Angola

Severe malaria facts

Malaria is responsible for 35% of mortality in children, 9% of post-neonatal mortality, and 25% of maternal morbidity*

Malaria causes 60% of hospital admissions in children under 5 years of age, and 10% of admissions of pregnant women.*

Mortality rate in children <5 years decreased by 25% between 2011 and 2016 (currently 68 deaths/1,000 live births)*

Inpatient malaria deaths increased from 2015: 8,581 to 2016: 15,997 based on Key Survey-Based Malaria Indicator

*National Health Development Plan (PNDS 2013), Annex 4

 


In country management of severe malaria

There is a newly developed policy for use of community health workers managed jointly with the Ministry of Territorial Administration (Annex 32 – Agentes de Desenvolvimento Comunitário e Sanitário (ADECOs) policy), community health initiatives will start to be implemented (as soon as the decree is passed) to extend and expand access to health prevention and curative services to especially hard-to-reach and underserved communities.

Integrated management of childhood illnesses (IMCI) is progressively being introduced at health facility level and scaling up of activities is still expected in all provinces.

In 2018, the Ministry of Health agreed to introduce integrated community case management for common childhood illnesses (malaria, pneumonia and diarrhoea).

Challenges in addressing severe malaria

Unequal investment in infrastructure leaving many communities isolated and/or hard to reach;

Insufficient human resources;

Asymmetric distribution of human resources between urban and rural areas;

Variable levels of investments in community health workers;

Logistics challenges impeding the sustainable supply of drugs to public health facilities;

The storage conditions of pharmaceutical products are sub-optimal in most of the municipal and health facility warehouses and lack skilled human resources to manage and appropriately use these commodities;

Gaps in stakeholder coordination, including municipalities that have their own budget to buy medicines and lack guidance from the central level.

In-patient malaria cases and deaths

Malaria distribution

Severe malaria policy and practice

National treatment guidelines
Recommendation Treatment
Strong Injectable artesunate (IV or IM)
Alternative Intramuscular artemether
Alternative Injectable quinine

*Since artesunate and artemether are often not available, injectable quinine continues to be the most commonly used treatment for severe malaria nationwide. 

Recommendation Pre-Referral
Alternative Rectal artesunate
Alternative Intramuscular artesunate
Alternative Intramuscular artemether
Alternative Intramuscular quinine

* A broad spectrum antibiotic should also be associated