Malaria Epidemic Forecasting and Preparedness Manual

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Fig 6: ELABERED - EPIDEMIC THRESHOLD400350Third quartileMedianMalaria OPD Cases300250200150100500Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov DecMonthCalculation of epidemic thresholdTo calculate the third quartile threshold, we need to have datafrom at least the last five years on number of cases by month, orby week, or both. Ten years would be even better. Any epidemicyear (e.g., 1998) should be included in this calculation.The epidemic threshold should be calculated for each healthfacility by month and by week. To detect epidemics quickly, itis best to use the weekly threshold. However, the weekly datamay not be available for the last five years, so monthly can beused first.The threshold can be calculated with or without a computer. Ifyou do not have a computer, you can still calculate thethresholds and make the graphs by hand. In this case, it is best touse five years’ data. If you have more than five, it is easier touse the computer.Eritrea Epidemic Manual, June 2003 19
To calculate and draw monthly threshold byhand1. Write down the data on malaria OPD cases by month foreach health facility (or subzoba) from the last five years asshown in Table 1 below.2. For each month, sort the numbers from lowest to highest,and write them in order as shown in Table 2 below. Forexample, take the number of cases from each January of thelast five years from the first line of Table 1, and write themin ascending order in the first line of Table 2. Repeat withall the other months.3. The middle number in each series (third column in Table 2)is the median. Take the median for each month and plot thepoints on a graph of cases by month, then join the pointswith a line. This is the average number of cases expectedper month.4. The 4 th highest number in each series (4 th column in Table2) is the third quartile. Take the third quartile numbers foreach month and plot them on a graph of cases by month,then join the points with a line. This is the epidemicthreshold line.20Eritrea 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 21 and 22: If there has been unusually large m
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: The threshold can be calculated by
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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