malaria surveillance in omanmalaria).pdf · malaria case definition a malaria case is a person in...
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Malaria Situation Update In Oman
Dr. Said Al Mukhaini
MD,MPH
Head, Malaria Epidemiology Section
Malaria Eradication Department
Ministry Of Health
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Presentation Outline
• Global Malaria Situation.
• History of Malaria Eradication Program in Oman
& it’s current status.
• Malaria Surveillance System in Oman.
• National Malaria Policy.
Global Malaria Situation
In 2008:
• 247 million cases of malaria
• 1 million deaths ,mostly among < 5 years.
• In Africa , a child dies every 45 seconds of malaria.
• 20% of all childhood deaths are due to malaria
(WHO 2010)
Global Malaria Situation
Global Malaria Situation
1950s & 60s
1970s
1990
1991 National Malaria Eradication Program was Launched
• Around 300,000 clinical malaria cases were diagnosed
• Malaria Control Program was launched
32,720 confirmed cases
One third of the population
History of Malaria Eradication Program in Oman
21580
15045
32720
19274
14827
16787
2800
617 662 897 977 872 688 633 584 734 615 544 443 701 957 898
4415
1184 603 129 114 29 6 2 6 6 0 0 0 4 8 0
0
5000
10000
15000
20000
25000
30000
35000
1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Nu
mb
er
Year
Classification of malaria cases, Sultanate of Oman, 1988-2009.
Autochthonous Imported Total
Start of epidemiological
classification of cases
Total Number of Autochthonous Malaria Cases & Annual
Parasite Incidence in the Sultanate of Oman , 1994-2008
Pf
18% PfPv 2%
Po 0%
Pv 80%
Proportion Of Cases According To Species 2009
1
10
19
1
1
1
402
1
2
403
2
11
1
43
Imp.
Imp.Afghanistan
Imp.Bangladesh
Imp.Congo
Imp.Ethiopia
Imp.Ghana
Imp.India
Imp.Nepal
Imp.Nigeria
Imp.Pakistan
Imp.Sudan
Imp.Tanzania
Imp.Uganda
Imp.Yemen
0100200300400500
Classification Of Cases According To Source Country 2009
Distribution of Cases Among Regions
Proportion Of Cases According To The Source (2009)
Proportion of malaria cases detected by the
private health institutes, Oman, 1999 - 2009.
Percent Year
20.5 1999
26.0 2000
25.5 2001
23.6 2002
28.8 2003
45.4 2004
49.5 2005
59.5 2006
69.9 2007
71.3 2008
66.0 2009
( Al Zadjali, M 2010)
Malaria Surveillance System in Oman
Objectives
• To detect malaria cases as early as possible
• To monitor the malaria situation in Oman
• To evaluate the control measures
• To assist in the case investigation to know the source of infection.
Malaria Case Definition
A malaria case is a person in whom, regardless of the presence
or absence of clinical symptoms, malaria parasites have been
confirmed by quality-controlled laboratory diagnosis.
Implications
• All cases must be confirmed microscopically before
treatment.
• All referred cases from private health institutions must be
confirmed before treatment.
• No clinical diagnosis.
• No presumptive treatment.
National Malaria Treatment Policy
• Malaria cases should be notified within 24 hours
• Management of malaria cases is free of charge
• Availability of antimalarial drugs is limited only to
governmental health institutes
Malaria Treatment
. ACT for uncomplicated P.f
• Chloroquine + primaquine (after testing G6PD status) for P.v
• Quinine inj. For sever malaria.
• Chemoprphylaxis:
Chloroquine + Pruguanil
Mefloquine
Doxycycline
Central Malaria Lab.
Regional Malaria Lab.
Health Facility Lab.
100% +ve slides
10% -ve slides
100% +ve slides
10% -ve slides
Feedback
Feedback
Lab. Quality Control
( Al Zadjali, M 2006)
( Al Zadjali, M 2006)
Thank You