Malaria control in Malawi: Current status and directions for the future

Abstract

The last decade has seen an increase in investment and concerted efforts by the Malawi Ministry of Health and partners to control malaria disease. This report summarizes what is known about the burden of malaria and the strategies being implemented to control it in Malawi. Over the past five years, roll out of treatment and prevention efforts have been successful in the country, as demonstrated by increased use of insecticide treated nets, improved access to prompt and effective treatment and the initiation of pilot studies of indoor residual spraying. However, unlike other countries in the region, the recent data have not suggested a decrease in the burden of disease. We describe the environment in which the activities of Malawi’s International Center for Excellence in Malaria Research (ICEMR) will be carried out and provide the rationale for the clinical, entomological and molecular studies. Our approach is to establish consistent, stainable data collection systems that are embedded within the public health sector. Through standardized and long-term studies of hosts, parasites and vectors, we hope to contribute to assessment of malaria disease burden, the appropriate application of interventions and policies and provide both the data collection and the health care infrastructure to ultimately eliminate the disease.

High prevalence of Plasmodium falciparum gametocyte infections in school-age children using molecular detection: patterns and predictors of risk from a cross-sectional study in southern Malawi

“…Malaria is endemic throughout Malawi, with seasonal variation driven by the annual rainy season that runs from November/December through March/April [43]. The majority of infections are attributable to P. falciparum , though both Plasmodium ovale and Plasmodium malariae have been detected, frequently as mixed infections with P. falciparum [44].…”

“…The majority of infections are attributable to P. falciparum , though both Plasmodium ovale and Plasmodium malariae have been detected, frequently as mixed infections with P. falciparum [44]. Vector information is somewhat limited, but Anopheles arabiensis , Anopheles gambiae sensu stricto, and Anopheles funestus have all been identified [43]. There is geographic heterogeneity, with risks being highest in humid lowland regions and in rural areas [43, 45].…”

“…Vector information is somewhat limited, but Anopheles arabiensis , Anopheles gambiae sensu stricto, and Anopheles funestus have all been identified [43]. There is geographic heterogeneity, with risks being highest in humid lowland regions and in rural areas [43, 45]. This study reports on sites from three districts: Blantyre, Thyolo, and Chikhwawa.…”

“…This study reports on sites from three districts: Blantyre, Thyolo, and Chikhwawa. Blantyre is a large urban area in the highlands, expected to have relatively low transmission; Thyolo is a rural area located mostly in the highlands, expected to have moderate transmission; and Chikhwawa is a rural area found in the hot, low-lying Shire Valley, and is known to have relatively high parasite transmission, with an estimated EIR of 172 infectious bites per year [43]. …”

Whole-Genome Scans Provide Evidence of Adaptive Evolution in Malawian Plasmodium falciparum Isolates

“…Recently, the prevalence of parasitemia in rural children was higher than that in urban children (47% vs 15%), and the prevalence in the central region of Malawi (50%) was higher than that in the southern (42%) and northern (23%) regions (Malawi National Malaria Indicator Survey, 2010, ). On the other hand, scaled up malaria interventions (eg, LLIN use) have benefitted pregnant women by reducing the prevalence of peripheral parasitemia (from 23.5% to 5.0%) and placental malaria (from 25.2% to 6.8%) [4]. …”