Malaria Epidemic Forecasting and Preparedness Manual

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4. AssessingVulnerabilitySocial factorsSocial factors include population movements within the samecountry, or between neighbouring countries. This includesinternally displaced persons, returnees or refugees moving dueto war or natural disaster.People may be moving from areas of no malaria transmission toareas that have transmission, in which case they do not havemuch immunity to malaria and are vulnerable to infection in thenew place. Movement of people may also bring malaria fromareas of high transmission to a new place that does not usuallyhave malaria, but has mosquitoes as potential vectors. Thereforetransmission to the local population will occur when infectedpeople move in.Population movements are hard to define in a scientific way.The important thing is for zoba/subzoba coordinators and healthfacilities to be aware of social disruption and movement, and tocommunicate this to other malaria control workers at national,zonal, and subzonal offices.Eritrea Epidemic Manual, June 2003 9
If there has been unusually large movement of people duringthe last year, raise the alert level by one step.If there have not been large population movements for a yearor more, go back down a step.Biological factorsWe also need to be aware of biological vulnerability factors. Anexample of this is when an area has not had malariatransmission for some time, so that people have lost theirimmunity, or when there is food shortage so people are at higherrisk of any illness. If a drought period continues for severalyears, people are very susceptible to malaria, especially childrenborn since the last high transmission years. Drought does not tellyou that an epidemic is likely to happen, just that if it does,things are likely to be bad.The same thing can happen even without drought, if controlmeasures are effective and the incidence of malaria becomesvery low. This is what happened in India and Sri Lanka in the1970s. After many years of DDT spraying, there were fewmalaria cases in these countries, and few people were immune.When spraying was cut back and transmission started again,there were large epidemics because the population was sovulnerable to infection.If there have been low numbers of malaria cases for 3 yearsor more, due to drought or very effective control measures inan area which previously had high incidence, raise the alertlevel by one step.After a high incidence year, go back down a step.10Eritrea Epidemic Manual, June 2003
Page 2: Malaria Epidemic Forecastingand Pre
Page 6: ContentsIntroduction...............
Page 9 and 10: There are also criteria for decidin
Page 12: 1. General Definitionof an Epidemic
Page 15 and 16: Fig 1: GASH BARKA - GULUJ 1996 - 20
Page 18: 3. GeographicStratificationStratifi
Page 23 and 24: Long-term forecasting (severalmonth
Page 25 and 26: You can see from Fig. 4 that there
Page 27 and 28: 6. Inform Epidemic Preparedness and
Page 29 and 30: The threshold can be calculated by
Page 31 and 32: To calculate and draw monthly thres
Page 33 and 34: Table 2:MonthRe-ordered OPD malaria
Page 35 and 36: To calculate and draw weekly thresh
Page 37 and 38: Definition of an epidemicAt the beg
Page 39 and 40: 2. Drugs3. Insecticides for IRS and
Page 41 and 42: factor (for example increase in num
Page 43 and 44: ResponseWhen to change from “ALER
Page 45 and 46: Table 2:MonthJanFebMarAprMayJunJuly
Page 47 and 48: Graphs are shown in the sheets call
Page 49 and 50: Month GraphEXAMPLE Health Centre400
Page 51 and 52: Week Data continuedweek median 3rd

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