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IDSR Epidemiological Bulletin – Week 43.

IDSR Bulletin Dashboard – Week 43, 2026

Weekly IDSR Bulletin

Epidemiological Week 43 (19th – 25th October, 2026)

Status: Official Release Reporting Rate: 97% Completeness Published: 26th October 2026

Editorial Team & Contributors

Dr. Matthew Kagoli
Mrs. Flora Dimba
Austin Zgambo
Noel Khunga
James Jere
Sikhona Chipeta
Henderson Parker Banda
Mercy Mwalwanda
MALARIA CASES
23,292
2 Inpatient Fatalities
COMPLETENESS
97.0%
Target ≥ 80% (+3% Rise)
TIMELINESS
95.0%
Target ≥ 80% (+2% Rise)
BLOODY DIARRHOEA
1,025
0 Deaths
MEASLES ALERTS
36
30 Epi-Linked Cases
EBS SIGNALS
98
48 Verified Events

I. Main Epidemiological Feature: Disease & Event Burden in Epi Week 43

National Feature Epi Week 43 Summary

Reporting Completeness Surges to 97% as EBS Signals Nearly Double to 98

In Epidemiological Week 43, Malaria recorded 23,292 cases nationwide with 2 deaths. Public health surveillance also registered 36 new Measles alerts (30 epi-linked), 1,025 cases of bloody diarrhoea, 156 Typhoid fever cases (1 death), 76 AEFI cases, 53 SARI cases, 7 Maternal deaths, 6 Meningococcal meningitis cases, and 2 AFP cases.

• Malaria Burden: Total reported cases stood at 23,292 with clinical outcomes resulting in 2 fatalities in Salima DHO and Mangochi DHO.
• Measles & Vaccine-Preventable Diseases: 36 new alerts reported with 30 epi-linked cases. Nsanje has reached 529 cumulative cases and Balaka 494 cases since early 2026.
• Enteric & Respiratory Burden: Typhoid fever increased to 156 cases (1 death in Mchinji DHO), while Bloody Diarrhoea rose to 1,025 cases across reporting centers.
Strategic Action Directives

Enteric Disease Control: Strengthen WASH measures and clinical case management for Typhoid and Bloody Diarrhoea hotspots in Mchinji and surrounding districts.

Signal Verification & Outbreak Control: DRRTs must urgently investigate and verify community signals, while EPI teams accelerate targeted measles vaccination outreach in Nsanje, Balaka, and Chikwawa.

Priority Disease & Condition Alerts (Epi Week 43)

Distribution of reported priority conditions and outpatient/inpatient alerts nationwide

Highest Alert Volume Bloody Diarrhoea (1,025)
Vaccine Alerts AEFI (76) / Measles (36)
Severe Fatalities Maternal (7) / Malaria (2) / Typhoid (1)

II. Health System Reporting Performance

1. National Reporting Trend (W28 – W43)

Analysis & Insights

Analytics: National IDSR reporting performance rebounded sharply in Epidemiological Week 43, with completeness increasing from 94% to 97% and timeliness advancing from 93% to 95% on the One Health Surveillance Platform (OHSP).

Insights: This performance improvement underscores robust health facility compliance nationwide and successful routine supervisory follow-up across reporting sites.

Recommendations: Maintain active platform support to solidify performance gains well above the 80% national minimum target.

2. Zonal Reporting Rates (Week 43)

Analysis & Insights

Analytics: All health zones and Central Hospitals exceeded the 80% national target. Central Hospitals achieved 100% on both metrics. Central East, South East, and South West scored 98% completeness with timeliness between 96%-98%. North achieved 93% completeness and 93% timeliness, while Central West logged 91% completeness and 90% timeliness.

Insights: Performance across all 6 reporting zones remains remarkably uniform and above key surveillance benchmarks.

Recommendations: Focus targeted follow-ups on specific underperforming district sites within North and Central West zones.

III. Event-Based Surveillance (EBS)

3. Community EBS Signal Verification Status

Analysis & Insights

Analytics: In Epidemiological Week 43, 98 community signals were reported across 6 districts. Verification confirmed 48 signals (49%) as true public health events, 49 signals (50%) were unverified, and 1 signal (1%) was discarded.

Insights: Clustered illness symptoms and severe watery diarrhoea with dehydration made up the vast majority of community reports (63 of 98 signals).

Recommendations: District Rapid Response Teams (DRRTs) must prioritize unverified signals in high-density districts to ensure zero undetected outbreaks.

4. Verified EBS Signals by Risk Level

Analysis & Insights

Analytics: Formal risk assessments were conducted for 46 of the 48 verified community events. Results show 27 events (59%) classified as High Risk, 10 (22%) as Very High Risk, 4 (8%) as Moderate Risk, and 5 (11%) as Low Risk.

Insights: An overwhelming 81% of assessed events were categorized as High or Very High Risk, pointing to substantial public health threats in reporting communities.

Recommendations: Deploy emergency response teams immediately to all High and Very High risk event locations.

IV. Epidemic Prone & Priority Conditions Performance

5. Measles Outbreak: Cumulative Cases in Key Hotspots

Analysis & Insights

Analytics: In Epidemiological Week 43, 30 new epi-linked cases were reported from Dedza, Balaka, Chikwawa, and Mulanje. Cumulative outbreak totals show Nsanje with 529 cases (84 lab-confirmed), Balaka with 494 cases (74 lab-confirmed), Chikwawa with 387 cases (38 lab-confirmed), and Dedza with 378 cases (13 lab-confirmed).

Insights: While transmission in several health facility catchments has been declared contained after 42 days of zero cases, active clusters persist in Golomoti, Ngabu, and Ndamera.

Recommendations: EPI teams must sustain high-coverage routine immunization catch-up activities and field investigations in active hotspot catchments.

6. Reporting Performance by Site (Underperforming Units)

Analysis & Insights

Analytics: Out of 33 reporting sites, 30 (90%) reached the national ≥80% benchmark for completeness and timeliness. Three DHOs failed to meet targets: Likoma DHO (77% completeness, 71% timeliness), Karonga DHO (83% completeness, 70% timeliness), and Mulanje DHO (77% completeness, 77% timeliness).

Insights: Balaka DHO successfully recovered compliance to 100% in Week 43, while Likoma, Karonga, and Mulanje experienced data submission lags.

Recommendations: Zonal epidemiology focal points must directly mentor data entry teams in Likoma, Karonga, and Mulanje to resolve OHSP uploading issues.

V. Targeted District & Programmatic Recommendations

1. District Reporting Compliance

Likoma, Karonga, and Mulanje DHOs must immediately resolve internal data upload backlogs to restore weekly reporting timeliness and completeness to the ≥80% national benchmark on OHSP.

2. Enteric & Malaria Case Management

All District Health Offices must enforce strict clinical protocols for severe malaria and enteric fevers (Typhoid/Bloody Diarrhoea) while maintaining adequate stocks of mRDTs, parenteral Artesunate, and IV fluids.

3. Outbreak Surveillance & EPI Response

DRRTs and EPI must conduct rapid field risk assessments for the 48 verified community signals and intensify routine childhood immunization catch-up campaigns in persistent measles transmission zones.

Official IDSR Documentation

Access the full official PDF bulletin for Epidemiological Week 43, 2026, including detailed district-level performance tables and annexes.

PUBLISHED BY

Moses Nyambalo Phiri

Ministry of Health, Lilongwe, Malawi

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