National Center For Infectious Diseases Prevention and Control DR :Ibrahim Kraza Damascus. June 2005 Background Malaria was endemic in libya until 1973 where it was declared by WHO to be a country free of malaria. The situation continued like this unil 1976 where there was an epidemic of febrile illness among petroleum company workers in hoone ,clinical presentation was like malaria , blood slides of all 12 cases (2 pakistanian ,10 libyan ) were positive for falciparum malaria ,reconfirmed in a referral lab. In Tripoli ,patients were treated ,and chemoprophylaxis given for the limited surroundings . No more cases reported in the whole country for 10 years later. Background cont.. In 1986 only imported cases started to appear and most of them from african countries and bangladish,and india . In 2003 in addition to 44 imported cases reported , few cases reported thought to be an indigenous in southern areas (sebha province) , as a responce to that symposium conducted in sebha with collaboration to advisors from endemic counries and professionals in malaria epidemiology, and after strict epidemiological investigations in the areas where the case reported , concluded finally to be an introduced cases. Sebrata Tripoli Tobruk Benghazi Sirt Obari Sebha Malarial Cases Distribution in Libya during 2004 60 ___ Median : 27 Years --- Mean: 27.7 ± 12.9 Years 50 40 30 20 10 0 N= 15 Age Distribution of Malarial Reported Cases Gender: 12 M: 3 F. All cases confirmed microscopically. All cases are imported, except for one case thought to be an introduced. Nigerian 2 Libyan 7 Sudanian 6 Nationality Distribution for Malarial Cases during 2004 in Libya Africa Sudan Middle Africa Niger Benin No 0 1 2 3 4 5 6 7 Count Travel History for Reported Malarial Cases in Libya in 2004 5 4 TRAVEL Africa 3 Sudan Middle 2 Africa Niger 1 No 0 Benin P.Malari P.Falciparum P.Vivax Parasite Type Types of Malaria parasite in relation to travel history 3.0 2.0 1.0 0.0 1 2 3 4 5 6 7 8 9 10 11 12 Month Distribution of Malarial Cases according to Months of the Year ( 2004 ) Elimination strategy by year 2004 Training , retraining of personnel. Sensitization of medical decision makers & medical personnel as well towards malaria as it doesn’t create a problem at present time. Improving surviellance system. Elimination strategy objectives To prevent reemergence of malaria transmission in the country. To control imported malaria. Elimination Strategy Activities Activities of consolidation (in areas at risk): .Case detection (active + passive ). .Vector control measures. Prevention of imported malaria . Case detection . . chemoprophylaxis. Plan of action for 2004 Objectives To strengthen and maintain the stopping of the transmission in the high risk areas. To control imported malaria. Activities and achievements Intensifying the active case detection in areas at risk . National survey for (15) selected counties for one year to be conducted before the end of june 2006, for recent epidemiological and entomological map. Tripoli AL-ATroon Shaksouk AL-Khms Derna Joush Kersa Kasr Elhaj Ras Ahlal Benghazi Tigi Taurga Drej A.Sergenti GirriatGharbia Girriat Sharkiah A.Multicolor A.Coustani Zella Medwin A.Gambiae Uenzirickr Aggar Ishkida A.Broussesi Brack Idri Berghin Guttai Ghorda Duesa A.Hispniola Deisa Techerciba Oubari Germa Sebha A.Matasi Gharagh Guddwa Ghat Traghen Zwela A.Turkhudi Serdalas Zizau EL-Berket Aggar Atabat Fongur Tmesa A.Superpictus Tessau Gawat UM EL-Hamam Mourzouk A.maculipenis Ghatroun A.Lambranchiae A.Sacharrovi A.maculipenis Activities and achievements ( Conti.. ) A represenative blood samples will be taken from population of 15 provinces including camps of immigrants from Chad, Niger, Muritania, and other African countries ,to be examined by rapid test for malaria to know the magnitude of the problem and to take action accordingly. Activities and achievements cont. Strengthening the surviellance system in all 33 provinces in the country. Training and retraining activities : I. condensed course for one week at December 2004 conducted for laboratory diagnosis of malaria for 16 lab. Technicians from 15 provinces at risk. II. condensed course for one week at December 2004 for 16 health workers who will be involved in the survey mentioned earlier . III. continuous health education . Reduced sensibility of health managers and decision makers towards malaria . Less availability of professional personnel in clinical and laboratory diagnosis of malaria apart from main hospitals in big cities . Reduced public cooperation in taking chemoprophylaxis when travelling to endemic countries. Uncontrolled movement of immigrants from endemic countries through unpatroled boarders.