Zambia

Country Overview

Malaria Country Profile

• The country reported over 5 million cases of malaria in 2019, reaching a plateau compared to 2015.  
• 100% of the population is at risk of contracting malaria (Total Population: 17.86 million)
• Malaria incidence remained largely unchanged at 336 cases per 1,000 population in 2015 and 305 cases per 1,000 population in 2019.
• Plasmodium falciparum is the most deadly and common malaria parasite.

Elimination Strategies Implemented

Zambia’s National Malaria Strategic Plan lays out a strategy to move from accelerated burden reduction to malaria elimination by 2021.

Zambia’s malaria elimination strategy involves a two-pronged approach that targets areas with a package of interventions based on transmission levels. In districts with 50 or more malaria cases per 1,000 population, the focus is on reducing the disease burden and strengthening health systems. In contrast, districts with fewer than 50 cases per 1,000 population, surveillance is the key intervention. In both settings, a step by step approach is used to ensure a sustainable malaria elimination project.

The stepwise approach towards malaria elimination in Zambia consists of five components which have a corresponding set of actions for different malaria transmission intensities. The first step is to accelerate case management and optimise on vector control. This involves scaling up interventions like LLINs, IRS, timely diagnosis and effective treatment. The second component of the strategy is to build strong information systems which allow for quality and timely reporting. Followed by these two components, the next strategy is to clear parasites from communities. Strategies can include mass drug administration and transmission – blocking vaccines. The fourth component after achieving community wide reduction is to proactively find and treat the few cases as they occur. The final component in the elimination end game is to document and maintain zero local transmission.

Best Practices

• Over 10 million nets were distributed in a LLIN mass campaign in 2017.
• The national programme's policy on malaria in pregnancy includes the provision of:
  • Free Intermittent preventive treatment in pregnancy (IPTp) with at least four doses of Sulfadoxine-Pyrimethamine (SP) during pregnancy
  • Free long-lasting insecticide-treated nets (LLINs)
  • Free prompt diagnosis and treatment of clinical malaria
• Zambia has rolled out nationwide CHWs who seek to provide access to health care at community level. These trained cadres provide surveillance and adequate human resources which are necessary as the country aims at zero local transmission.
• A mass drug administration trial was conducted in Southern Province, and based on these results MDA will be implemented where appropriate in elimination-targeted areas of Zambia as part of an intervention package that includes highest coverage with vector control methods and case management, a robust surveillance system, as well as a system to detect and treat individual cases.