03 December 2022

First Man taking Jab

His Excellency`s first Jab
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03 December 2022
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03 December 2022
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03 December 2022
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Acute Respiratory Infections (ARIs)

The proportion of children with acute respiratory infection (ARIs) taken to health facilities increased from 19.6% in 2004 to 70% in 2010. There has been reduction in pneumonia case fatality from 18% in 2000 to 5.7 % in 2008.

Non-Communicable Disease (NCDs)

Cancer is a generic term for a large group of diseases that can affect any part of the body. One defining feature of cancer is the rapid creation of abnormal cells that grow beyond their usual boundaries, and which can then ..

Malaria in children under five

Malaria is a preventable and treatable disease. The primary objective of treatment is to ensure complete cure. Children under 5 years of age are one of most vulnerable groups affected by malaria.

HIV and AIDS

With a national average adult HIV prevalence of 10.6% and about 50,000 deaths annually associated with HIV, Malawi, like most countries in the Southern African region still faces a severe HIV epidemic with resultant socio-economic development challenges.

Major Communicable Diseases

Apart from malaria, the other major communicable diseases are tuberculosis, HIV/AIDS and STIs. 

Tuberculosis

With regard to tuberculosis, the effort to collaborate and support the HIV/AIDS programme is paying off. More cases of tuberculosis are being ascertained and treatment failure is diminishing. The tuberculosis MDG targets provide a measure of success (Figure 1). 

Figure 1 Tuberculosis MDG Indicators

The treatment success rate at 86% is slightly above the World Health Organization (WHO) target of 85%. However, the case detection rate (46%) is still below WHO target (70%). Through the National Tuberculosis Control Programme additional strategies have been developed to include the private sector and also increase the detection rate while maintaining the treatment success rate.

 Sexually Transmitted Infections including HIV and AIDS

This component of the EHP consumes the greatest resources with direct costs in the order of an estimated 16% of the direct costs for the first year of the programme. This is, however, expected to increase as the country moves towards universal coverage for new ART regime. As part of the HIV prevention strategy, the health sector provides 25 million and 1 million of male and female condoms, respectively, per annum. HIV testing and counselling is an integral part of the HIV prevention strategy. Approximately 1.8 million people were counselled and tested for HIV in 2009/2010, which is 28% of the sexually active population. HIV testing among couples is limited and in the HSSP there are strategies to promote couple testing because of the high level of HIV discordant couples (Figure 2). Another key prevention component is Prevention of Mother to Child Transmission (PMTCT). In 2009/10 37% of HIV positive mothers received appropriate drugs and counselling. The HSSP provides strategies for increasing this annually by 10% over the five year period. Testing and treatment of other STIs is an important HIV prevention activity. 

About half the number of cases as estimated in the BoD study were treated in 2010.  The strategic plan has put in place strategies to increase this number by improving access by 10% a year.

Figure 2 HIV cases  2007                                                                                

Figure 3 ARV coverage by Zone

ARVs are the mainstay of treatment. The criteria of who benefits from ARVs change as and when advice from WHO is updated. So far the implications are that more people will benefit from them. In 2009/2010 with the criteria for starting ARVs based on a CD4 count of less than 250 cells per mm3 , 228,468 adults were on ARVs which was 71% of eligible cases and 22,519 children were on ARVs, which was 29% of eligible children (Figure 13). Strategies have been put in place to increase adult coverage to 80% in 2011/2 and by 20% each year in children to reach the MDG target of 80%.  Numbers will have to be revised upwards in the course of the implementation of the HSSP if additional resources are mobilized to fund the additional cases derived from the CD4 count change to 350 and maternity cases. 

 

Figure 4 Adult and child ART coverage in Malawi

Alongside ARVs is the treatment of Opportunistic Infections (OIs) and community-based home care for AIDS patients. Currently, the coverage of OI treatment is about 20% of need and there are plans to increase coverage by 10% annually. The coverage of home-based care is about right but the quality of care and the availability of drugs are important and need improvement.

 

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