Wellcome Open Research (Apr 2023)

Malaria Burden Stratification in Malawi- A report of a consultative workshop to inform the 2023-2030 Malawi Malaria Strategic Plan [version 1; peer review: 1 approved, 2 approved with reservations]

  • Atupele Kapito-Tembo,
  • Esloyn Musa,
  • Patrick, Ken Kalonde,
  • James Chirombo,
  • Lumbani Munthali,
  • Maclear Masambuka,
  • Abdoulaye Bangoura,
  • Tapiwa Ntwere,
  • Melody Sakala,
  • Beatriz Galatas Adrade,
  • Michael Give Chipeta,
  • Dianne J Terlouw,
  • Donnie Mategula,
  • Austin Gumbo,
  • Judy Gichuki,
  • Michael Kayange,
  • William Sheahan,
  • Collins Mitambo,
  • Collins Kwizombe,
  • Nyanyiwe Masingi Mbeye,
  • Benard Banda,
  • Jacob Kawonga,
  • Alinafe Kalanga,
  • Gracious Hamuza,
  • Jacob Kafulafula,
  • Dina Kamowa,
  • Halima Twaibi,
  • Akuzike Banda

Journal volume & issue
Vol. 8

Abstract

Read online

Background: Malawi's National Malaria Control Programme (NMCP) is developing a new strategic plan for 2023-2030 to combat malaria and recognizes that a blanket approach to malaria interventions is no longer feasible. To inform this new strategy, the NMCP set up a task force comprising 18 members from various sectors, which convened a meeting to stratify the malaria burden in Malawi and recommend interventions for each stratum. Methods: The burden stratification workshop took place from November 29 to December 2, 2022, in Blantyre, Malawi, and collated essential data on malaria burden indicators, such as incidence, prevalence, and mortality. Workshop participants reviewed the malaria burden and intervention coverage data to describe the current status and identified the districts as a appropriate administrative level for stratification and action. Two scenarios were developed for the stratification, based on composites of three variables. Scenario 1 included incidence, prevalence, and under-five all-cause mortality, while Scenario 2 included total malaria cases, prevalence, and under-five all-cause mortality counts. The task force developed four burden strata (highest, high, moderate, and low) for each scenario, resulting in a final list of districts assigned to each stratum. Results: The task force concluded with 10 districts in the highest-burden stratum (Nkhotakota, Salima, Mchinji, Dowa, Ntchisi, Mwanza, Likoma, Lilongwe, Kasungu and Mangochi) 11 districts in the high burden stratum (Chitipa, Rumphi, Nkhata Bay, Dedza, Ntcheu, Neno, Thyolo, Nsanje, Zomba, Mzimba and Mulanje) and seven districts in the moderate burden stratum (Karonga, Chikwawa, Balaka, Machinga, Phalombe, Blantyre, and Chiradzulu). There were no districts in the low-burden stratum. Conclusion: The next steps for the NMCP are to review context-specific issues driving malaria transmission and recommend interventions for each stratum. Overall, this burden stratification workshop provides a critical foundation for developing a successful malaria strategic plan for Malawi.

Keywords