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?

Volunteer actions

25. Mass vaccination campaigns 24. Routine vaccinations 01. Community-based surveillance 02. Community mapping 03. Communicating with the community 04. Community referral to health facilities 05. Volunteer protection and safety 12. Managing fever 19. Psychosocial support 23. Chemoprophylaxis 36. Vector and reservoir control 37. Mosquito nets / bed nets 38. Waste disposal and clean-up campaigns 43. Social mobilization and behaviour change