Weekly IDSR Bulletin
Epidemiological Week 43 (19th – 25th October, 2026)
Editorial Team & Contributors
I. Main Epidemiological Feature: Disease & Event Burden in Epi Week 43
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.
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
II. Health System Reporting Performance
1. National Reporting Trend (W28 – W43)
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)
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
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
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
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)
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.