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Epidemic Control Toolkit
for community volunteers
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Malaria

Last update: 2024-05-23

Key facts

Transmission: Vector-borne (mosquito)

  • Mosquito bite (mostly spread by night-time biting mosquitoes, from sunset to sunrise), 
  • During pregnancy and delivery, from mother to child
  • Organ transplants and blood transfusions from infected donors (rarely)

Most vulnerable to severe consequences

  • Infants and children under five years
  • Pregnant women 
  • People living with HIV/AIDS

Most vulnerable to contracting the disease

  • Mobile populations and transient people (those moving from low risk to high-risk areas)
  • People living or working near mosquito-breeding sites (stagnant water)

General symptoms

  • Fever
  • Chills/shaking (usually)
  • Muscle pain (sometimes)
  • Tiredness (sometimes)
  • Nausea, with or without vomiting (sometimes)
  • Headache (sometimes)
  • Back pain (sometimes)

Symptoms of severe malaria

  • Any of the general symptoms, usually worsening
  • Convulsions
  • Loss of consciousness
  • Yellowing of the skin and eyes (jaundice)
  • Shortness of breath and/or difficulty breathing
  • Bleeding
  • Dark (or black) urine

What can you do to prevent and control an epidemic?

Vector control and prevention

  • Prevent mosquito bites by advocating the use of:
    • Insecticide-treated curtains or screens on windows and doors 
    • Personal protection (application of repellents, wearing long sleeved clothes)
    • Insecticide-treated bed nets 
  • Initiate elimination of mosquitos and breeding sites
    • Outside:
      • Promote removal of standing water and scrub around communities, application of larvicides
      • Promote community clean-up campaigns to remove rubbish and cover water containers
    • Indoors:
      • Support any ongoing indoor residual spraying (IRS)

Monitoring the community and identifying sick people 

  • Identify people in the community with suspected malaria according to the community case definition

Treatment and management

  • Rapidly detect and refer suspected cases to health facilities
  • Promote intermittent prevention therapy (IPT) for pregnant women and infants
  • Promote chemoprophylaxis (anti-malaria medicine) for vulnerable populations (when applicable)
  • Promote early treatment, especially for vulnerable groups and severe infections
  • Provide psychosocial support to the sick person and their family members

Social mobilization and behaviour change

  • Increase social mobilization and behaviour change communication
    • Promote the use of insecticide-treated bed nets and curtains, IPT, IRS and chemoprophylaxis

Immunization 

  • Support mass vaccination campaign (if available)

Mapping and community assessment

  • Make a map of the community.
  • Mark the following information on the map:
    • How many people have fallen sick with malaria? Where?
    • How many people have died? Where? When?
    • Who and where are the vulnerable people?
    • Where are the local health facilities and services? (include traditional healers)
  • Record the following information on the back of the map:
    • When did people start to fall sick with malaria? 
    • Who (which groups) are the most affected?
    • How many people are receiving antimalarial medicines?
    • How many people have become severely ill (see symptoms of severe malaria)? Where?
    • How many people live in the affected community? 
      • How many are children under five years?
      • How many are pregnant women?
    • Do people generally cover their water containers (inside and outside)? Who is responsible for the maintenance of containers for household drinking water and for vessels to do laundry; is it women or men?
    • How does the community usually remove standing, stagnant water?
    • How common is it for people to live in houses with insect screens on windows and doors? 
    • How common is it for people to sleep under insecticide-treated bed nets?
      • How many children and pregnant women sleep under a bed net at night? 
      • Are nets hung up and maintained properly? 
      • If people are not using nets, why not?
    • What are the community’s habits, practices and beliefs regarding indoor spraying?
    • Are children badly affected by malaria? Are there other groups (specific ages, occupations, geographic areas, etc.) that are badly affected? 
    • What are the community’s habits, practices and beliefs regarding use of repellents, sprays, etc.?
    • Have the authorities established a vector control programme?
    • Is a social mobilization or health promotion programme in place?
    • Which sources do people use/trust the most for information?
      • Are there rumours or misinformation about malaria? What are the rumours?