Malaria

Malaria symptoms usually start within 10-15 days of getting bitten by an infected mosquito. Getting tested early is important as some types of malaria can cause severe illness and death. Infants, children under 5 years, pregnant women, travellers, and people with HIV or AIDS are at higher risk. Severe symptoms include extreme tiredness and fatigue, impaired consciousness, multiple convulsions, difficulty breathing, dark or bloody urine, jaundice, and abnormal bleeding.

People with severe symptoms should get emergency care right away. Malaria infection during pregnancy can also cause premature delivery, stillbirth, or delivery of a baby with low birth weight.

WHO recommends that all suspected cases of malaria be confirmed using parasite-based diagnostic testing. Malaria is a serious infection and requires treatment with multiple medicines. The most common medicines are Artemisinin-based combination therapy medicines like artemether-lumefantrine, artesunate+amodiaquine, artesunate+mefloquine, artesunate+sulfadoxine-pyrimethamine, dihydroartemisinin+piperaquine and artesunate+pyronaridine. Primaquine should be added to the main treatment to prevent relapses of infection with the P. vivax and P. ovale parasites. In case of severe disease, people need to go to a health centre or hospital for injectable medicines.

• WHO Guidelines for malaria: the Guidelines provide WHO's most up-to-date recommendations for malaria in one easy-to-navigate online platform MAGICapp
• The New WHO Initiative aims to support an effective regional response to An. Stephensi in Africa through a five-pronged approach: increasing collaboration; strengthening surveillance; improving information exchange;developing guidance and prioritizing research to evaluate the impact of interventions and tools against An. Stephensi.
• Strategy to respond to antimalarial drug resistance in Africa: the Strategy to respond to antimalarial drug resistance in Africa aims to improve detection, delay emergence, and limit selection and spread of resistant parasites.
• Global Vector Control Response 2017–2030 GVCR is an integrated approach to strengthen vector control worldwide through increased capacity, improved surveillance, better coordination, and integrated action.
• Framework for implementing the Global Technical Strategy for malaria 2016–2030 in the African Region:  this framework guides implementation of the GTS in the WHO African Region.
• A framework for malaria elimination: the document provides guidance on the tools, activities and strategies needed to achieve malaria elimination and prevent re-establishment.
• Framework for the allocation of limited malaria vaccine supply: the Framework is designed to support prioritization decisions at the start of vaccine roll-out and over the coming years, with periodic reviews and updates to ensure it remains useful and appropriate.
• E- 2025 Initiative: aims to end AIDS, TB, and malaria epidemics in Africa by 2025.
• The Sahel Malaria Elimination Initiative is a partnership between the Government of Monaco and the National Malaria Control Programs of eight West African countries to eliminate malaria in the Sahel region by 2030.
• Global technical strategy for malaria 2016-2030:  the Strategy sets a target of reducing global malaria incidence and mortality rates by 90% by 2030.
• 2022 World Malaria Report

Anopheles stephensi is a major threat to the control and elimination of malaria in Africa, but large-scale surveillance of the vector is needed. An stephensi has been expanding its range over the last decade, with detections reported in Djibouti, Ethiopia, Sudan, Somalia, Nigeria and Ghana. It thrives in urban settings. Countries are encouraged to step up surveillance activities to ensure early detection of this vector.

WHO has been leading efforts to introduce the RTS, S vaccine in African countries with high malaria burden. In 2019, the vaccine was introduced in Ghana, Kenya, and Malawi as part of a pilot program to assess its effectiveness and safety in real-world settings. Following the WHO recommendation for broader use of the malaria vaccine in moderate to high Plasmodium falciparum malaria transmission areas, issued in October 2021, the WHO has supported Ghana and Malawi to expand the vaccine administration in comparator areas. By the end of March 2023, 1.5 million children with RTS, S, and more than 4.1 million doses had been administered since the initial launch in 2019. Malawi launched expansion of RTS, S on 29 November 2022. It was followed by Ghana, which launched the expansion on 20 February 2023. Kenya launched the expansion on 7 March 2023.  At least 28 countries in Africa have expressed interest in introducing the vaccine, with some additional countries to start in early 2024. The unprecedented demand for the first malaria vaccine is considered an opportunity to bring children back to clinics to catch up on missed vaccines and child health interventions – including reinforcing the need for children to sleep under ITNs every night. WHO has also been working with African countries to scale up other proven malaria control interventions, such as insecticide-treated bed nets, indoor residual spraying, intermittent preventive treatment of malaria in pregnant women, seasonal malaria chemoprevention, perennial malaria chemoprevention in young children as well as prompt diagnosis and treatment of malaria cases.