Mozambique

Malaria is endemic in Mozambique and the entire population is at risk of contracting the disease. Pregnant women and children under the age of five have the greatest risk of developing severe malaria. Plasmodium falciparum accounts for 90% of all malaria infections, while P. malariae accounts for 9% and P. ovale for 1%. [1] 

Mozambique is among the four countries that accounted for the highest rates of malaria cases and deaths worldwide (4.2% of global cases and 3.8% of global deaths in 2020). [2] The country has the second highest prevalence of malaria in Eastern and Southern Africa (17.9% in 2020), and is one of the five countries with the highest levels of severe anaemia among children under five years of age. [2] 

Between 2017 and 2020, cases fell slightly by 2% from 328 to 320 per 1000 of the population at risk, while deaths remained at 0.76 per 1000 of the population at risk. [2] In 2015, malaria was responsible for 45% of outpatient visits and 56% of paediatric admissions. [4] Malaria caused 29% of all hospital deaths among the general population and 42% of deaths in children under five years of age. [4] Malaria prevalence among children aged 6 to 59 months remained stable from 2011 to 2018 at around 40 percent, but the prevalence of low hemoglobin in the same ages increased from 9 percent in 2011 to 14 percent in 2018.  

Data from the 2018 Malaria Indicator Survey (MIS) showed that malaria prevalence varies across the country. Prevalence is higher in the Northern and Central regions (ranging from 29 percent in Sofala to 57 percent in Cabo Delgado) and lower in the Southern region (ranging from 1 percent in Maputo city to 35 percent in Inhambane).[1] 

Between 2015 and 2018, the proportion of the population that slept under an insecticide-treated net (ITN) the previous night increased from 45% to 68%. In the same period, the proportion of children under five years of age who slept under an ITN the previous night increased from 48% to 73%, and the proportion of pregnant women who slept under an ITN the previous night increased from 52% to 76%.[1] 

Case management 

Injectable artesunate is used as treatment for severe malaria in all groups; rectal artesunate is used as a pre-referral intervention at the community level among children under six years of age.[1] 

Malaria in pregnancy 

Mozambique has been implementing the WHO updated guidelines on intermittent preventative treatment (IPTp) since 2014. These recommend administering IPTp as early as possible starting in the second trimester (13 weeks) and at each scheduled ANC visit until the time of delivery, as long as there has been an interval of at least one month since the last dose of sulfadoxine-pyrimethamine (SP).[1] 

The proportion of pregnant women who received two or more doses of IPTp (IPTp2) increased from 35% in 2015 to 61% in 2018. [1] The proportion of pregnant women who received three or more doses of IPTp (IPTp3) increased from 23% to 41% over the same period. [1]