Democratic Republic of Congo

Severe malaria facts

DRC has the following:

  • 2nd largest number of malaria cases and deaths globally (11% of all cases and 11% of deaths worldwide).
  • Highest number of malaria cases in Central Africa (55% of all malaria cases in Central Africa).
  • In 2016, malaria also accounted for 13% of deaths in children under 5 years of age and 19% of deaths in children aged 28 days - 12 months old.
  • The proportion of severe malaria cases reported remained around a median of 7% (range of variation: 7-9%).

From 2016 to 2017, the number of malaria cases increased by over 870,000, while the number of deaths remained fairly stable.

Inpatient deaths attributable to malaria was about 24.8% (2011 – 2014), and the case fatality rate for malaria was about 4.2 in that period.

Hospitalizations due to malaria was about 54.8% (2011 – 2014).

Inpatient and mortality rates

Severe malaria distribution

Malaria prevalence

  • Equatorial variant (forests and savannahs):  most severe cases occur in under-5s
  • Tropical variant (humid areas): more severe cases of malaria are observed up to a greater age
  • Mountainous variant (areas at an altitude of over 1,000 m): Severe cases of malaria can occur in all age brackets and as an epidemic or as acute annual outbreaks

Severe malaria policy and practice

National treatment guidelines
Recommendation Treatment
Strong Injectable artesunate
Alternative Injectable quinine
Recommendation Pre-referral
Strong Rectal artesunate
Recommendation during pregnancy
Intravenous quinine 


"In line with the WHO recommendation, injectable quinine should be replaced with injectable artesunate in the treatment of serious cases by June 2015. The systematic substitution of quinine with injectable artesunate has a significant economic impact on the budget. The transfer plan envisions a transition period of 3 years, initially defined as 2013 to 2015 in line with the NSP, but following the challenges of funding gaps and availability of pre-qualified injectable artesunate on the market, the estimated transition period is now from 2014 to 2016." - The Global Fund Concept Note