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FOURTH INTERCOUNTRY MEETING OF NATIONAL MALARIA PROGRAMME MANAGERS ISFAHAN ISLAMIC REPUBLIC OF IRAN

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FOURTH INTER-COUNTRY MEETING OF NATIONAL MALARIA PROGRAMME ... July. June. May. Apr. Mar. Feb. Jan. Malaria Cases. Malaria Cases in Somalia, 2004. 1st Quarter ... – PowerPoint PPT presentation

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Title: FOURTH INTERCOUNTRY MEETING OF NATIONAL MALARIA PROGRAMME MANAGERS ISFAHAN ISLAMIC REPUBLIC OF IRAN


1
FOURTH INTER-COUNTRY MEETING OF NATIONAL MALARIA
PROGRAMME MANAGERS ISFAHANISLAMIC REPUBLIC OF
IRAN
25 28 May 2004
Presented by Dr. Said Farah Ahmed RBM Nation
Focal Point WHO Somalia E-mail
whogarcdc_at_hotmail.com E-mail
bedenle54_at_hotmail.com
  • Dr. Waqar Ahmed Butt
  • RBM Coordinator WHO Somalia
  • E-mail rbm_at_som.emro.who.int
  • Email waqbutt54_at_hotmail.com

2
Administrative Map
3
Health Facility Accessibility
NWZ NEZ CS
zones Hospitals 9 Hospitals 5
Hospitals 23 MCH 53 MCH
54 MCH 70 HPs 197
HPs 98 HPs
4
Malaria Microscopy Centers and Referral
Laboratories in Somalia
5
SITUATION OF THE PROGRAM
  • Somalia belongs to the zone of Afrotropical
    malaria .
  • The deadly Plasmodium faciparum is overwhelmingly
    predominant.
  • Malaria situation ranges from unstable but
    epidemic prone areas( Somaliland and Puntland )
    to stable meso-endemic in central and
    hyper-endemic in the south of the country
  • Over all, all age groups are affected but
    severely children , pregnant women and nomadic
  • Control measures priorities vary in different
    zones. In north, to reduce malaria transmission
    through effective anti-larval and epidemic
    preparedness is the top priority, while in South
    and central , to reduce morbidity and to prevent
    the mortality in high risk groups through early
    diagnosis and prompt treatment and personnel
    protection With ITNs are the top priorities

6
Malaria Control Activities
  • Laboratory services available in hospitals
    trainings for laboratory technicians on malaria
    microscopy and rapid diagnostic test for malaria
    in areas with no laboratory facility (paracheck)
  • Vector control measures such as larvivorous fish,
    ITNs as personnel protection, indoor residual
    spray in outbreak prone areas.
  • Surveillance, monitoring and Evaluation
  • Prompt response to malaria out breaks with
    adequate AMD and Laboratory diagnostic services
    at site
  • Limited activities in Larvivrous fish programme
    in NWZ

7
Epidemiological Stratum in Somalia Sentinel
sites for AMD Efficacy Study
Djibouti
Hypo endemic
Burao
Ethiopia
Galcayo
Baidoa
B/hawa
Meso-endemic
Jowhar
Jannale
Kenya
Hyper-endemic
Jamaame
8
DEVELOPMENT OF CHLOROQUINE RESISTANCE IN SOMALIA
1986-1997
9
Table1 Therapeutic Efficacy of Chloroquine (CQ)
2003
10
Table 2 Therapuetic efficacy of Sulphadoxine /
Pyrimethamine (SP) in 2003
11
Achievements for Malaria Control Programin
Somalia 2003
  • Effective celebration of the 3rd anniversary of
    AMD
  • Assessment of malaria situation in epidemic
    malaria prone areas (NEZ NWZ)
  • Establishment of malaria task force at national
    and zonal level
  • Two weeks training workshop on entomology by VCP/
    scientist from EMRO
  • Training on malaria microscopy for 14 lab.
    technicians from cross border areas
    (Somalia/Ethiopia)

12
Achievements for Malaria Control Programin
Somaliacont.
  • Prompt response to malaria outbreaks in Awdal and
    Galbeed regions and pre-positioning AMDs in te
    other zones.
  • Extension of one more sentinel site for AMD
    efficacy in Somalia (B/Hawa in SZ).
  • Supervisory visit to NWZ (Borama,
    Berbera,Togdher, Galbeed and AwdalRegions) and
    NEZ (Mudug,Nugal and BariRegions)

13
Achievements for Malaria Control Programme in
Somalia 2004
  • Response to malaria problems reported from
    coastal areas in NWZ
  • Basic Malaria Microscopy training in NEZ Puntland
    for 11 Laboratory Technicians
  • Basic malaria microscopy training in South
    Central zones for 9 laboratory technicians
  • Basic malaria microscopy training for 9 private
    laboratory technicians in Garowe Punt and
  • Indoor residual house spraying campaign completed
    in Awdal Galbeed regions (epidemic prone areas
    in NWZ)
  • Four health professional staff from Galgudud were
    trained
  • 6 health professional staff training on mosquito
    net impregnation in NEZ
  • 28 health professional staff training on mosquito
    net impregnation in south Central zone
  • 4th Africa Malaria Day celebrated in Somalia
    with theme A Malaria Free-Future with slogan
    Children for children to Roll Back Malaria

14
Future activities
  • AMD efficacy study for combination (AQSP) and
    Mono-therapy (AQ) in four sentinel sites of CS
    zones
  • To develop malaria treatment guideline for
    Somalia
  • Training of one entomologist in integrated vector
    control management

15
Malaria Cases in Somalia, 2002
16
Malaria Cases in Somalia, 2003
17
Malaria Cases in Somalia, 20041st Quarter
18
Outbreak, Notification and Response in NWZ,2003
19
Outbreak, Notification .
Slide 19
20
ITNs DISTRIBUTION IN SOMALIA 2003
21
ITNs Distribution 4th Africa Malaria Day in
Hargeisa Orphanage Center, NWZ of Somalia
22
FOURTH AFRICA MALARIA DAY CEREMONY IN THE
GAROWEMCH SCHOOL CHILDREN,TEACHERS ELDERS
23
Continue
24
Community Concept on ITNs (IEC)
  • Community Concept
  • Is the Insecticide for Impregnation of the bed
    nets Harmful to Human (Children lt5 years
    Pregnant mothers)?
  • Will the ITN protect us from biting or kill the
    mosquito?
  • How long can it protect us from Mosquito bites?
  • Awareness!

25
MAIN CONSTRAINTS
  • There is no organized Malaria control program
    and activities in most of the country with
    exception of NWZ NEZ.
  • Unstable and constantly changing security
    situation limiting access and operation in the S
    C zones
  • Inadequate and irregular supply due to high
    operational cost
  • Lack of effective central government to
    coordinate the control activities
  • WHO trained health staff left the public health
    facilities due to low remuneration and
    incentives
  • Self medication adapted by Somali community which
    may provoke resistance of parasite to
    anti-malarial
  • No respect and compliance with the existing
    Malaria Drug Policy as the AMD is imported and
    distributed by private sector
  • Security concern increases burden on programme
    budget

26
RECOMMEDATIONS
  • Completion of the anti- malaria drug efficacy
    study, on combination therapy to develop new
    policy for malaria treatment in the country.
  • Strengthening of existing laboratory services
    and Extension of the laboratory services to the
    peripheral health facilities (malarious/ malaria
    prone areas (both by training of the staff and
    capacity buildings)
  • Development of common strategy for purchasing,
    distribution, re-impregnation , utilization
    follow up and efficacy evaluation of the ITNs
    (all partners)
  • Provision of IPT in MCHs for pregnant woman in
    2nd and 3rd trimester
  • Training the health professionals on malaria case
    management country wide
  • Consensus on development of IECB With partner and
    other organizations dealing with malaria control
    program

27
Moving on 60 of Somalias population comprises
people of nomadic nature
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