Technical Guidelines for Integrated Disease Surveillance ... - PHRplus

MalariaBackground Malaria is a highly prevalent tropical illness with fever following the bite of infectivefemale Anopheles mosquitoes, which transmit a parasite, Plasmodium falciparum, p.ovale, P. vivax or P. malariae. Serious malarial infections are usually due to P.falciparum and may result in severe anaemia and cerebral involvement. Malaria is hyperendemic in Ghana (transmission is high and stable throughout theyear). It accounts for 40% of all OPD cases, 36.9% of admissions, 13.2 % of all deaths and25% of deaths among children under 5. Three main plasmodium species cause disease: P. Falciparum accounts for 80-90% ofall cases, P. Malariae accounts for 10-20% whilst P. Ovale accounts for 0.15%. Children under 5 years and pregnant women are at most risk of developing severemalaria with accompanied death.Incubation period from the time of being bitten to onset of symptoms is 7 to 30 days.P. Falciparum choloquine-resistant strains have emerged in some parts of the country,with levels of resistance ranging from 6% to 19%. However, chloroquine is still effectiveas the first-line drug.Surveillance goal Improve percentage of inpatient malaria cases confirmed microscopically (from current17% to 50%).Monitor anti-malarial resistance using district sentinel sites.Case definitionUncomplicated malaria:Any person with fever or fever with headache, back pain, chills, sweats, myalgia, nauseaand vomiting diagnosed clinically as malaria.Confirmed uncomplicated malaria:Any person with fever or fever with headache, back pain, chills, sweats, myalgia, nauseaand vomiting and with laboratory confirmation of diagnosis by malaria blood film or otherdiagnostic test for malaria parasites.Severe malaria:Any person hospitalized with a primary diagnosis of malaria and confirmed by a positiveblood smear or other diagnostic test for malaria.In addition, the person may have any of the following: change in behaviour (confusion ordrowsiness), altered consciousness, general weakness (prostration), convulsions,hypoglycemia (sugar