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. 2023 Jun 18;45(Suppl 1):7.
doi: 10.11604/pamj.supp.2023.45.1.39804. eCollection 2023.

Malaria elimination in Zanzibar: where next?

Mohamed Haji Ali  1 , Jovin Kitau  2 , Abdullah Suleiman Ali  3 , Abdul-Wahid Al-Mafazy  4 , Sisay Gashu Tegegne  2 , Omar Ussi  1 , Christine Musanhu  2 , Shija Joseph Shija  1 , Bakari Omar Khatib  1 , Humphrey Mkali  5 , Sigsbert Mkude  5 , Geofrey Makenga  5 , Elizabeth Kasagama  6 , Fabrizio Molteni  6 , Noela Kisoka  6 , Chonge Kitojo  7 , Naomi Serbantez  7 , Erik Reaves  8 , Zabulon Yoti  2
Affiliations

Malaria elimination in Zanzibar: where next?

Mohamed Haji Ali et al. Pan Afr Med J. .

Abstract

In 2018, Zanzibar developed a national malaria strategic plan IV (2018-2023) to guide elimination of malaria by 2023. We assessed progress in the implementation of malaria activities as part of the end-term review of the strategic plan. The review was done between August and October 2022 following the WHO guideline to assess progress made towards malaria elimination, effectiveness of the health systems in delivering malaria case management; and malaria financing. A desk review examined available malaria data, annual work plans and implementation reports for evidence of implemented malaria activities. This was complemented by field visits to selected health facilities and communities by external experts, and interviews with health management teams and inhabitants to authenticate desk review findings. A steady increase in the annual parasite incidence (API) was observed in Zanzibar, from 2.7 (2017) to 3.6 (2021) cases per 1,000 population with marked heterogeneity between areas. However, about 68% of the detected malaria cases were imported into Zanzibar. Malaria case follow-up and investigation increased from <70% in 2017 to 94% and 96% respectively, in 2021. The review noted a 3.7-fold increase of the health allocation in the country's budget, from 31.7 million USD (2017/18) to 117.3 million USD (2022/23) but malaria allocation remained low (<1%). The varying transmission levels in the islands suggest a need for strategic re-orientation of the elimination attempts from a national-wide to a sub-national agenda. We recommend increasing malaria allocation from the health budget to ensure sustainability of malaria elimination interventions.

Keywords: Malaria; Zanzibar; elimination; malaria programme review.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
average malaria cases distribution by age groups and sex in Zanzibar
Figure 2
Figure 2
malaria cases classification in Zanzibar (A), Pemba (B), Unguja (C) 2017-2022
Figure 3
Figure 3
performance charts: annual cases notified, with health facility complete and fully investigated by the District Malaria Surveillance Officers (DMSO), 2012-2022
Figure 4
Figure 4
annual proportion of Anopheles species analyzed by PCR in Unguja (A) and Pemba (B) 2010-2021
Figure 5
Figure 5
average sporozoite rate in Zanzibar between 2017 and 2021
See this image and copyright information in PMC

References

    1. World Health Organization . Geneva: WHO; 2021. World malaria report. Accessed March 24, 2023.
    1. Moonen B, Cohen JM, Tatem AJ, Cohen J, Hay SI, Sabot O, et al. A framework for assessing the feasibility of malaria elimination. Malar J. 2010 Nov 11;9:322. - PMC - PubMed
    1. Zanzibar Malaria Elimination Programme . Zanzibar. 2009. Malaria Elimination in Zanzibar: a feasibility assessment.
    1. WHO/HQ A, IST/ESA, WCO-Tanzania Mission Report of the Zanzibar Malaria Elimination Audit 5 - 9 October 2015. 2015. Accessed March 24, 2023.
    1. Revolutionary Government of Zanzibar Ministry Of Health . Zanzibar Malaria Elimination Programme: Zanzibar Malaria Elimination Strategic Plan IV 2018/19-2022/23 December 2017. Accessed March 24, 2023.