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How malaria surveillance is maintaining low transmission rates in Angola

There is a serious risk of low malaria transmission in southern Angola reverting back to previous high rates if progress made in case management and surveillance is not maintained. A reduction in activities also puts malaria elimination efforts in neighbouring countries at risk.

MENTOR began supporting National Malaria Control Programme (NMCP) and local governments in two provinces to improve the quality and coverage of data and accelerate efforts to reduce transmission, after malaria cases started to decline significantly in this region two years ago.

With case transmission declining, improved data quality and reporting rates stable, the transition to active surveillance became essential to the elimination ambitions for the region, particularly in areas bordering countries like Namibia.

Malaria surveillance is core to improve regional progress towards malaria elimination. Active surveillance, including case line listing, was initiated in border municipalities targeting health facilities that had an average of fewer than five cases per month over the past three years and maintained a consistent reporting rate.

The improvements were evident when looking to DHIS2 reporting rates. Since the start of the implementation of malaria surveillance activities in 2018, the supported municipalities increased substantially their reporting rates. Six out of seven municipalities have achieved more than 90% of reporting rates when in 2020 only one municipality achieved this target (and the remaining six had rates ranging from 0 to 64,6%)

At the same time, the team collaborated with Saudigitus to create a case-based tracker within DHIS2, that is being gradually integrated into the Angola National Information system (SIS Angola) and will enhance data quality.

Earlier in September, a training session and pilot programme involving technicians from 42 health facilities and corresponding municipal and provincial teams took place in Cunene and Cuando Cubango Provinces. Representatives from Studies, Planning and Statistics Office (GEPE) of MoH and NMCP led the training, equipping health facilities with the necessary resources for case listing, classification, investigation, and initiating reactive case detection and foci investigation.

“The fight against malaria in the south with focus in elimination activities is important to facilitate regional progress towards disease elimination. The MENTOR Initiative has been working with us, MoH and NMCP to provide support to vector control, entomology, case management and data interventions with clear improvements throughout the past two years. Going forward with this approach in our region, we are committed to work sustainability so that in the future we can say this initiative worked.” – André José Domingos, Malaria Provincial Focal Point.

This work is funded through a regional grant managed by the E8 and funded by the Global Fund. As it enters its last year, project activities are being handed to local government staff despite the funding challenges to ensure wide implementation across the region.

“MENTOR remains committed to relentless advocacy and collaboration with local and central governments and stakeholders to secure the essential resources required for key active surveillance initiatives.” – Teresa Nóbrega, Country Director, The MENTOR Initiative.