
18
12
6
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
2014 | 117
Deaths (P.vivax)
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Madagascar

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

6880000
16000000
0
22880000

30
70
0

Major plasmodium species: P. falciparum (100%), P. vivax (0%)

Major anopheles species:
An. funestus, An. gambiae, An. arabiensis
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
387045
641

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2004
2009

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1993

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
Yes
Yes
No

Larval control Use of larval control recommended

No

IPT

IPT used to prevent malaria during pregnancy

Yes

2006

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2006
2006

Treatment

ACT is free for all ages in public sector

Yes 2006
Artemisinin-based monotherapies withdrawn
Yes 2006
Single dose of primaquine is used as gametocidal medicine for P. falciparum No
Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes 2008

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+AQ
2006
AS+AQ
2006
QN 2006
QN
2006

Type of RDT used

Year

Min

Median

Max

Follow-up No. of studies

AL
20062006 1.7
1.7
1.7
AS+AQ
20062013
0
0
8.7

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

Cases tested and treated in public sector

Survey source: DHS 2009, MIS 2011, DHS 2013

Cases per 1000

100
80
60
40
20
0

80
64
48
32
16
0

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Management and other costs

Survey source: DHS 2009, MIS 2011, DHS 2013

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

20
16
12
8
4
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2004, DHS 2009, MIS 2011, DHS 2013

V. Impact

Funding source(s): Government,

Global Fund, USAID/PMI, WHO,
UNICEF, Other (bilateral)

Others

Tests (%)

(%)

100
80
60
40
20
0

WHO/UNICEF

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

With access to an ITN (model)

With access to an ITN (survey)

USAID/PMI

ITN and IRS coverage

Others

Admissions

Population (%)

100
80
60
40
20
0

World Bank

Cases (P. vivax)

Suspected cases tested

Survey source: MIS 2011, DHS 2013
<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

5
4
3
2
1
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Cases (p.vivax) points
118 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Species
P. falciparum
P. falciparum

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

5
4
3
2
1
0

Deaths

Global Fund

Cases (%)

Government

1
18

Pie chart includes 76%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

IV. Coverage

28 days
28 days

Financing by intervention in 2013

Sources of financing

ABER (%)

Contribution (US$m)

80
64
48
32
16
0

P.f + P.v specific (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

III. Financing

2003
1993
2003
2006

Malawi

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

PF-RATIO

>75

4060

6080

PP

2013

%
100
0
0

2040

>75

4060

6080
80100
Based on 2012 reported data

80100

I. Epidemiological profile
16400000
0
0
16400000

No cases

1.010

2040

Based on 2012 reported data

High transmission (> 1 case per 1000 population)

Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

1.010

Population

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. funestus, An. gambiae, An. arabiensis
Programme phase:

Control

Reported confirmed cases: 1280892

Reported deaths:
3723

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2006
2010

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2007

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
No
No

Larval control Use of larval control recommended

No

IPT

IPT used to prevent malaria during pregnancy

Yes

1993

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
No

2011

Treatment

ACT is free for all ages in public sector

Yes 2007
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes 2007

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2007
AL
2007
AS+AQ 2007
AS; QN
2013

Type of RDT used

P.f only

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20052012
0
4.45
19.5
28 days
8
P. falciparum
AS+AQ
20052012
0
1.7
3.6
28 days
3
P. falciparum

No data reported for 2013

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

(%)

100
80
60
40
20
0

USAID/PMI

WHO/UNICEF

Cases tested and treated in public sector

Survey source: DHS 2004, DHS 2010, DHS 2012, MIS 2012

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

Antimalarials distributed vs reported cases

ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases

Test positivity
100
80
60
40
20
0

1500
1200
900
600
300
0

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Survey source: MICS 2006, DHS 2010, DHS 2012, MIS 2012

Suspected cases tested

<5 with fever with finger/heel stick (survey)

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2000, DHS 2004, MICS 2006, DHS 2010, MIS 2012

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

100
80
60
40
20
0

Others

Tests (%)

Population (%)

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

With access to an ITN (model)

With access to an ITN (survey)

World Bank

ITN and IRS coverage

Others

Cases (P. vivax)

Suspected cases tested

Survey source: MIS 2012
<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

20
16
12
8
4
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

80
64
48
32
16
0

Deaths

Global Fund

IV. Coverage

Cases (%)

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

60
48
36
24
12
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 119
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Malaysia

Western Pacific Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
Number of active foci
Number of people living within active foci
Number of people living in malaria-free areas
Total

2013

3027
1050000
28700000
29750000

4
96

Parasites and vectors

Major plasmodium species: P. falciparum (16%), P. vivax (13%)
Major anopheles species:
An. balabacensis, An. donaldi, An. maculatus, An. sundaicus, An. flavirostris
Programme phase:

Pre-elimination

Total confirmed cases, 2013:

Total deaths, 2013:

3850
14

Indigenous cases, 2013:

Indigenous deaths, 2013:

2921
10

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

1995
1995

IRS

IRS is recommended
DDT is authorized for IRS

No

Larval control Use of larval control recommended

Yes

IPT

IPT used to prevent malaria during pregnancy

N/A

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Foci and case investigation undertaken

Case reporting from private sector is mandatory

Yes
Yes
Yes
Yes
Yes
Yes
Yes

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1967

Treatment

ACT is free for all ages in public sector

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
Yes

Directly observed treatment with primaquine is undertaken

Yes

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

Global Fund

World Bank

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013
Insecticide & spraying materials

Cases tracked
100
80
60
40
20
0

Suspected cases tested points

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

ACTs distributed vs reported P. falciparum cases

ACTs as % of all antimalarials received by <5 (survey)

Cases investigated

ACTs as % of all antimalarials received by <5 (survey)

Malaria
test positivity
and ABER
Antimalarials
distributedrate
vs reported
cases

Primaquine distributed vs reported P.vivax cases

ACTs distributed vs reported P.falciparum cases points
ACTs distributed vs reported P.falciparum cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Slide positivity rate

Pie chart includes 100%

of total contributions

Management and other costs

Suspected cases tested

(%)

Cases (%)
Positivity rate (%)

1.0
0.8
0.6
0.4
0.2
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

RDT positivity rate

15 000
12 000
9000
6000
3000
0

Reporting completeness
Foci investigated
Cases investigated points
Cases investigated
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Total cases
Indigenous cases (P. falciparum)

Aber (microscopy & RDT)

Slide positivity points
Slide positivity rate

Foci investigated

Number of malaria cases

200
160
120
80
40
0

Impact: Achieved >75% decrease in case incidence in 2013

RDT positivity rate points
120 | WORLD MALARIA
REPORT 2014
RDT positivity rate

Species

Cases tested

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtreated
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v cases

Follow-up No. of studies

Funding source(s): Government

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Max

Others

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

WHO/UNICEF

Cases (%)

100
80
60
40
20
0

Median

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

Cases

Population (%)

IV. Coverage

USAID/PMI

Min

Financing by intervention in 2013

Sources of financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government

Year

ABER (%)

Contribution (US$m)

50
40
30
20
10
0

AS+MQ

QN+T
QN+T

CQ+PQ(14d)

0.50 mg/kg (14 days)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

III. Financing

1995
1988

Imported cases points

Imported cases
Indigenous (P.vivax) points

Imported cases
Indigenous cases (P. vivax)

Mali

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

13800000
1530000
0
15330000

90
10
0

Major plasmodium species: P. falciparum (100%), P. vivax (0%)

Major anopheles species:
An. gambiae, An. funestus, An. funestus, An. funestus
Programme phase:

Control

Reported confirmed cases: 1367218

Reported deaths:
1680

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
No

2005

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2007

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
No
Yes

Larval control Use of larval control recommended

No

IPT

IPT used to prevent malaria during pregnancy

Yes

2003

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2008
2008

Treatment

ACT is free for all ages in public sector

No

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes 2010

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

Year

Min

Median

100
80
60
40
20
0

Survey source: DHS 2006, DHS 2010, DHS 2013

Cases per 1000

100
80
60
40
20
0

4000
3200
2400
1600
800
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Management and other costs

Survey source: DHS 2006, DHS 2013

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

100
80
60
40
20
0

Funding source(s): Global Fund,

USAID/PMI, WHO, UNICEF

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2001, DHS 2006, DHS 2013

V. Impact

Species
P. falciparum
P. falciparum

Cases tested and treated in public sector

100
80
60
40
20
0

Tests (%)

(%)

9
4

Pie chart includes 96%

of total contributions

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

With access to an ITN (model)

With access to an ITN (survey)

28 days
28 days

Cases (P. vivax)

Suspected cases tested

Survey source: DHS 2010, DHS 2013
<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

15
12
9
6
3
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

25
20
15
10
5
0

Deaths

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

WHO/UNICEF

Admissions

100
80
60
40
20
0

USAID/PMI

ABER (%)

Contribution (US$m)
Population (%)

IV. Coverage

World Bank

Follow-up No. of studies

3.8
7.6

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

Cases (%)

Global Fund

Max

Financing by intervention in 2013

Sources of financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government

Therapeutic efficacy tests (clinical and parasitological failure, %)

AL
20052011
0
0.9
AS+AQ
20052007
0
2.25

50
40
30
20
10
0

AS+AQ
2007
AL; AS+AQ
2007
AL 2007
QN

Type of RDT used

Medicine

III. Financing

2008

1993

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
2014 | 121
Deaths (P.vivax)
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Mauritania

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

2300000
1210000
389000
3899000

59
31
10

Major plasmodium species: P. falciparum (100%), P. vivax (0%)

Major anopheles species:
An. gambiae, An. arabiensis, An. pharoensis
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

1587
25

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
No

1998

IRS

IRS is recommended
DDT is authorized for IRS

No
No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
Yes

Larval control Use of larval control recommended

No

IPT

IPT used to prevent malaria during pregnancy

Yes

2008

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2011
2009

Treatment

ACT is free for all ages in public sector

Yes 2009
Artemisinin-based monotherapies withdrawn
Yes

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
Yes

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+AQ

AL; AS+AQ

QN

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AS+AQ
20122012 1.8
1.8
1.8
28 days
2
P. falciparum

Cases (%)

Cases tested and treated in public sector

Cases per 1000

100
80
60
40
20
0

800
640
480
320
160
0

Survey source: MICS 2007

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Management and other costs

Survey source: MICS 2007

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

0.80
0.64
0.48
0.32
0.16
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Funding source(s): Government,

WHO, UNICEF

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

(%)

WHO/UNICEF

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

With access to an ITN (model)

With access to an ITN (survey)

100
80
60
40
20
0

USAID/PMI

Tests (%)

Population (%)

IV. Coverage

World Bank

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

1.5
1.2
0.9
0.6
0.3
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
122 | WORLD MALARIA
REPORT
2014
Cases (p.vivax)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

10
8
6
4
2
0

Deaths

Global Fund

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

15
12
9
6
3
0

ABER (%)

Contribution (US$m)

III. Financing

Mayotte, France

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
Number of active foci
Number of people living within active foci
Number of people living in malaria-free areas
Total

2013

0
0
222000
222000

0
100

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. funestus, An. gambiae
Programme phase:

Elimination

Total confirmed cases, 2013:

Total deaths, 2013:

82
0

Indigenous cases, 2013:

Indigenous deaths, 2013:

1
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2010
2010

IRS

IRS is recommended
DDT is authorized for IRS

No

Yes

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Foci and case investigation undertaken

Case reporting from private sector is mandatory

Yes
No
No
Yes
Yes
Yes
Yes

Yes

Year
Antimalaria treatment policy
Medicine
adopted

Larval control Use of larval control recommended

IPT

IPT used to prevent malaria during pregnancy

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Treatment

ACT is free for all ages in public sector

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
Yes

Directly observed treatment with primaquine is undertaken

Yes

System for monitoring of adverse reactions to antimalarials exists

Yes

First-line treatment of unconfirmed malaria

First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

Global Fund

World Bank

WHO/UNICEF

Max

Follow-up No. of studies

Species

Others

Cases tested

Cases (%)

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases tracked

(%)

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtreated
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

100
80
60
40
20
0

Suspected cases tested points

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

ACTs distributed vs reported P. falciparum cases

ACTs as % of all antimalarials received by <5 (survey)

Cases investigated

ACTs as % of all antimalarials received by <5 (survey)

Malaria
test positivity
and ABER
Antimalarials
distributedrate
vs reported
cases

Primaquine distributed vs reported P.vivax cases

ACTs distributed vs reported P.falciparum cases points
ACTs distributed vs reported P.falciparum cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Slide positivity rate

RDT positivity rate

Foci investigated

Number of malaria cases

20
16
12
8
4
0

Cases

Population (%)
Cases (%)

USAID/PMI

ITN and IRS coverage

Others

Positivity rate (%)

Median

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

At high risk protected with ITNs

Households with at least one ITN

20
16
12
8
4
0

Min

Financing by intervention in 2013

Sources of financing

IV. Coverage

100
80
60
40
20
0

Year

No data reported for 2013

Government
100
80
60
40
20
0

ABER (%)

Contribution (US$m)

5
4
3
2
1
0

AL

QN

CQ+PQ

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

III. Financing

800
640
480
320
160
0

Reporting completeness
Foci investigated
Cases investigated points
Cases investigated
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Total cases
Indigenous cases (P. falciparum)

Imported cases
Indigenous cases (P. vivax)

Impact: On track for >75% decrease in incidence 20002015

Aberpositivity
(microscopy
RDT)
RDT
rate&points
RDT positivity rate
Slide positivity points
Slide positivity rate

WORLD MALARIA REPORT 2014 | 123

Imported cases points
Imported cases
Indigenous (P.vivax) points

Mexico

Region of the Americas

EURO / PAHO
Confirmed cases
API 1000 population
per

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

I. Epidemiological profile
Population
Number of active foci
Number of people living within active foci
Number of people living in malaria-free areas
Total

2013

61
4060000
118300000
122360000

3
97

Parasites and vectors

Major plasmodium species: P. falciparum (0%), P. vivax (100%)
Major anopheles species:
An. pseudopunctipennis, An. albimanus, An. darlingi, An. punctimacula, An. punctimacula
Programme phase:

Pre-elimination

Total confirmed cases, 2013:

Total deaths, 2013:

499
0

Indigenous cases, 2013:

Indigenous deaths, 2013:

495
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2012
2012

IRS

IRS is recommended
DDT is authorized for IRS

No
No

Larval control Use of larval control recommended

Yes

IPT

IPT used to prevent malaria during pregnancy

N/A

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Foci and case investigation undertaken

Case reporting from private sector is mandatory

Yes
Yes
Yes
Yes
Yes
Yes
Yes

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

Year
Antimalaria treatment policy
Medicine
adopted

Treatment

ACT is free for all ages in public sector

No

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

Yes

System for monitoring of adverse reactions to antimalarials exists

Yes

First-line treatment of unconfirmed malaria

First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

Global Fund

World Bank

WHO/UNICEF

Follow-up No. of studies

Species

Others

Cases tested

Cases (%)

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases tracked

(%)

Antimalarials distributed vs reported cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtreated
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

100
80
60
40
20
0

Suspected cases tested points

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

Primaquine distributed vs reported P. vivax cases

Cases investigated

Primaquine distributed vs reported P.vivax cases

Malaria
test positivity
and ABER
Antimalarials
distributedrate
vs reported
cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Slide positivity rate

RDT positivity rate

8000
6400
4800
3200
1600
0

Reporting completeness
Foci investigated
Cases investigated points
Cases investigated
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Total cases
Indigenous cases (P. falciparum)

Impact: Achieved >75% decrease in case incidence in 2013

RDT positivity rate points
124 | WORLD MALARIA
REPORT 2014
RDT positivity rate
Aber (microscopy & RDT)
Slide positivity points
Slide positivity rate

Foci investigated

Number of malaria cases

60
48
36
24
12
0

Cases

Population (%)
Cases (%)

USAID/PMI

ITN and IRS coverage

Others

Positivity rate (%)

Max

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

At high risk protected with ITNs

Households with at least one ITN

0.5
0.4
0.3
0.2
0.1
0

Median

Financing by intervention in 2013

Sources of financing

IV. Coverage

100
80
60
40
20
0

Min

No data reported for 2013

Government
100
80
60
40
20
0

Year

ABER (%)

Contribution (US$m)

30
24
18
12
6
0

CQ+PQ

AL+QN

CQ+PQ

0.25 mg/kg (14 days)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

III. Financing

Imported cases points

Imported cases
Indigenous (P.vivax) points

Imported cases
Indigenous cases (P. vivax)

Mozambique

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

25800000
0
0
25800000

100
0
0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. funestus, An. gambiae, An. arabiensis
Programme phase:

Control

Reported confirmed cases: 2998874

Reported deaths:
2941

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

IRS

IRS is recommended
DDT is authorized for IRS

Yes
Yes

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Larval control Use of larval control recommended

IPT

IPT used to prevent malaria during pregnancy

Yes

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

Treatment

ACT is free for all ages in public sector

Yes

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum

Primaquine is used for radical treatment of P. vivax

G6PD test is a requirement before treatment with primaquine

Directly observed treatment with primaquine is undertaken

System for monitoring of adverse reactions to antimalarials exists

Yes/ Year
No adopted

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2004
AL
2004

AS; QN

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20052012
0
3.1
5.8
28 days
9
P. falciparum

(%)

100
80
60
40
20
0

WHO/UNICEF

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

Cases tested and treated in public sector

Cases (%)

Survey source: DHS 2011

Cases per 1000

100
80
60
40
20
0

800
640
480
320
160
0

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Management and other costs

Survey source: DHS 2011

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

120
96
72
48
24
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2003, MICS 2008, DHS 2011

V. Impact

Funding source(s): USAID/PMI,

WHO, UNICEF

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

With access to an ITN (model)

With access to an ITN (survey)

USAID/PMI

Tests (%)

Population (%)

IV. Coverage

World Bank

Cases (P. vivax)

Suspected cases tested

Survey source: DHS 2011
<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

30
24
18
12
6
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

30
24
18
12
6
0

Deaths

Global Fund

Pie chart includes 32%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

120
96
72
48
24
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 125
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Myanmar

South-East Asia Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

19700000
12200000
21300000
53200000

37
23
40

Major plasmodium species: P. falciparum (74%), P. vivax (26%)

Major anopheles species:
An. minimus, An. dirus
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
333871
236

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2003
2003

IRS

IRS is recommended
DDT is authorized for IRS

Yes
Yes

Larval control Use of larval control recommended

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

Treatment

ACT is free for all ages in public sector

Yes

Artemisinin-based monotherapies withdrawn

Yes 2012
Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes 2010
Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes

Year

Min

Median

Max

AL
AS+MQ
DHA-PPQ

20072013
20112013
20112013

0
0
2.5

1
0
3.4

6
2.2
4.8

Follow-up No. of studies

28 days
42 days
42 days

20
5
3

Species
P. falciparum
P. falciparum
P. falciparum

Financing by intervention in 2013

World Bank

USAID/PMI

WHO/UNICEF

Others

ITN and IRS coverage

Others

Cases tested and treated in public sector

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

Cases (%)

Population (%)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

<5 with fever with finger/heel stick (survey)

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

ACTs as % of all antimalarials received by <5 (survey)

% fever cases <5 seeking treatment at public HF (survey)

100
80
60
40
20
0

Reporting completeness

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Antimalarials distributed vs reported cases

ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases

Test positivity

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

Tests (%)

(%)

Medicine

Cases (P. vivax)

Malaria admissions and deaths

5
4
3
2
1
0

100 000
80 000
60 000
40 000
20 000
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Increase in case incidence 2000-2015

Cases (p.vivax) points
126 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

3000
2400
1800
1200
600
0

Deaths

Global Fund

Cases per 1000

Therapeutic efficacy tests (clinical and parasitological failure, %)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

At high risk protected with ITNs

Households with at least one ITN

10
8
6
4
2
0

AL; AM; AS+MQ; DHA-PPQ; PQ 2008

AS+D; AS+T
2008
AM; AS; QN
2008
CQ+PQ(14d)
2008
0.25 mg/kg (14 days)

Type of RDT used

Sources of financing

IV. Coverage

100
80
60
40
20
0

First-line treatment of unconfirmed malaria

First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

No data reported for 2013

Government
100
80
60
40
20
0

Year
Antimalaria treatment policy
Medicine
adopted

Admissions

25
20
15
10
5
0

ABER (%)

Contribution (US$m)

III. Financing

Namibia

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

1540000
115000
645000
2300000

67
5
28

Major plasmodium species: P. falciparum (100%), P. vivax (0%)

Major anopheles species:
An. arabiensis, An. gambiae, An. funestus
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

4911
21

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

1998

IRS

IRS is recommended
DDT is authorized for IRS

Yes
Yes

1965
1965

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
No
Yes
No
No

Larval control Use of larval control recommended

Yes

IPT

IPT used to prevent malaria during pregnancy

Yes

2005

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2005
1990

Treatment

ACT is free for all ages in public sector

Yes 2005
Artemisinin-based monotherapies withdrawn
Yes 2005
Single dose of primaquine is used as gametocidal medicine for P. falciparum No
Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes

2012

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2006
AL
2006
QN 2006
QN
2006
AL
2006

Type of RDT used

P.f + P.v, P.o, P.m (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

(%)

100
80
60
40
20
0

WHO/UNICEF

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

Cases tested and treated in public sector

Cases (%)

Survey source: DHS 2007

Cases per 1000

100
80
60
40
20
0

2500
2000
1500
1000
500
0

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Management and other costs

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

25
20
15
10
5
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2000, DHS 2007

V. Impact

Funding source(s): Government,

Global Fund, WHO

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

With access to an ITN (model)

With access to an ITN (survey)

USAID/PMI

Tests (%)

Population (%)

IV. Coverage

World Bank

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

7.5
6.0
4.5
3.0
1.5
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

100
80
60
40
20
0

Deaths

Global Fund

Pie chart includes 99%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

20
16
12
8
4
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 127
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Nepal

South-East Asia Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

1010000
12300000
14500000
27810000

4
44
52

Major plasmodium species: P. falciparum (12%), P. vivax (88%)

Major anopheles species:
An. fluviatilis, An. annularis, An. maculatus
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

1974
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2007
2007

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1962

Larval control Use of larval control recommended

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
No
No
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1962

Treatment

ACT is free for all ages in public sector

Yes 2005
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

CQ

AL+PQ
2004
AS; QN

AS; QN

CQ+PQ(14d)
2004
3.75 mg -15 mg/day (2 weeks)

Type of RDT used

P.f + P.v specific (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20052011
0
0
0
28 days
8
P. falciparum
CQ
20082011
0
0
0
28 days
8
P. vivax

World Bank

(%)

100
80
60
40
20
0

Cases (%)

Cases tested and treated in public sector

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

Management and other costs

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

Test positivity
100
80
60
40
20
0

3000
2400
1800
1200
600
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

% fever cases <5 seeking treatment at public HF (survey)

0.5
0.4
0.3
0.2
0.1
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS
Survey source: DHS 2001, DHS 2006, DHS 2011

V. Impact

Reporting completeness

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
Antimalarials
vs reported
points2010 2011 2012 2013
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Funding source(s): Government,

Global Fund, WHO

Others

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

At high risk protected with ITNs

Households with at least one ITN

WHO/UNICEF

Tests (%)

Population (%)

IV. Coverage

USAID/PMI

Cases (P. vivax)

Malaria admissions and deaths

2.0
1.6
1.2
0.8
0.4
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Increase in case incidence 2000-2015

Cases (p.vivax) points
128 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

50
40
30
20
10
0

Deaths

Global Fund

Pie chart includes 89%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

10
8
6
4
2
0

ABER (%)

Contribution (US$m)

III. Financing

Nicaragua

Region of the Americas

EURO / PAHO
Confirmed cases
API 1000 population
per

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

79000
2970000
3030000
6079000

1
49
50

Major plasmodium species: P. falciparum (18%), P. vivax (82%)

Major anopheles species:
An. albimanus, An. pseudopunctipennis
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

1194
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2004
2004

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1959

Larval control Use of larval control recommended

Yes

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
Yes
Yes
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

Treatment

ACT is free for all ages in public sector

Yes

Artemisinin-based monotherapies withdrawn

No

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes 2013
Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

Yes

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

CQ+PQ(1d)

AS+MQ; AS+SP

QN

CQ+PQ(7d)

0.50 mg/kg (7 days)

Type of RDT used

P.f + P.v specific (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

CQ
20052006
0
0
0
28 days
1
P. falciparum

World Bank

ITN and IRS coverage

Cases per 1000

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

100
80
60
40
20
0

Suspected cases tested

Primaquine distributed vs reported P.v. cases points
Primaquine distributed vs reported P.v. cases
Antimalarials distributed vs reported cases points
Antimalarials distributed vs reported cases
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Reporting completeness

RDT positivity rate

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v. cases

Insecticide & spraying materials

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

5
4
3
2
1
0

Management and other costs

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk
protected with IRS
Survey source: DHS 2001

Tests (%)

(%)

Cases tested and treated in public sector

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Funding source(s): Government,

Global Fund, USAID/PMI

Others

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

WHO/UNICEF

Cases (%)

Population (%)

IV. Coverage

USAID/PMI

Cases (P. vivax)

Malaria admissions and deaths

20
16
12
8
4
0

250
200
150
100
50
0

Slide positivity rate points

Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

10
8
6
4
2
0

Deaths

Global Fund

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

4.0
3.2
2.4
1.6
0.8
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 129
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Niger

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

PF-RATIO

>75

4060

6080

No cases

1.010
PP

2040

Based on 2012 reported data

2040

>75

4060

6080
80100
Based on 2012 reported data

80100

I. Epidemiological profile
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

1.010

Population

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

2013

Parasites and vectors

12300000
5530000
0
17830000

69
31
0

Major plasmodium species: P. falciparum (98%), P. vivax (0%)

Major anopheles species:
An. gambiae, An. funestus, An. arabiensis
Programme phase:

Control

Reported confirmed cases: 1431798

Reported deaths:
2209

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
No

2005

IRS

IRS is recommended
DDT is authorized for IRS

Yes
Yes

2003

Larval control Use of larval control recommended

Yes

2010

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
Yes
No

IPT

IPT used to prevent malaria during pregnancy

Yes

2005

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2010

Treatment

ACT is free for all ages in public sector

No

Artemisinin-based monotherapies withdrawn

Yes

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2005
AL
2005
QN 2005
AS; QN

Type of RDT used

P.f only

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20052011 3.7
5.55
10.4
28 days
6
P. falciparum

No data reported for 2013

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Global Fund

WHO/UNICEF

Cases tested and treated in public sector

Cases (%)

Survey source: DHS 2006

Cases per 1000

Antimalarials distributed vs reported cases

ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases

Test positivity
100
80
60
40
20
0

2000
1600
1200
800
400
0

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ACTs as % of all antimalarials received by <5 (survey)

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Survey source: DHS 2012

Suspected cases tested

<5 with fever with finger/heel stick (survey)

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk
protected with IRS
Survey source: DHS 2006, DHS 2012

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

100
80
60
40
20
0

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

(%)

USAID/PMI

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

With access to an ITN (model)

With access to an ITN (survey)

100
80
60
40
20
0

World Bank

ITN and IRS coverage

Others

Tests (%)

Population (%)

IV. Coverage

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

50
40
30
20
10
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Cases (p.vivax) points
130 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

25
20
15
10
5
0

Deaths

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

3000
2400
1800
1200
600
0

ABER (%)

Contribution (US$m)

III. Financing

Nigeria

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

PF-RATIO

>75

4060

6080

PP

2013

%
100
0
0

2040

>75

4060

6080
80100
Based on 2012 reported data

80100

I. Epidemiological profile
173600000
0
0
173600000

No cases

1.010

2040

Based on 2012 reported data

High transmission (> 1 case per 1000 population)

Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

1.010

Population

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. gambiae, An. funestus, An. arabiensis, An. moucheti, An. melas, An. nili
Programme phase:

Control

Reported confirmed cases:

Reported deaths:
7878

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2001
2009

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2007

Larval control Use of larval control recommended

Yes

2010

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
No
No

IPT

IPT used to prevent malaria during pregnancy

Yes

2004

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2010

Treatment

ACT is free for all ages in public sector

Yes 2009
Artemisinin-based monotherapies withdrawn
Yes

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL; AS+AQ
2004
AL; AS+AQ
2004
QN 2004
AS; AM; QN
2011

Type of RDT used

P.f + all species (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

100
80
60
40
20
0

500
400
300
200
100
0

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity
100
80
60
40
20
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Management and other costs

Survey source: MICS 2007, DHS 2008, MIS 2010, DHS 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2003, MICS 2007, DHS 2008, MIS 2010, DHS 2013

V. Impact
Cases per 1000

Cases tested and treated in public sector

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

% fever cases <5 seeking treatment at public HF (survey)

5
4
3
2
1
0

Funding source(s): Global Fund

Others

Cases (P. vivax)

Suspected cases tested

Survey source: MIS 2010
<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

7.5
6.0
4.5
3.0
1.5
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

10
8
6
4
2
0

Deaths

(%)

100
80
60
40
20
0

WHO/UNICEF

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Survey source: DHS 2003, DHS 2008, MIS 2010, DHS 2013
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

With access to an ITN (model)

With access to an ITN (survey)

USAID/PMI

Tests (%)

Population (%)

IV. Coverage

World Bank

Cases (%)

Global Fund

Pie chart includes 16%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

200
160
120
80
40
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
2014 | 131
Deaths (P.vivax)
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Pakistan

Eastern Mediterranean Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

52700000
126400000
3080000
182180000

29
69
2

Major plasmodium species: P. falciparum (17%), P. vivax (83%)

Major anopheles species:
An. culicifacies, An. stephensi
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
281755
244

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
No

2008
2008

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1961

Larval control Use of larval control recommended

Yes

1961

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2011
1961

Treatment

ACT is free for all ages in public sector

Yes 2009
Artemisinin-based monotherapies withdrawn
Yes 2009
Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes 2012
Primaquine is used for radical treatment of P. vivax
Yes 2009
G6PD test is a requirement before treatment with primaquine
Yes 2009
Directly observed treatment with primaquine is undertaken
No

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

CQ

AS+SP+PQ
2013
AL; QN
2013
AS; QN
2007
CQ+PQ(14d)
2007
0.25 mg/kg (14 days)

Type of RDT used

P.f + P.v specific (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20122013
0
0.6
1.2
28 days
2
P. falciparum
AS+SP
20072012
0
0
1.5
28 days
9
P. falciparum

World Bank

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

(%)

Cases tested and treated in public sector

Cases (%)

Survey source: Other nat.

Cases per 1000

Management and other costs

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

Test positivity
100
80
60
40
20
0

80 000
64 000
48 000
32 000
16 000
0

Survey source: DHS 2007

% fever cases <5 seeking treatment at public HF (survey)

2.0
1.6
1.2
0.8
0.4
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Reporting completeness

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
Antimalarials
vs reported
points2010 2011 2012 2013
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Funding source(s): Global Fund,

WHO, Other (bilateral)

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

WHO/UNICEF

Tests (%)

Population (%)

IV. Coverage

USAID/PMI

Cases (P. vivax)

Malaria admissions and deaths

5
4
3
2
1
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Cases (p.vivax) points
132 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

300
240
180
120
60
0

Deaths

Global Fund

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

20
16
12
8
4
0

ABER (%)

Contribution (US$m)

III. Financing

Panama

Region of the Americas

EURO / PAHO
Confirmed cases
API 1000 population
per

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

170000
2750000
943000
3863000

4
71
24

Major plasmodium species: P. falciparum (1%), P. vivax (99%)

Major anopheles species:
An. albimanus, An. pseudopunctipennis, An. punctimacula, An. aquasalis, An. darlingi
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

705
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
No

2012

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1957

Larval control Use of larval control recommended

Yes

1957

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
Yes
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1957
1957

Treatment

ACT is free for all ages in public sector

Yes

Artemisinin-based monotherapies withdrawn

No

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

Yes

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL+PQ(1d)
2012

QN

CQ+PQ(7d); CQ+PQ(14d)

0.25 mg/kg (14 days)

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

World Bank

Cases per 1000

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

100
80
60
40
20
0

Suspected cases tested

Primaquine distributed vs reported P.v. cases points
Primaquine distributed vs reported P.v. cases
Antimalarials distributed vs reported cases points
Antimalarials distributed vs reported cases
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Reporting completeness

RDT positivity rate

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v. cases

Insecticide & spraying materials

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

2.0
1.6
1.2
0.8
0.4
0

Management and other costs

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

Tests (%)

(%)

Cases tested and treated in public sector

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Funding source(s): Government,

USAID/PMI

Others

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

WHO/UNICEF

Cases (%)

Population (%)

IV. Coverage

USAID/PMI

Cases (P. vivax)

Malaria admissions and deaths

10
8
6
4
2
0

120
96
72
48
24
0

Slide positivity rate points

Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

5
4
3
2
1
0

Deaths

Global Fund

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

10
8
6
4
2
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: On track for 50%-75% decrease in case incidence 2000-2015

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 133
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Papua New Guinea

Western Pacific Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

6880000
439000
0
7319000

94
6
0

Major plasmodium species: P. falciparum (87%), P. vivax (11%)

Major anopheles species:
An. punctulatus, An. farauti, An. koliensis
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
279994
307

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2004
2005

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2000

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
No
No

Larval control Use of larval control recommended

No

IPT

IPT used to prevent malaria during pregnancy

Yes

2009

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2010
2004

Treatment

ACT is free for all ages in public sector

Yes 2010
Artemisinin-based monotherapies withdrawn
Yes 2012
Single dose of primaquine is used as gametocidal medicine for P. falciparum No
Primaquine is used for radical treatment of P. vivax
Yes 2009
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes 2000

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2008
DHA-PPQ
2008
AM; AS
2008
AL+PQ
2009
AL; QN

7.5 mg - adult (14 days)

Type of RDT used

P.f + P.v, P.o, P.m (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20052007 2.7
2.7
2.7
28 days
1
P. falciparum
DHA-PPQ
20052007
12
12
12
42 days
1
P. falciparum

No data reported for 2013

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

World Bank

Cases tested and treated in public sector

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

<5 with fever with finger/heel stick (survey)

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

ACTs as % of all antimalarials received by <5 (survey)

30 000
24 000
18 000
12 000
6000
0

Reporting completeness

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
Antimalarials
vs reported
points2010 2011 2012 2013
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Antimalarials distributed vs reported cases

ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases

Test positivity
100
80
60
40
20
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

40
32
24
16
8
0

Others

Tests (%)

Population (%)

Survey source: Other nat.

(%)

WHO/UNICEF

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

USAID/PMI

ITN and IRS coverage

Others

Cases (P. vivax)

Malaria admissions and deaths

10
8
6
4
2
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Increase in case incidence 2000-2015

Cases (p.vivax) points
134 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

800
640
480
320
160
0

Deaths

Global Fund

IV. Coverage

Cases (%)

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

35
28
21
14
7
0

ABER (%)

Contribution (US$m)

III. Financing

Paraguay

Region of the Americas

EURO / PAHO
Confirmed cases
API 1000 population
per

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

Represents foci (active or non-active)

I. Epidemiological profile
Population
Number of active foci
Number of people living within active foci
Number of people living in malaria-free areas
Total

2013

0
1060000
5740000
6800000

16
84

Parasites and vectors

Major plasmodium species: P. falciparum (0%), P. vivax (0%)
Major anopheles species:
An. darlingi, An. albitarsis
Programme phase:

Elimination

Total confirmed cases, 2013:

Total deaths, 2013:

11
0

Indigenous cases, 2013:

Indigenous deaths, 2013:

0
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

No
No

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1957

Larval control Use of larval control recommended

No

IPT

IPT used to prevent malaria during pregnancy

N/A

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Foci and case investigation undertaken

Case reporting from private sector is mandatory

Yes
Yes
No
Yes
Yes
Yes
No

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1957
1957

Treatment

ACT is free for all ages in public sector

Yes 2005
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
Yes 1957
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

Global Fund

World Bank

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013
Insecticide & spraying materials

Cases tracked
100
80
60
40
20
0

Suspected cases tested points

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

Primaquine distributed vs reported P. vivax cases

Cases investigated

Primaquine distributed vs reported P.vivax cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Pie chart includes 100%

of total contributions

Management and other costs

Suspected cases tested

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtreated
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

(%)

Cases (%)
Positivity rate (%)

100
80
60
40
20
0

Malaria
test positivity
and ABER
Antimalarials
distributedrate
vs reported
cases

ABER (microscopy & RDT)

Species

Cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Follow-up No. of studies

Funding source(s): Government

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Antimalarials distributed vs reported cases

Max

Others

ITN and IRS coverage

8.0
6.4
4.8
3.2
1.6
0

WHO/UNICEF

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

USAID/PMI

Cases (%)

100
80
60
40
20
0

Median

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

RDT positivity rate

Foci investigated

Number of malaria cases

80
64
48
32
16
0

Cases

Population (%)

IV. Coverage

Min

Financing by intervention in 2013

Sources of financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government

Year

ABER (%)

Contribution (US$m)

6.0
4.8
3.6
2.4
1.2
0

AL+PQ

AS

CQ+PQ

0.25mk/kg (14days)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

III. Financing

1957
1957

1957
1957
1957

8000
6400
4800
3200
1600
0

Reporting completeness
Foci investigated
Cases investigated points
Cases investigated
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Total cases
Indigenous cases (P. falciparum)

Imported cases
Indigenous cases (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Aberpositivity
(microscopy
RDT)
RDT
rate&points
RDT positivity rate
Slide positivity points
Slide positivity rate

WORLD MALARIA REPORT 2014 | 135

Imported cases points
Imported cases
Indigenous (P.vivax) points

Peru

Region of the Americas

EURO / PAHO
Confirmed cases
API 1000 population
per

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

1370000
3490000
25500000
30360000

5
12
84

Major plasmodium species: P. falciparum (16%), P. vivax (84%)

Major anopheles species:
An. pseudopunctipennis, An. albimanus, An. darlingi
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

43139
4

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

Larval control Use of larval control recommended

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
Yes
Yes
Yes

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

Treatment

ACT is free for all ages in public sector

Yes

Artemisinin-based monotherapies withdrawn

Yes

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

Yes

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+MQ
2001

AS+MQ

CQ+PQ(7d)

0.50 mg/kg (7 days)

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AS+MQ
20052006 1.1
1.1
1.1
28 days
1
P. falciparum
CQ+PQ
20062008 0.5
0.6
1.1
28 days
3
P. vivax

World Bank

Cases tested and treated in public sector

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

100
80
60
40
20
0

Suspected cases tested

Primaquine distributed vs reported P.v. cases points
Primaquine distributed vs reported P.v. cases
Antimalarials distributed vs reported cases points
Antimalarials distributed vs reported cases
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v. cases

Insecticide & spraying materials

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

5
4
3
2
1
0

Management and other costs

Suspected cases tested

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS
Survey source: DHS 2000, DHS 2006, DHS 2008

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

Tests (%)

(%)

100
80
60
40
20
0

Funding source(s): USAID/PMI

Others

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

WHO/UNICEF

Cases (%)

Population (%)

IV. Coverage

USAID/PMI

Cases (P. vivax)

RDT positivity rate

Malaria admissions and deaths

40
32
24
16
8
0

100
80
60
40
20
0

Slide positivity rate points

Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: On track for 50%-75% decrease in case incidence 2000-2015

Cases (p.vivax) points
136 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

25
20
15
10
5
0

Deaths

Global Fund

Pie chart includes 12%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

150
120
90
60
30
0

ABER (%)

Contribution (US$m)

III. Financing

Philippines

Western Pacific Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

7060000
71400000
19900000
98360000

7
73
20

Major plasmodium species: P. falciparum (79%), P. vivax (20%)

Major anopheles species:
An. flavirostris, An. maculatus, An. balabacensis, An. litoralis
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

6514
12

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2006
2000

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2002

Larval control Use of larval control recommended

Yes

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
No
Yes
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2004
2003

Treatment

ACT is free for all ages in public sector

Yes 2003
Artemisinin-based monotherapies withdrawn
Yes 2003
Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes 2006
Primaquine is used for radical treatment of P. vivax
Yes 2007
G6PD test is a requirement before treatment with primaquine
Yes 2011
Directly observed treatment with primaquine is undertaken
Yes 2010
System for monitoring of adverse reactions to antimalarials exists
Yes 2009

2009

2009

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2009
AL+PQ
2009
QN+CL; QN+D; QN+T
2002
QN+T; QN+CL; QN+D
2002
CQ+PQ(14d)
2002
0.50 mg/kg (14 days)

Type of RDT used

P.f + P.v specific (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

CQ
20052010
0
0
0
28 days
2
P. vivax

World Bank

(%)

Cases (%)

Cases tested and treated in public sector

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

Management and other costs

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

1.0
0.8
0.6
0.4
0.2
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high
risk protected with IRS
Survey source: DHS 2003, DHS 2008

100
80
60
40
20
0

5000
4000
3000
2000
1000
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Reporting completeness

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Funding source(s): Government,

Global Fund, WHO

Others

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

WHO/UNICEF

Tests (%)

Population (%)

IV. Coverage

USAID/PMI

Cases (P. vivax)

Malaria admissions and deaths

1.0
0.8
0.6
0.4
0.2
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

600
480
360
240
120
0

Deaths

Global Fund

Pie chart includes 86%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

40
32
24
16
8
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 137
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Republic of Korea

Western Pacific Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
Number of active foci
Number of people living within active foci
Number of people living in malaria-free areas
Total

2013

25
5630000
43600000
49230000

11
89

Parasites and vectors

Major plasmodium species: P. falciparum (0%), P. vivax (100%)
Major anopheles species:
An. sinensis
Programme phase:

Elimination

Total confirmed cases, 2013:

Total deaths, 2013:

443
2

Indigenous cases, 2013:

Indigenous deaths, 2013:

383
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
No

2001

IRS

IRS is recommended
DDT is authorized for IRS

No

Larval control Use of larval control recommended

Yes

2001

IPT

IPT used to prevent malaria during pregnancy

N/A

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Foci and case investigation undertaken

Case reporting from private sector is mandatory

No
No
No
No
Yes
Yes
Yes

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2001

Treatment

ACT is free for all ages in public sector

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
Yes 2001
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes 2011

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

Contribution (US$m)

5
4
3
2
1
0

Population (%)

IV. Coverage
100
80
60
40
20
0

Max

Follow-up No. of studies

Species

WHO/UNICEF

Pie chart includes 97%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

Funding source(s): Government

Others

Cases tested
Management and other costs
Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
No data
reported for 2013
Diagnostics

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ITNs

All ages who slept under an ITN (survey)

At high risk protected with IRS

Insecticide & spraying materials

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtreated
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

Cases tracked

(%)

Cases (%)

USAID/PMI

Median

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

World Bank

Min

Financing by intervention in 2013

Sources of financing

Global Fund

Year

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government

CQ

CQ+PQ(14d)

0.25 mg/kg (14 days)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

III. Financing

2001
2001
2001

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v cases

V. Impact

100
80
60
40
20
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

ACTs distributed vs reported P. falciparum cases

ACTs as % of all antimalarials received by <5 (survey)

Cases investigated

ACTs as % of all antimalarials received by <5 (survey)

Malaria
test positivity
and ABER
Antimalarials
distributedrate
vs reported
cases

Number of malaria cases

Cases

Primaquine distributed vs reported P.vivax cases

ACTs distributed vs reported P.falciparum cases points
ACTs distributed vs reported P.falciparum cases

No data reported for 2013

Foci investigated

5000
4000
3000
2000
1000
0

Reporting completeness
Foci investigated
Cases investigated points
Cases investigated
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Total cases
Indigenous cases (P. falciparum)
Impact: Achieved >75% decrease in case incidence in 2013

138 | WORLD MALARIA REPORT 2014

Imported cases points
Imported cases
Indigenous (P.vivax) points

Imported cases
Indigenous cases (P. vivax)

Rwanda

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

PF-RATIO

>75

4060

6080

PP

2013

%
100
0
0

2040

>75

4060

6080
80100
Based on 2012 reported data

80100

I. Epidemiological profile
11800000
0
0
11800000

No cases

1.010

2040

Based on 2012 reported data

High transmission (> 1 case per 1000 population)

Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

1.010

Population

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. gambiae, An. funestus, An. arabiensis
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
962618
409

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
No

2004

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2009

Larval control Use of larval control recommended

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
No
No

IPT

IPT used to prevent malaria during pregnancy

No

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
No

2009

Treatment

ACT is free for all ages in public sector

No

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2005
AL
2005
QN 2005
AS; QN
2012

Type of RDT used

P.f + all species (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20062009
0
1.3
4.5
28 days
3
P. falciparum

No data reported for 2013

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

WHO/UNICEF

Cases tested and treated in public sector

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

Antimalarials distributed vs reported cases

ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases

Test positivity
100
80
60
40
20
0

2000
1600
1200
800
400
0

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Survey source: DHS 2008, DHS 2010, DHS 2013

Suspected cases tested

<5 with fever with finger/heel stick (survey)

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2000, DHS 2005, DHS 2008, DHS 2010, DHS 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

100
80
60
40
20
0

Others

Tests (%)

Population (%)
(%)

100
80
60
40
20
0

USAID/PMI

WHO_UNICEF
USAID/PMI
Survey source: DHS 2005, DHS 2008, DHS 2010, DHS 2013
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

With access to an ITN (model)

With access to an ITN (survey)

World Bank

ITN and IRS coverage

Others

Cases (P. vivax)

Suspected cases tested

Survey source: DHS 2008, DHS 2010
<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

30
24
18
12
6
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

50
40
30
20
10
0

Deaths

Global Fund

IV. Coverage

Cases (%)

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

50
40
30
20
10
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 139
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Sao Tome and Principe

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

PF-RATIO

>75

4060

6080

PP

2013

%
100
0
0

2040

>75

4060

6080
80100
Based on 2012 reported data

80100

I. Epidemiological profile
193000
0
0
193000

No cases

1.010

2040

Based on 2012 reported data

High transmission (> 1 case per 1000 population)

Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

1.010

Population

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. gambiae
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

9243
11

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2005
2008

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2003

Larval control Use of larval control recommended

Yes

2004

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
No
No
No

IPT

IPT used to prevent malaria during pregnancy

Yes

2004

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2001
2008

Treatment

ACT is free for all ages in public sector

Yes 2008
Artemisinin-based monotherapies withdrawn
No

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes 2013
Primaquine is used for radical treatment of P. vivax
Yes 2013
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

Yes 2013
System for monitoring of adverse reactions to antimalarials exists
No

2008
2013

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+AQ
2004
AS+AQ
2004
AL 2004
QN
2004

0.25 mg/kg (14 days)

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

Global Fund

Cases tested and treated in public sector

Cases (%)

Survey source: DHS 2009

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Survey source: DHS 2009

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS

Cases per 1000

12 000
9600
7200
4800
2400
0

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines

Survey source: DHS 2009

Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity
100
80
60
40
20
0

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Management and other costs

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

400
320
240
160
80
0

Others

Tests (%)

Population (%)

WHO/UNICEF

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

(%)

USAID/PMI

ITN and IRS coverage

Others

With access to an ITN (model)

With access to an ITN (survey)

100
80
60
40
20
0

World Bank

Funding source(s): Government,

Global Fund, USAID/PMI, World
Bank, WHO, UNICEF, Other
(bilateral), Other (all types)

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

120
96
72
48
24
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Cases (p.vivax) points
140 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

250
200
150
100
50
0

Deaths

Government

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

IV. Coverage
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

5
4
3
2
1
0

ABER (%)

Contribution (US$m)

III. Financing

Saudi Arabia

Eastern Mediterranean Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
Number of active foci
Number of people living within active foci
Number of people living in malaria-free areas
Total

2013

29
40400
28800000
28840400

0
100

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. arabiensis, An. sergentii, An. stephensi, An. fluviatilis, An. multicolor
Programme phase:

Elimination

Total confirmed cases, 2013:

Total deaths, 2013:

2513
0

Indigenous cases, 2013:

Indigenous deaths, 2013:

34
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

1980
1980

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

Larval control Use of larval control recommended

Yes

IPT

IPT used to prevent malaria during pregnancy

N/A

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Foci and case investigation undertaken

Case reporting from private sector is mandatory

Yes
Yes
No
No
No
Yes
No

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1963

Treatment

ACT is free for all ages in public sector

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes 1985
Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
Yes 1985
Directly observed treatment with primaquine is undertaken
No

System for monitoring of adverse reactions to antimalarials exists

Yes 1990

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

Global Fund

World Bank

WHO/UNICEF

Follow-up No. of studies

Species

Others

Cases tested

Cases (%)

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases tracked

(%)

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtreated
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

100
80
60
40
20
0

Suspected cases tested points

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

ACTs distributed vs reported P. falciparum cases

ACTs as % of all antimalarials received by <5 (survey)

Cases investigated

ACTs as % of all antimalarials received by <5 (survey)

Malaria
test positivity
and ABER
Antimalarials
distributedrate
vs reported
cases

Primaquine distributed vs reported P.vivax cases

ACTs distributed vs reported P.falciparum cases points
ACTs distributed vs reported P.falciparum cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Slide positivity rate

RDT positivity rate

Foci investigated

Number of malaria cases

60
48
36
24
12
0

Cases

Population (%)
Cases (%)

USAID/PMI

ITN and IRS coverage

Others

Positivity rate (%)

Max

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

At high risk protected with ITNs

Households with at least one ITN

0.5
0.4
0.3
0.2
0.1
0

Median

Financing by intervention in 2013

Sources of financing

IV. Coverage

100
80
60
40
20
0

Min

No data reported for 2013

Government
100
80
60
40
20
0

Year

ABER (%)

Contribution (US$m)

30
24
18
12
6
0

AS+SP+PQ
2012
AL 2007
AM; AS; QN
2007
CQ+PQ(14d)

0.25 mg/kg (14 days)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

III. Financing

1980
1980

1990

8000
6400
4800
3200
1600
0

Reporting completeness
Foci investigated
Cases investigated points
Cases investigated
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Total cases
Indigenous cases (P. falciparum)

Imported cases
Indigenous cases (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Aberpositivity
(microscopy
RDT)
RDT
rate&points
RDT positivity rate
Slide positivity points
Slide positivity rate

WORLD MALARIA REPORT 2014 | 141

Imported cases points
Imported cases
Indigenous (P.vivax) points

Senegal

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

13600000
565000
0
14165000

96
4
0

Major plasmodium species: P. falciparum (100%), P. vivax (0%)

Major anopheles species:
An. gambiae, An. arabiensis, An. funestus, An. pharoensis, An. melas
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
345889
815

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

1998
1998

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2005

Larval control Use of larval control recommended

Yes

2010

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
No
No
No

IPT

IPT used to prevent malaria during pregnancy

Yes

2003

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2007
2007

Treatment

ACT is free for all ages in public sector

Yes 2010
Artemisinin-based monotherapies withdrawn
Yes 2010
Single dose of primaquine is used as gametocidal medicine for P. falciparum No
Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes 2007

2012
2012

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+AQ
2005
AL; AS+AQ
2005

AS; QN

Type of RDT used

P.f only

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

Cases per 1000

100
80
60
40
20
0

250
200
150
100
50
0

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity
100
80
60
40
20
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Management and other costs

Survey source: MIS 2006, MIS 2009, DHS 2011, DHS 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2005, MIS 2006, MIS 2009, DHS 2011, DHS 2013

% fever cases <5 seeking treatment at public HF (survey)

25
20
15
10
5
0

Cases tested and treated in public sector

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Funding source(s): Global Fund,

USAID/PMI, WHO, UNICEF

Others

Cases (P. vivax)

Suspected cases tested

Survey source: MIS 2009, DHS 2011, DHS 2013
<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

7.5
6.0
4.5
3.0
1.5
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Cases (p.vivax) points
142 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

20
16
12
8
4
0

Deaths

(%)

100
80
60
40
20
0

WHO/UNICEF

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI Survey source: DHS 2005, MIS 2006, MIS 2009, DHS 2011, DHS 2013
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

With access to an ITN (model)

With access to an ITN (survey)

USAID/PMI

Tests (%)

Population (%)

IV. Coverage

World Bank

Cases (%)

Global Fund

Pie chart includes 99%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

40
32
24
16
8
0

ABER (%)

Contribution (US$m)

III. Financing

Sierra Leone

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

6090000
0
0
6090000

100
0
0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. gambiae, An. funestus, An. melas
Programme phase:

Control

Reported confirmed cases: 1701958

Reported deaths:
4326

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2002
2010

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2010

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
No
No

Larval control Use of larval control recommended

No

IPT

IPT used to prevent malaria during pregnancy

Yes

2005

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2010
2008

Treatment

ACT is free for all ages in public sector

Yes 2010
Artemisinin-based monotherapies withdrawn
Yes 2005
Single dose of primaquine is used as gametocidal medicine for P. falciparum No
Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes 2005

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+AQ
2004
AL; AS+AQ
2004
QN 2004
AS; AM; QN

Type of RDT used

P.f only

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20112011
0
0
0
28 days
2
P. falciparum
AS+AQ
20112011
0
0
0
28 days
2
P. falciparum

WHO/UNICEF

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

Cases tested and treated in public sector

Survey source: DHS 2008, DHS 2013

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

1500
1200
900
600
300
0

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity
100
80
60
40
20
0

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Management and other costs

Survey source: MICS 2005, DHS 2008, DHS 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: MICS 2005, DHS 2008, DHS 2013

% fever cases <5 seeking treatment at public HF (survey)

300
240
180
120
60
0

Others

Tests (%)

Population (%)
(%)

100
80
60
40
20
0

USAID/PMI

ITN and IRS coverage

Others

With access to an ITN (model)

With access to an ITN (survey)

World Bank

Funding source(s): Government,

Global Fund, World Bank, UNICEF,
Other (bilateral), Other (all types)

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

50
40
30
20
10
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

150
120
90
60
30
0

Deaths

Global Fund

Cases (%)

Government

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

IV. Coverage
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

1000
800
600
400
200
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 143
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Solomon Islands

Western Pacific Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

556000
0
5610
561610

99
0
1

Major plasmodium species: P. falciparum (53%), P. vivax (47%)

Major anopheles species:
An. farauti, An. punctulatus, An. koliensis
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
25609
18

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2009
1996

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1969

Larval control Use of larval control recommended

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
Yes
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1968
2007

Treatment

ACT is free for all ages in public sector

Yes 2008
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
Yes 2009
G6PD test is a requirement before treatment with primaquine
Yes 2009
Directly observed treatment with primaquine is undertaken
No

System for monitoring of adverse reactions to antimalarials exists

No

1990
2013

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2009
AL
2009
QN 2009
AL; AS
2009
AL+PQ(14d)
2009
0.25 mg/kg (14 days)

Type of RDT used

P.f + P.v specific (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20082013
0
0
6.3
28 days
3
P. falciparum
AL
20082013
4
5.1
31.6
28 days
3
P. vivax

Global Fund

World Bank

Cases (%)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages who slept under an ITN (survey)

At high risk protected with IRS

Cases per 1000

Management and other costs

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

Test positivity
100
80
60
40
20
0

2000
1600
1200
800
400
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

Tests (%)

Population (%)

Cases tested and treated in public sector

% fever cases <5 seeking treatment at public HF (survey)

250
200
150
100
50
0

Others

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

(%)

WHO/UNICEF

ITN and IRS coverage

Others

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

USAID/PMI

Reporting completeness

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
Antimalarials
vs reported
points2010 2011 2012 2013
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Funding source(s): Government,

Global Fund, USAID/PMI, World
Bank, WHO, UNICEF, Other
(bilateral), Other (all types)

Cases (P. vivax)

Malaria admissions and deaths

80
64
48
32
16
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Increase in case incidence 2000-2015

Cases (p.vivax) points
144 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

80
64
48
32
16
0

Deaths

Government

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

IV. Coverage
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

10
8
6
4
2
0

ABER (%)

Contribution (US$m)

III. Financing

Somalia

Eastern Mediterranean Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Insufficient data
0

Insufficient data
No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

>75

4060

6080

No cases

1.010
PP

2040

Based on 2012 reported data

2040

>75

4060

6080
80100
Based on 2012 reported data

80100

I. Epidemiological profile
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Insufficient data

Insufficient data
0

PF-RATIO

1.010

Population

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

2013

Parasites and vectors

7310000
3180000
0
10490000

70
30
0

Major plasmodium species: P. falciparum (100%), P. vivax (0%)

Major anopheles species:
An. arabiensis, An. funestus
Programme phase:

Control

Reported confirmed cases:

10470
Reported deaths:

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2005
2005

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2004

Larval control Use of larval control recommended

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
No
No
No
No

IPT

IPT used to prevent malaria during pregnancy

No

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2006
2006

Treatment

ACT is free for all ages in public sector

Yes 2006
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

No

2006

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+SP
2011
AS+SP
2011
AL 2011
AS; QN
2006
CQ+PQ
2006

Type of RDT used

P.f + all species (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20132013
0
0.5
1
28 days
2
P. falciparum
AS+SP
20052011
0
1
22.2
28 days
5
P. falciparum

Cases tested and treated in public sector

Cases (%)

Survey source: Other nat.

Cases per 1000

Survey source: MICS 2006

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity
100
80
60
40
20
0

10 000
8000
6000
4000
2000
0

Survey source: MICS 2006; Other nat.

% fever cases <5 seeking treatment at public HF (survey)

5
4
3
2
1
0

Management and other costs

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS

Reporting completeness

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Funding source(s): Global

Fund, WHO

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

(%)

WHO/UNICEF

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

With access to an ITN (model)

With access to an ITN (survey)

100
80
60
40
20
0

USAID/PMI

Tests (%)

Population (%)

IV. Coverage

World Bank

Cases (P. vivax)

Malaria admissions and deaths

2.5
2.0
1.5
1.0
0.5
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

80
64
48
32
16
0

Deaths

Global Fund

Pie chart includes 76%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

20
16
12
8
4
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 145
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

South Africa

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

PF-RATIO

>75

4060

6080

No cases

1.010
PP

2040

Based on 2012 reported data

2040

>75

4060

6080
80100
Based on 2012 reported data

80100

I. Epidemiological profile
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

1.010

Population

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

2013

Parasites and vectors

2110000
3170000
47500000
52780000

4
6
90

Major plasmodium species: P. falciparum (100%), P. vivax (0%)

Major anopheles species:
An. arabiensis, An. funestus
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

8645
104

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

No
No

IRS

IRS is recommended
DDT is authorized for IRS

Yes
Yes

1930

Larval control Use of larval control recommended

Yes

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
No
No
No

IPT

IPT used to prevent malaria during pregnancy

No

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1997

Treatment

ACT is free for all ages in public sector

Yes 2001
Artemisinin-based monotherapies withdrawn
Yes

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
Yes

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL; QN+CL; QN+D
AS; QN
QN
AL+PQ; CQ+PQ

2001
2001
2001

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

Cases (%)

Cases tested and treated in public sector

Cases per 1000

15
12
9
6
3
0

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity
100
80
60
40
20
0

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Management and other costs

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

1.0
0.8
0.6
0.4
0.2
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Funding source(s): Government,

WHO

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

(%)

WHO/UNICEF

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

With access to an ITN (model)

With access to an ITN (survey)

100
80
60
40
20
0

USAID/PMI

Tests (%)

Population (%)

IV. Coverage

World Bank

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
Antimalarials
vs reported
points2010 2011 2012 2013
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

15
12
9
6
3
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Cases (p.vivax) points
146 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

1.0
0.8
0.6
0.4
0.2
0

Deaths

Global Fund

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

60
48
36
24
12
0

ABER (%)

Contribution (US$m)

III. Financing

South Sudan

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

11300000
0
0
11300000

100
0
0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. gambiae, An. arabiensis, An. funestus, An. nili
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
262520
1311

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2008
2008

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2006

Larval control Use of larval control recommended

Yes

2013

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
No
No

IPT

IPT used to prevent malaria during pregnancy

Yes

2006

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2013
2005

Treatment

ACT is free for all ages in public sector

Yes 2006
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+AQ
2006
AS+AQ
2006
AL 2006
AM; AS; QN
2004
AS+AQ+PQ

Type of RDT used

P.f + all species (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

Global Fund

Cases tested and treated in public sector

Cases (%)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

100
80
60
40
20
0

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity
100
80
60
40
20
0

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Management and other costs

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

100
80
60
40
20
0

Others

Tests (%)

Population (%)

WHO/UNICEF

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

(%)

USAID/PMI

ITN and IRS coverage

Others

With access to an ITN (model)

With access to an ITN (survey)

100
80
60
40
20
0

World Bank

Funding source(s): Government,

Global Fund, USAID/PMI, WHO,
Other (bilateral), Other (all types)

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

2.0
1.6
1.2
0.8
0.4
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

15
12
9
6
3
0

Deaths

Government

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

IV. Coverage
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

8000
6400
4800
3200
1600
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 147
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Sri Lanka

South-East Asia Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
Number of active foci
Number of people living within active foci
Number of people living in malaria-free areas
Total

2013

0
0
21300000
21300000

0
100

Parasites and vectors

Major plasmodium species: P. falciparum (0%), P. vivax (0%)
Major anopheles species:
An. culicifacies, An. subpictus, An. annularis, An. varuna
Programme phase:

Elimination

Total confirmed cases, 2013:

Total deaths, 2013:

95
0

Indigenous cases, 2013:

Indigenous deaths, 2013:

0
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

1992
2004

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1945

Larval control Use of larval control recommended

Yes

IPT

IPT used to prevent malaria during pregnancy

N/A

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Foci and case investigation undertaken

Case reporting from private sector is mandatory

Yes
Yes
Yes
Yes
No
Yes
Yes

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1911

Treatment

ACT is free for all ages in public sector

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
Yes

Directly observed treatment with primaquine is undertaken

Yes

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

Global Fund

World Bank

100
80
60
40
20
0

Monitoring and evaluation

Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013
Insecticide & spraying materials

Suspected cases tested points

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

ACTs distributed vs reported P. falciparum cases

ACTs as % of all antimalarials received by <5 (survey)

Cases investigated

ACTs as % of all antimalarials received by <5 (survey)

Primaquine distributed vs reported P.vivax cases
ACTs distributed vs reported P.falciparum cases points
ACTs distributed vs reported P.falciparum cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Funding source(s): Government,

Global Fund

Human Resources & technical Assistance

Malaria
test positivity
and ABER
Antimalarials
distributedrate
vs reported
cases

ABER (microscopy & RDT)

Pie chart includes 99%

of total contributions

Cases tracked

(%)

Cases (%)
Positivity rate (%)

15
12
9
6
3
0

RDT positivity rate

250 000
200 000
150 000
100 000
50 000
0

Reporting completeness
Foci investigated
Cases investigated points
Cases investigated
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Total cases
Indigenous cases (P. falciparum)

Aber (microscopy & RDT)

Slide positivity points
Slide positivity rate

Foci investigated

Number of malaria cases

50
40
30
20
10
0

Impact: Achieved >75% decrease in case incidence in 2013

RDT positivity rate points
148 | WORLD MALARIA
REPORT 2014
RDT positivity rate

Species

Management and other costs

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtreated
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v cases

Follow-up No. of studies

Cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Max

Others

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

WHO/UNICEF

Cases (%)

100
80
60
40
20
0

Median

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

Cases

Population (%)

IV. Coverage

USAID/PMI

Min

Financing by intervention in 2013

Sources of financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government

Year

ABER (%)

Contribution (US$m)

15
12
9
6
3
0

AL+PQ
2008
QN 1936
CQ+PQ(14d)
2008
AL (2nd & 3rd trimester); QN

0.25 mg/kg (14 days)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

III. Financing

2008

1958
2008

Imported cases points

Imported cases
Indigenous (P.vivax) points

Imported cases
Indigenous cases (P. vivax)

Sudan

Eastern Mediterranean Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

33000000
4970000
0
37970000

87
13
0

Major plasmodium species: P. falciparum (95%), P. vivax (5%)

Major anopheles species:
An. arabiensis, An. funestus, An. gambiae, An. nili, An. pharoensis
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
592383
685

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2005
2010

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1956

Larval control Use of larval control recommended

Yes

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
No
No

IPT

IPT used to prevent malaria during pregnancy

No

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
No

2009

Treatment

ACT is free for all ages in public sector

Yes 2005
Artemisinin-based monotherapies withdrawn
Yes 2004
Single dose of primaquine is used as gametocidal medicine for P. falciparum No
Primaquine is used for radical treatment of P. vivax
Yes 2005
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+SP
2011
AS+SP
2011
AL 2011
AM; QN
2011
AL+PQ(14d)
2011
0.25 mg/kg (14 days)

Type of RDT used

P.f + P.v specific (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

Population (%)

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

WHO/UNICEF

Cases tested and treated in public sector

Survey source: DHS 2012; Other nat.

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS

Cases per 1000

Management and other costs

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

Test positivity

Tests (%)

Survey source: Other nat.

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

35
28
21
14
7
0

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

(%)

USAID/PMI

ITN and IRS coverage

Others

With access to an ITN (model)

With access to an ITN (survey)

100
80
60
40
20
0

World Bank

100
80
60
40
20
0

Reporting completeness

Suspected cases tested

Survey source: Other nat.
<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Funding source(s): Government,

Global Fund, USAID/PMI, World
Bank, WHO, UNICEF, Other
(bilateral), Other (all types)

Cases (P. vivax)

Malaria admissions and deaths

10
8
6
4
2
0

200 000
160 000
120 000
80 000
40 000
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

2500
2000
1500
1000
500
0

Deaths

Global Fund

Cases (%)

Government

Pie chart includes

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

IV. Coverage
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

100
80
60
40
20
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 149
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Suriname

Region of the Americas

EURO / PAHO
Confirmed cases
API 1000 population
per

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

84700
0
455000
539700

16
0
84

Major plasmodium species: P. falciparum (46%), P. vivax (54%)

Major anopheles species:
An. darlingi, An. nuneztovari
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

729
1

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2006
2006

IRS

IRS is recommended
DDT is authorized for IRS

No
No

2006

Larval control Use of larval control recommended

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
No
Yes
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1955
1955

Treatment

ACT is free for all ages in public sector

Yes 2004
Artemisinin-based monotherapies withdrawn
Yes

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes 2004
Primaquine is used for radical treatment of P. vivax
Yes 2004
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

No

2000
2000
2000

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL+PQ
2004
AS+MQ 2004
AS

CQ+PQ(14d)
2004
0.25 mg/kg (14 days)

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20052011
0
2.35
4.7
28 days
2
P. falciparum

Global Fund

World Bank

Cases (%)

Population (%)

Cases tested and treated in public sector

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

Management and other costs

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

Tests (%)

100
80
60
40
20
0

Suspected cases tested

Primaquine distributed vs reported P.v. cases points
Primaquine distributed vs reported P.v. cases
Antimalarials distributed vs reported cases points
Antimalarials distributed vs reported cases
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v. cases

Insecticide & spraying materials

Test positivity

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

35
28
21
14
7
0

Others

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

(%)

WHO/UNICEF

ITN and IRS coverage

Others

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

USAID/PMI

Funding source(s): USAID/PMI,

World Bank, WHO, UNICEF, Other
(all types)

Cases (P. vivax)

RDT positivity rate

Malaria admissions and deaths

100
80
60
40
20
0

400
320
240
160
80
0

Slide positivity rate points

Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Cases (p.vivax) points
150 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

25
20
15
10
5
0

Deaths

Government

Pie chart includes 9%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

IV. Coverage
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

2.5
2.0
1.5
1.0
0.5
0

ABER (%)

Contribution (US$m)

III. Financing

Swaziland

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

PF-RATIO

>75

4060

6080

No cases

1.010
PP

2040

Represents foci (active or non-active)

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

1.010

Population

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

2013

Parasites and vectors

0
350000
900000
1250000

0
28
72

Major plasmodium species: P. falciparum (100%), P. vivax (0%)

Major anopheles species:
An. arabiensis, An. gambiae, An. funestus
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

131
4

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2002
2010

IRS

IRS is recommended
DDT is authorized for IRS

Yes
Yes

1946

Larval control Use of larval control recommended

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
Yes
No
No

IPT

IPT used to prevent malaria during pregnancy

No

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2010
2010

Treatment

ACT is free for all ages in public sector

Yes 2010
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes 2010

2012
2010
2010

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2009
QN
2009
QN
AS

QN

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

Global Fund

WHO/UNICEF

Cases tested and treated in public sector

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

Cases (%)

Survey source: DHS 2007

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

200
160
120
80
40
0

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity
100
80
60
40
20
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Management and other costs

Survey source: MICS 2010

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2007, MICS 2010

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

2.0
1.6
1.2
0.8
0.4
0

Others

Tests (%)

Population (%)
(%)

100
80
60
40
20
0

USAID/PMI

ITN and IRS coverage

Others

With access to an ITN (model)

With access to an ITN (survey)

World Bank

Funding source(s): Government,

Global Fund, WHO, Other
(all types)

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
Antimalarials
vs reported
points2010 2011 2012 2013
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

10
8
6
4
2
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

10
8
6
4
2
0

Deaths

Government

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

IV. Coverage
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

5
4
3
2
1
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
2014 | 151
Deaths (P.vivax)
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Tajikistan

EURO / PAHO
Confirmed cases
API 1000 population
per

European Region

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

Based on 2012 reported data

Based on 2012 reported data

I. Epidemiological profile
Population
Number of active foci
Number of people living within active foci
Number of people living in malaria-free areas
Total

2013

14
1950000
6260000
8210000

24
76

Parasites and vectors

Major plasmodium species: P. falciparum (0%), P. vivax (100%)
Major anopheles species:
An. superpictus, An. pulcherrimus
Programme phase:

Elimination

Total confirmed cases, 2013:

Total deaths, 2013:

14
0

Indigenous cases, 2013:

Indigenous deaths, 2013:

3
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2006
2006

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1997

Larval control Use of larval control recommended

Yes

1998

IPT

IPT used to prevent malaria during pregnancy

N/A

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Foci and case investigation undertaken

Case reporting from private sector is mandatory

Yes
No
No
Yes
No
Yes
Yes

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1997

Treatment

ACT is free for all ages in public sector

Yes

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes 2004
Primaquine is used for radical treatment of P. vivax
Yes 1997
G6PD test is a requirement before treatment with primaquine
No 2014
Directly observed treatment with primaquine is undertaken
Yes 2004
System for monitoring of adverse reactions to antimalarials exists
Yes 1997

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

Global Fund

World Bank

100
80
60
40
20
0

Cases (%)

Monitoring and evaluation

Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013
Insecticide & spraying materials

Suspected cases tested points

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

ACTs distributed vs reported P. falciparum cases

ACTs as % of all antimalarials received by <5 (survey)

Cases investigated

ACTs as % of all antimalarials received by <5 (survey)

Primaquine distributed vs reported P.vivax cases
ACTs distributed vs reported P.falciparum cases points
ACTs distributed vs reported P.falciparum cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Funding source(s): Government,

Global Fund, USAID/PMI, WHO,
Other (all types)

Human Resources & technical Assistance

Malaria
test positivity
and ABER
Antimalarials
distributedrate
vs reported
cases

ABER (microscopy & RDT)

Pie chart includes 100%

of total contributions

Cases tracked

(%)

Cases (%)
Positivity rate (%)

10
8
6
4
2
0

RDT positivity rate

20 000
16 000
12 000
8000
4000
0

Reporting completeness
Foci investigated
Cases investigated points
Cases investigated
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Total cases
Indigenous cases (P. falciparum)

Aber (microscopy & RDT)

Slide positivity points
Slide positivity rate

Foci investigated

Number of malaria cases

150
120
90
60
30
0

Impact: Achieved >75% decrease in case incidence in 2013

RDT positivity rate points
152 | WORLD MALARIA
REPORT 2014
RDT positivity rate

Species

Management and other costs

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtreated
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v cases

Follow-up No. of studies

Cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Max

Others

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

WHO/UNICEF

ITN and IRS coverage

Others

Cases

Population (%)

100
80
60
40
20
0

USAID/PMI

Median

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government

Min

Financing by intervention in 2013

Sources of financing

IV. Coverage

Year

ABER (%)

Contribution (US$m)

5
4
3
2
1
0

AL
2008
QN 2004
QN
2004
CQ+PQ(14d)
2004
0.25 mg/kg (14 days)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

III. Financing

2004

1997

2009
2000

Imported cases points

Imported cases
Indigenous (P.vivax) points

Imported cases
Indigenous cases (P. vivax)

Thailand

South-East Asia Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

5360000
28100000
33500000
66960000

8
42
50

Major plasmodium species: P. falciparum (44%), P. vivax (47%)

Major anopheles species:
An. dirus, An. minimus, An. maculatus, An. sundaicus
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
33302
37

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

1992
1992

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1953

Larval control Use of larval control recommended

Yes

1953

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
Yes
Yes
Yes

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1991
1953

Treatment

ACT is free for all ages in public sector

Yes 1995
Artemisinin-based monotherapies withdrawn
Yes 1995
Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes 1995
Primaquine is used for radical treatment of P. vivax
Yes 1965
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

Yes 2008
System for monitoring of adverse reactions to antimalarials exists
No

1958
1958
1958
1995
1995

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+MQ
2007
QN+D 2007
QN+D
2007
CQ+PQ(14d)
2007
0.25 mg/kg (14 days)

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

World Bank

(%)

Cases (%)

Cases tested and treated in public sector

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

Management and other costs

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

2.0
1.6
1.2
0.8
0.4
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

100
80
60
40
20
0

20 000
16 000
12 000
8000
4000
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Reporting completeness

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
Antimalarials
vs reported
points2010 2011 2012 2013
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Funding source(s): Government,

Global Fund, USAID/PMI, WHO

Others

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

WHO/UNICEF

Tests (%)

Population (%)

IV. Coverage

USAID/PMI

Cases (P. vivax)

Malaria admissions and deaths

15
12
9
6
3
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

800
640
480
320
160
0

Deaths

Global Fund

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

25
20
15
10
5
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: On track for 50%-75% decrease in case incidence 2000-2015

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 153
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Timor-Leste

South-East Asia Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Insufficient data
0

Insufficient data
No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

>75

4060

6080

No cases

1.010
PP

2040

Based on 2012 reported data

2040

>75

4060

6080
80100
Based on 2012 reported data

80100

I. Epidemiological profile
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Insufficient data

Insufficient data
0

PF-RATIO

1.010

Population

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

2013

Parasites and vectors

872000
261000
0
1133000

77
23
0

Major plasmodium species: P. falciparum (50%), P. vivax (50%)

Major anopheles species:
An. subpictus, An. barbirostris
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

1025
3

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2005
2009

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2006

Larval control Use of larval control recommended

Yes

2007

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
No
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2007
2000

Treatment

ACT is free for all ages in public sector

Yes 2007
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
Yes 2006
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

World Bank

USAID/PMI

WHO/UNICEF

0
17.5

Cases (%)

Survey source: DHS 2010

100
80
60
40
20
0

1
1

Survey source: DHS 2010

Pie chart includes 80%

of total contributions

Funding source(s): Government,

Global Fund

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Tests (%)
Admissions

Test positivity
100
80
60
40
20
0

2000
1600
1200
800
400
0

Reporting completeness

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (P. vivax)

Malaria admissions and deaths

20
16
12
8
4
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Aber (microscopy
& RDT)
Cases
(p.vivax) points
154 | WORLD MALARIA
REPORT
2014
Cases (p.vivax)

Species
P. falciparum
P. vivax

Management and other costs

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

Cases (all species)

28 days
28 days

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk
protected with IRS
Survey source: DHS 2010

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Follow-up No. of studies

Cases tested and treated in public sector

% fever cases <5 seeking treatment at public HF (survey)

Cases per 1000

Max

0
17.5

Others

ABER (%)

Contribution (US$m)
Population (%)
(%)

60
48
36
24
12
0

Median

0
17.5

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Min

Financing by intervention in 2013

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

Year
20122013
20112013

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

80
64
48
32
16
0

Deaths

Global Fund

IV. Coverage
100
80
60
40
20
0

Sources of financing

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government

Therapeutic efficacy tests (clinical and parasitological failure, %)

AL
CQ

10
8
6
4
2
0

AL

QN+D
AM; AS; QN

CQ+PQ(14d)

Type of RDT used

Medicine

III. Financing

2002
2009

Togo

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

6820000
0
0
6820000

100
0
0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. gambiae, An. funestus, An. melas, An. arabiensis
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
882430
1361

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2004
2011

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2011

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
Yes
No

Larval control Use of larval control recommended

No

IPT

IPT used to prevent malaria during pregnancy

Yes

2003

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2010
2012

Treatment

ACT is free for all ages in public sector

No

Artemisinin-based monotherapies withdrawn

Yes

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine

Directly observed treatment with primaquine is undertaken

System for monitoring of adverse reactions to antimalarials exists

Yes 2009

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL; AS+AQ

AL; AS+AQ

AS; AM; QN

Type of RDT used

P.f only

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20052013
0
1.4
4.4
28 days
11
P. falciparum
AS+AQ
20052013
0
0
6
28 days
11
P. falciparum

No data reported for 2013

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Global Fund

WHO/UNICEF

Cases tested and treated in public sector

Cases per 1000

Antimalarials distributed vs reported cases

ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases

Cases (%)

Test positivity
100
80
60
40
20
0

1000
800
600
400
200
0

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ACTs as % of all antimalarials received by <5 (survey)

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Survey source: MICS 2006

Suspected cases tested

<5 with fever with finger/heel stick (survey)

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected
with IRS
Survey source: MICS 2006

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

150
120
90
60
30
0

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

(%)

USAID/PMI

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

With access to an ITN (model)

With access to an ITN (survey)

100
80
60
40
20
0

World Bank

ITN and IRS coverage

Others

Tests (%)

Population (%)

IV. Coverage

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

25
20
15
10
5
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

50
40
30
20
10
0

Deaths

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

20
16
12
8
4
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 155
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Turkey

EURO / PAHO
Confirmed cases
API 1000 population
per

European Region

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

I. Epidemiological profile
Population
Number of active foci
Number of people living within active foci
Number of people living in malaria-free areas
Total

2013

0
0
74900000
74900000

0
100

Parasites and vectors

Major plasmodium species: P. falciparum (0%), P. vivax (100%)
Major anopheles species:
An. sacharovi, An. superpictus, An. maculipennis
Programme phase:

Elimination

Total confirmed cases, 2013:

Total deaths, 2013:

285
3

Indigenous cases, 2013:

Indigenous deaths, 2013:

0
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

No
No

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1926

Larval control Use of larval control recommended

Yes

1926

IPT

IPT used to prevent malaria during pregnancy

N/A

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Foci and case investigation undertaken

Case reporting from private sector is mandatory

Yes
No
No
No
No
Yes
Yes

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1926

Treatment

ACT is free for all ages in public sector

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
Yes 1926
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

Yes 2007
System for monitoring of adverse reactions to antimalarials exists
No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

Global Fund

World Bank

WHO/UNICEF

Follow-up No. of studies

Species

Others

Cases tested

Cases (%)

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases tracked

(%)

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtreated
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

100
80
60
40
20
0

Suspected cases tested points

Suspected cases tested

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Reporting completeness

ACTs distributed vs reported P. falciparum cases

ACTs as % of all antimalarials received by <5 (survey)

Cases investigated

ACTs as % of all antimalarials received by <5 (survey)

Malaria
test positivity
and ABER
Antimalarials
distributedrate
vs reported
cases

Primaquine distributed vs reported P.vivax cases

ACTs distributed vs reported P.falciparum cases points
ACTs distributed vs reported P.falciparum cases

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Slide positivity rate

RDT positivity rate

12 000
9600
7200
4800
2400
0

Reporting completeness
Foci investigated
Cases investigated points
Cases investigated
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Total cases
Indigenous cases (P. falciparum)

Impact: Achieved >75% decrease in case incidence in 2013

RDT positivity rate points
156 | WORLD MALARIA
REPORT 2014
RDT positivity rate
Aber (microscopy & RDT)
Slide positivity points
Slide positivity rate

Foci investigated

Number of malaria cases

12000
9600
7200
4800
2400
0

Cases

Population (%)
Cases (%)

USAID/PMI

ITN and IRS coverage

Others

Positivity rate (%)

Max

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

At high risk protected with ITNs

Households with at least one ITN

1.0
0.8
0.6
0.4
0.2
0

Median

Financing by intervention in 2013

Sources of financing

IV. Coverage

100
80
60
40
20
0

Min

No data reported for 2013

Government
100
80
60
40
20
0

Year

ABER (%)

Contribution (US$m)

50
40
30
20
10
0

CQ+PQ(14d)

0.25 mg/kg (14 days)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

III. Financing

2010

1926
1930

Imported cases points

Imported cases
Indigenous (P.vivax) points

Imported cases
Indigenous cases (P. vivax)

Uganda

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PP

PF-RATIO

>75

4060

6080

No cases

1.010
PP

2040

Based on 2012 reported data

2040

>75

4060

6080
80100
Based on 2012 reported data

80100

I. Epidemiological profile
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

1.010

Population

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

2013

Parasites and vectors

33800000
3760000
0
37560000

90
10
0

Major plasmodium species: P. falciparum (100%), P. vivax (0%)

Major anopheles species:
An. gambiae, An. funestus, An. funestus
Programme phase:

Control

Reported confirmed cases: 1502362

Reported deaths:
7277

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2006
2013

IRS

IRS is recommended
DDT is authorized for IRS

Yes
Yes

2005
2008

Larval control Use of larval control recommended

Yes

2011

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
No
No

IPT

IPT used to prevent malaria during pregnancy

Yes

1998

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2012
2001

Treatment

ACT is free for all ages in public sector

Yes 2005
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2004
AL
2004
QN 2004
AS; QN
2012

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

WHO/UNICEF

Cases tested and treated in public sector

Survey source: DHS 2006, MIS 2009, DHS 2011

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

2000
1600
1200
800
400
0

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity
100
80
60
40
20
0

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Management and other costs

Survey source: DHS 2006, MIS 2009, DHS 2011

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2001, DHS 2006, MIS 2009, DHS 2011

% fever cases <5 seeking treatment at public HF (survey)

80
64
48
32
16
0

Others

Tests (%)

Population (%)

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

(%)

USAID/PMI

ITN and IRS coverage

Others

With access to an ITN (model)

With access to an ITN (survey)

100
80
60
40
20
0

World Bank

Funding source(s): Government,

Global Fund, USAID/PMI, UNICEF,
Other (bilateral), Other (all types)

Cases (P. vivax)

Suspected cases tested

Survey source: MIS 2009
<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

30
24
18
12
6
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

25
20
15
10
5
0

Deaths

Global Fund

Cases (%)

Government

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

IV. Coverage
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

200
160
120
80
40
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 157
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

United Republic of Tanzania (Mainland)

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

34900000
12900000
0
47800000

73
27
0

Major plasmodium species: P. falciparum (100%), P. vivax (0%)

Major anopheles species:
An. gambiae, An. arabiensis, An. funestus
Programme phase:

Control

Reported confirmed cases: 1550250

Reported deaths:
8526

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
No

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2006

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

No
No
No
No
No

Larval control Use of larval control recommended

Yes

IPT

IPT used to prevent malaria during pregnancy

Yes

2001

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2009

Treatment

ACT is free for all ages in public sector

Yes

Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2004
AL
2004
QN 2004
AS; AM; QN
2014

Type of RDT used

P.f + P.v specific (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

WHO/UNICEF

Cases tested and treated in public sector

WHO_UNICEF
USAID/PMI
Survey source: DHS 2005, DHS 2008, DHS 2010, DHS 2012
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

2000
1600
1200
800
400
0

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Survey source: DHS 2008, DHS 2010, DHS 2012

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity
100
80
60
40
20
0

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Management and other costs

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2005, DHS 2008, DHS 2010, DHS 2012

% fever cases <5 seeking treatment at public HF (survey)

80
64
48
32
16
0

Others

Tests (%)

Population (%)
(%)

100
80
60
40
20
0

USAID/PMI

ITN and IRS coverage

Others

With access to an ITN (model)

With access to an ITN (survey)

World Bank

Funding source(s): Government,

Global Fund, USAID/PMI, World
Bank, WHO, UNICEF, Other
(bilateral), Other (all types)

Cases (P. vivax)

Suspected cases tested

Survey source: DHS 2012
<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

25
20
15
10
5
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Cases (p.vivax) points
158 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

60
48
36
24
12
0

Deaths

Global Fund

Cases (%)

Government

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

IV. Coverage
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

250
200
150
100
50
0

ABER (%)

Contribution (US$m)

III. Financing

United Republic of Tanzania (Zanzibar)

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

1390000
0
0
1390000

100
0
0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. gambiae
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

2194
2

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2005
2008

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2006

Larval control Use of larval control recommended

Yes

2012

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
Yes
No
No

IPT

IPT used to prevent malaria during pregnancy

Yes

2004

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2007
2004

Treatment

ACT is free for all ages in public sector

Yes 2003
Artemisinin-based monotherapies withdrawn

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes 2003

2008
2011
2011

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+AQ
2004
AS+AQ
2004
QN 2004
AS; QN
2014

Type of RDT used

P.f + all species (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20062007
0
0
0
28 days
2
P. falciparum

Cases (%)

Cases tested and treated in public sector

Cases per 1000

100
80
60
40
20
0

1200
960
720
480
240
0

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Management and other costs

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

20
16
12
8
4
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Funding source(s): Government,

Global Fund, USAID/PMI

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

(%)

WHO/UNICEF

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

With access to an ITN (model)

With access to an ITN (survey)

100
80
60
40
20
0

USAID/PMI

Tests (%)

Population (%)

IV. Coverage

World Bank

Cases (P. vivax)

Suspected cases tested

Survey source: DHS 2012
<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

40
32
24
16
8
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

40
32
24
16
8
0

Deaths

Global Fund

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

10
8
6
4
2
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 159
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Vanuatu

Western Pacific Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

250000
0
2530
252530

99
0
1

Major plasmodium species: P. falciparum (31%), P. vivax (69%)

Major anopheles species:
An. farauti
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

2381
0

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2008
1990

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2008

Larval control Use of larval control recommended

Yes

2010

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
Yes
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
No

2009

Treatment

ACT is free for all ages in public sector

Yes 2009
Artemisinin-based monotherapies withdrawn
Yes 2012
Single dose of primaquine is used as gametocidal medicine for P. falciparum No
Primaquine is used for radical treatment of P. vivax
Yes 2009
G6PD test is a requirement before treatment with primaquine
Yes 2009
Directly observed treatment with primaquine is undertaken
Yes 2009
System for monitoring of adverse reactions to antimalarials exists
No

2013
2013
2013

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2007
QN 2007
QN
2007
AL+PQ(14d)
2007

Type of RDT used

P.f + P.v specific (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20112012 2.8
2.8
2.8
28 days
1
P. vivax

No data reported for 2013

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Global Fund

World Bank

Cases tested and treated in public sector

Cases (%)

Survey source: Other nat.

Cases per 1000

Survey source: Other nat.

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

<5 with fever with finger/heel stick (survey)

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

ACTs as % of all antimalarials received by <5 (survey)

1200
960
720
480
240
0

Reporting completeness

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
Antimalarials
vs reported
points2010 2011 2012 2013
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Antimalarials distributed vs reported cases

ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases

Test positivity
100
80
60
40
20
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

80
64
48
32
16
0

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

(%)

WHO/UNICEF

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

USAID/PMI

ITN and IRS coverage

Others

Tests (%)

Population (%)

IV. Coverage

Cases (P. vivax)

Malaria admissions and deaths

30
24
18
12
6
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Increase in case incidence 2000-2015

Cases (p.vivax) points
160 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

15
12
9
6
3
0

Deaths

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

7.5
6.0
4.5
3.0
1.5
0

ABER (%)

Contribution (US$m)

III. Financing

Venezuela (Bolivarian Republic of )

EURO / PAHO
Confirmed cases
API 1000 population
per

Region of the Americas

OTHERS

PF-RATIO

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
no cases

Insufficient data
0

Insufficient data

0
00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

2040

1.010

020

1.010
1050

4060

50100

6080

100

80100

PP

No cases

2040

>75

4060

6080
80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

791000
4930000
24700000
30421000

3
16
81

Major plasmodium species: P. falciparum (35%), P. vivax (65%)

Major anopheles species:
An. darlingi, An. aquasalis, An. nuneztovari, An. braziliensis, An. albitarsis
Programme phase:

Control

Reported confirmed cases:

Reported deaths:

78643
6

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2005
2005

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

Larval control Use of larval control recommended

Yes

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
Yes
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1936
1936

Treatment

ACT is free for all ages in public sector

Yes 2004
Artemisinin-based monotherapies withdrawn
Yes

Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes

Primaquine is used for radical treatment of P. vivax
Yes
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

Yes

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+MQ+PQ
2004
QN+CL; QN+D; QN+T
2004
AM; QN
2004
CQ+PQ(14d)
2004
0.25 mg/kg (14 days)

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AS+MQ
20052006
0
0
0
28 days
2
P. falciparum

No data reported for 2013

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Global Fund

World Bank

Cases tested and treated in public sector

Cases per 1000

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

Antimalarials distributed vs reported cases

Primaquine distributed vs reported P. v. cases

Tests (%)

Test positivity

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

% fever cases <5 seeking treatment at public HF (survey)

5
4
3
2
1
0

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

(%)

WHO/UNICEF

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

USAID/PMI

ITN and IRS coverage

Others

Cases (%)

Population (%)

IV. Coverage

100
80
60
40
20
0

Suspected cases tested

Primaquine distributed vs reported P.v. cases points
Primaquine distributed vs reported P.v. cases
Antimalarials distributed vs reported cases points
Antimalarials distributed vs reported cases
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Slide positivity rate

Reporting completeness

RDT positivity rate

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Cases (P. vivax)

Malaria admissions and deaths

10
8
6
4
2
0

50
40
30
20
10
0

Slide positivity rate points

Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

40
32
24
16
8
0

Deaths

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

15
12
9
6
3
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Increase in case incidence 2000-2015

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
2014 | 161
Deaths (P.vivax)
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Viet Nam

Western Pacific Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

16100000
18300000
57300000
91700000

18
20
63

Major plasmodium species: P. falciparum (60%), P. vivax (40%)

Major anopheles species:
An. minimus, An. dirus, An. sundaicus
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
17128
6

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

1992
1992

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

1958

Larval control Use of larval control recommended

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
Yes
No
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

1958
1958

Treatment

ACT is free for all ages in public sector

Yes 2003
Artemisinin-based monotherapies withdrawn
Yes 2013
Single dose of primaquine is used as gametocidal medicine for P. falciparum Yes 2003
Primaquine is used for radical treatment of P. vivax
Yes 1960
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes 1980

1958
1958

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

DHA-PPQ
QN+CL; QN+D
AS; QN
CQ+PQ(14d)
AS - 2nd & 3rd trimesters; QN

Type of RDT used

2013
2013
2013

P.f + P.v specific (Combo)

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

World Bank

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

(%)

Cases tested and treated in public sector

Cases (%)

Survey source: DHS 2005

Cases per 1000

Management and other costs

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

1.0
0.8
0.6
0.4
0.2
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk
protected with IRS
Survey source: DHS 2002

100
80
60
40
20
0

80 000
64 000
48 000
32 000
16 000
0

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

Reporting completeness

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
Antimalarials
vs reported
points2010 2011 2012 2013
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Funding source(s): Government,

Global Fund, WHO, UNICEF

Others

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

WHO/UNICEF

Tests (%)

Population (%)

IV. Coverage

USAID/PMI

Cases (P. vivax)

Malaria admissions and deaths

15
12
9
6
3
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Achieved >75% decrease in case incidence in 2013

Cases (p.vivax) points
162 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

150
120
90
60
30
0

Deaths

Global Fund

Pie chart includes

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

15
12
9
6
3
0

ABER (%)

Contribution (US$m)

III. Financing

Yemen

Eastern Mediterranean Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

6 100 000
12 900 000
5 400 000
24 400 000

25
53
22

Major plasmodium species: P. falciparum (99%), P. vivax (1%)

Major anopheles species:
An. arabiensis, An. culicifacies, An. sergentii
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
102778
55

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2002
2009

IRS

IRS is recommended
DDT is authorized for IRS

Yes
No

2001

Larval control Use of larval control recommended

Yes

2002

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
No
Yes
No
No

IPT

IPT used to prevent malaria during pregnancy

N/A

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2001
2002

Treatment

ACT is free for all ages in public sector

Yes 2009
Artemisinin-based monotherapies withdrawn
Yes 2009
Single dose of primaquine is used as gametocidal medicine for P. falciparum No
Primaquine is used for radical treatment of P. vivax
Yes 2001
G6PD test is a requirement before treatment with primaquine
Yes 2009
Directly observed treatment with primaquine is undertaken
No

System for monitoring of adverse reactions to antimalarials exists

No

2006

2001

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AS+SP
2009
AS+SP
2009
AL 2009
AM; QN
2009
CQ+PQ(14d)

0.25 mg/kg (14 days)

Type of RDT used

P.f only

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20072013
0
0
1.1
28 days
4
P. falciparum
AS+SP 20072013
0 0 3 28 days 7
P. falciparum

Global Fund

World Bank

Cases (%)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages who slept under an ITN (survey)

At high risk protected with IRS

At high risk protected with ITNs

All ages who slept under an ITN (survey)
Cases
Households
withtracked
at least one ITN
At high risk protected with IRS Points
At high risk protected with IRS

Cases per 1000

Management and other costs

Human Resources & technical Assistance
Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

Test positivity
100
80
60
40
20
0

3500
2800
2100
1400
700
0

Survey source: Other nat.

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

Tests (%)

Population (%)

Survey source: Other nat.

% fever cases <5 seeking treatment at public HF (survey)

80
64
48
32
16
0

Others

Cases tested and treated in public sector

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria budget (USD)

(%)

WHO/UNICEF

ITN and IRS coverage

Others

At high risk protected with ITNs

Households with at least one ITN

100
80
60
40
20
0

USAID/PMI

Reporting completeness

Suspected cases tested

Survey source: Other nat.
<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
Antimalarials
vs reported
points2010 2011 2012 2013
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Cases (all species)

Funding source(s): Government,

Global Fund, WHO, Other
(all types)

Cases (P. vivax)

Malaria admissions and deaths

7.5
6.0
4.5
3.0
1.5
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

100
80
60
40
20
0

Deaths

Government

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

IV. Coverage
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

25
20
15
10
5
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: Insufficiently consistent data to assess trends

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 163
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)

Zambia

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

14300000
0
0
14300000

100
0
0

Parasites and vectors

Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species:
An. gambiae, An. funestus, An. arabiensis
Programme phase:

Control

Reported confirmed cases:

Reported deaths:
3548

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2005
1998

IRS

IRS is recommended
DDT is authorized for IRS

Yes
Yes

Larval control Use of larval control recommended

No

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
No
No
No
No

IPT

IPT used to prevent malaria during pregnancy

Yes

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

Treatment

ACT is free for all ages in public sector

Yes 2003
Artemisinin-based monotherapies withdrawn
Yes

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

No

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2002
AL
2002
QN 2002
AS; AM; QN
2014

Type of RDT used

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20052012
0
0
6.7
28 days
12
P. falciparum

WHO/UNICEF

WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

Cases tested and treated in public sector

Survey source: DHS 2002, DHS 2007

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

3500
2800
2100
1400
700
0

Reporting completeness

Estimated cases detected - top

Fever cases INF5 seeking treatment at public hf

Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Monitoring and evaluation
Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Test positivity
100
80
60
40
20
0

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER

ABER (microscopy & RDT)

Management and other costs

Survey source: DHS 2007, MIS 2008, MIS 2010, MIS 2012

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

V. Impact

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2002, DHS 2007

% fever cases <5 seeking treatment at public HF (survey)

5
4
3
2
1
0

Others

Tests (%)

Population (%)
(%)

100
80
60
40
20
0

USAID/PMI

ITN and IRS coverage

Others

With access to an ITN (model)

With access to an ITN (survey)

World Bank

Funding source(s): Government,

Global Fund, USAID/PMI, WHO,
UNICEF, Other bilateral, Other
(all types)

Cases (P. vivax)

Suspected cases tested Survey source: MIS 2006, MIS 2008, MIS 2010, MIS 2012
<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

5
4
3
2
1
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

Admissions (P. vivax)

Deaths (P. vivax)

Impact: On track for 50%-75% decrease in case incidence 2000-2015

Cases (p.vivax) points
164 | WORLD MALARIA
REPORT 2014
Cases (p.vivax)
Aber (microscopy & RDT)

Admissions (P.vivax) points

Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (P.vivax) points

Deaths (P.vivax)
Deaths (all species) points
Deaths (all species)

100
80
60
40
20
0

Deaths

Global Fund

Cases (%)

Government

Pie chart includes 100%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

IV. Coverage
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

80
64
48
32
16
0

ABER (%)

Contribution (US$m)

III. Financing

Zimbabwe

African Region

OTHERS

Confirmed cases
per
1000 population/
OTHERS
Parasite prevalence
PR
(PP)

Proportion of cases
PF-RATIO
due
to P. falciparum

PR

Insufficient data

Insufficient data
0

Insufficient data

Insufficient data
0

No cases

00.1

Very low PP

00.1

Very low PP

0.11.0

020

0.11.0

020

PF-RATIO

1.010
PP

1.010
PP

2040

>75

4060

6080

No cases

2040

>75

4060

6080
80100

80100

I. Epidemiological profile
Population
High transmission (> 1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total

2013

Parasites and vectors

6660000
0
6660000
13320000

50
0
50

Major plasmodium species: P. falciparum (100%), P. vivax (0%)

Major anopheles species:
An. arabiensis, An. gambiae, An. funestus
Programme phase:
Reported confirmed cases:
Reported deaths:

Control
422633
352

II. Intervention policies and strategies

Intervention Policies/strategies

Yes/ Year
No adopted

Intervention Policies/strategies

Yes/ Year
No adopted

ITN

ITNs/LLINs distributed free of charge

ITNs/LLINs distributed to all age groups

Yes
Yes

2009
2009

IRS

IRS is recommended
DDT is authorized for IRS

Yes
Yes

1947
2004

Surveillance ACD for case investigation (reactive)

ACD of febrile cases at community level (pro-active)

Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted

Yes
No
No
No
No

Larval control Use of larval control recommended

Yes

IPT

IPT used to prevent malaria during pregnancy

Yes

2004

Diagnosis

Patients of all ages should receive diagnostic test

Malaria diagnosis is free of charge in the public sector

Yes
Yes

2009
2009

Treatment

ACT is free for all ages in public sector

Yes 2009
Artemisinin-based monotherapies withdrawn
Yes

Single dose of primaquine is used as gametocidal medicine for P. falciparum No

Primaquine is used for radical treatment of P. vivax
No
G6PD test is a requirement before treatment with primaquine
No

Directly observed treatment with primaquine is undertaken

No

System for monitoring of adverse reactions to antimalarials exists

Yes

2012

Year
Antimalaria treatment policy
Medicine
adopted
First-line treatment of unconfirmed malaria
First-line treatment of P. falciparum
Treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax

AL
2004
AL
2004
QN 2004
QN
2004

Type of RDT used

P.f only

Therapeutic efficacy tests (clinical and parasitological failure, %)

Medicine

Year

Min

Median

Max

Follow-up No. of studies

Species

AL
20062010
0
2.4
14.3
28 days
28
P. falciparum

(%)

100
80
60
40
20
0

WHO/UNICEF

Cases tested and treated in public sector

Survey source: DHS 2006, DHS 2011

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases per 1000

100
80
60
40
20
0

400
320
240
160
80
0

Reporting completeness

Estimated cases detected - top

ConfirmedEstimated
malaria
cases
per- 1000
cases
detected
bottomand ABER
Fever cases INF5 seeking treatment at public hf
Reporting completeness points
Reporting completeness

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Cases (all species)

Human Resources & technical Assistance

Survey source: DHS 2011

Monitoring and evaluation

Antimalarial medicines
Diagnostics

2000 2001 2002 2003 2004 2005 ITNs2006 2007 2008 2009 2010 2011 2012 2013

Suspected cases tested

Antimalarials distributed vs reported cases
Insecticide & spraying materials
<5 with fever with finger/heel stick (survey)
ACTs distributed vs reported P. f. cases
Primaquine distributed vs reported P. v. cases
ACTs as % of all antimalarials received by <5 (survey)

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

ABER (microscopy & RDT)

Management and other costs

Test positivity

% fever cases <5 seeking treatment at public HF (survey)

35
28
21
14
7
0

100
80
60
40
20
0

All ages who slept under an ITN (survey)

At risk protected with IRS

With access to an ITN (model)

All ages who slept under an ITN (survey)
Cases
With access
to antracked
ITN (survey)
At risk protected with IRS points
At risk protected with IRS
Survey source: DHS 2006, MICS 2009, DHS 2011

V. Impact

Funding source(s): Government,

Global Fund, USAID/PMI, WHO

Others

Cases (P. vivax)

Suspected cases tested

<5 with fever with finger/heel stick (survey)
ACTs as % of all antimalarials received by <5
Primaquine distributed vs reported P.v cases points
Primaquine distributed vs reported P.v cases
ACTs distributed vs reported P.f cases points
ACTs distributed vs reported P.f cases
Antimalarials
vs reported
points2010 2011 2012 2013
2000 2001 2002 2003 2004
2005 distributed
2006 2007
2008 cases
2009
distributedrate
vs reported cases RDT positivity rate
Parasite prevalence (survey) Antimalarials
Slide positivity

Malaria admissions and deaths (per 100 000)

20
16
12
8
4
0

Parasite prevalence
Slide positivity rate points
Slide positivity rate
RDT positivity rate points
RDT positivity rate
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Admissions (all species)

Deaths (all species)

20
16
12
8
4
0

Deaths

ITN and IRS coverage

Others
WHO_UNICEF
USAID/PMI
Worldbank (USD)
Global Fund (USD)
Malaria expenditure (USD)

With access to an ITN (model)

With access to an ITN (survey)

USAID/PMI

Tests (%)

Population (%)

IV. Coverage

World Bank

Cases (%)

Global Fund

Pie chart includes 83%

of total contributions

Insecticides & spray materials

ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Government
100
80
60
40
20
0

Financing by intervention in 2013

Sources of financing

Admissions

35
28
21
14
7
0

ABER (%)

Contribution (US$m)

III. Financing

Admissions (P. vivax)

Deaths (P. vivax)

Impact: On track for 50%-75% decrease in case incidence 2000-2015

Aber (microscopy
& RDT)
Cases
(p.vivax) points
Cases (p.vivax)

Deaths (P.vivax) points

Admissions (P.vivax) points

WORLD
MALARIA REPORT
Deaths (P.vivax) 2014 | 165
Admissions (P.vivax)

Cases (all species) points

Admissions (all species) points

Cases (all species)

Admissions (all species)

Deaths (all species) points

Deaths (all species)