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National Malaria Surveillance Guidelines 2019, Nepal

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National Malaria Surveillance Guidelines 2019, Nepal

Published by Epidemiology and Disease Control Division 

Malaria surveillance system

A malaria surveillance system comprises the people, procedures, tools and structures necessary to generate information on malaria cases and deaths. The information is used for planning, implementing, monitoring and evaluating malaria programs. An effective malaria surveillance system enables program managers to:

  • Identify and target areas and population groups most severely affected by malaria, to deliver the necessary interventions effectively and to advocate for resources;
  • Regularly assess the impact of intervention measures and progress in reducing the disease burden and help countries to decide whether adjustments or combinations of interventions are required to further reduce transmission;
  • Detect and respond to epidemics in a timely way;
  • Provide relevant information for certification of elimination; and
  • Monitor whether the re-establishment of transmission has occurred and, if so, guide the response.

Nepal’s surveillance system is expected to receive individual case notification within 24 hours of case detection from public, private, community and all other sources. Case notification is expected to trigger prompt case investigation within 48 hours of notification and focus investigation and response is expected within 7 days of case detection.

In Nepal at present malaria cases are reported using three different systems:

  1. Malaria Disease Information System (MDIS) (case notification within 24 hours of case detection).
  2. District Health Information System 2 (DHIS-2) (aggregate, monthly data).
  3. Early Warning and Reporting System (EWARS-weekly reporting).

Malaria surveillance in different transmission settings

High transmission:  Case incidence >100/1000 pop

Surveillance : Data analysis on aggregated numbers

  • Age and sex

Specific Actions :

  • Ensure Universal Access to quality assured diagnosis and prompt effective treatment at population level.

Moderate transmission:  Case incidence > 50 – <100/1000 pop & Low transmission: Case incidence >25 – <50/1000 pop

Surveillance :

Data analysis on

  • (each and every malaria case)
  • Greater heterogeneity in the distribution of malaria.
  • Identify vulnerable population groups and identify hot spots and hot pops and ensure targeted interventions.

Specific Actions :

  • Map areas of residual transmission, and
  • Analyse case distribution at individual HH and community level.
  • Frequent data analysis to detect potential focal outbreaks
  • Respond to focal outbreaks

Very low transmission (in elimination settings) : Case incidence <25/1000 pop

Surveillance :

  • Prompt detection and response to new cases and foci.

Specific Actions :

  • All cases of malaria and foci investigation conducted.
  • Eliminate foci of transmission and maintain malaria-free status.
  • Resource intensive and additional skills, training is required.

The burden of malaria in Nepal puts all areas of the country in the ‘Very low transmission’ category



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