Central African Republic

Malaria facts

The malaria prevalence rate in the Central African Republic is stable, with high transmission during the rainy season. The country is also characterized by complex emergency situations that pose epidemic risks. Anopheles gambiae is the main vector, and Plasmodium falciparum is found in 99.6 percent of cases.[1]

Malaria was the top reason for medical consultations among the general population (42.3 %) in 2016, and among internally displaced people it accounted for 47.1 % of consultations.[1] 

Between 2016 and 2019, case numbers fell slightly by 1% from 349 to 345 per 1000 of the population at risk, while deaths fell by 14% from 0.85 to 0.73 per 1000 of the population at risk.[2] The country’s complex military and political crisis however leaves it exposed to epidemics. [1, 3]

Malaria in young children

Malaria prevalence among children aged 6–59 months (using RDT testing rate as a proxy) was 73% in 2017. This rate varied, by region, however, ranging from 90% in the north and eastern regions, 70% in the western regions and 20% in the southern regions.[1]

Malaria case management and control

Artemether–lumefantrine is used for the treatment of uncomplicated malaria while injectable artesunate and IM artemether as well as injectable quinine are used for severe malaria.[1] For patients with signs of severe malaria, community health workers administered artesunate rectal capsules (ARC) before referring them to the nearest health facility.

About 60% of those at risk were protected by either indoor residual spraying (IRS) or insecticide treated nets (ITN).[1]

Health facilities

According to reports from malaria focal points, there were approximately 989 health care facilities in the Central African Republic in 2015, of which 835 were operational while 154 of these are non-operational.[1]

The country drew up a national malaria control policy in 2016, in line with the Global Technical Strategy for Malaria 2016-2030. The plan included adopting the World Health Organization’s recommendation on Intermittent preventative treatment of malaria in pregnancy (IPTp).[1]

Severe malaria policy and practice

National Treatment Guidelines
Recommendation Treatment
Strong Injectable artesunate (IV)
Alternative Injectable artemether
Alternative Injectable quinine
Recommendation Pre-Referral
Alternative Rectal artesunate
Alternative Intramuscular artesunate
Alternative Intramuscular quinine 
Alternative Rectal quinine