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Author: Moses Nyambalo Phiri

  • IDSR Epidemiological Bulletin – Week 39.

    IDSR Epidemiological Bulletin – Week 39.

    IDSR Bulletin Dashboard – Week 39, 2026

    Weekly IDSR Bulletin

    Epidemiological Week 39 (21st – 27th September, 2026)

    Status: Official Release Malaria High Burden Alert Published: 2nd October 2026

    Editorial Team & Contributors

    Dr. Matthew Kagoli
    Mrs. Flora Dimba
    Joseph Bitilinyu-Bango
    Wiseman Chimwaza
    Austin Zgambo
    Noel Khunga
    MALARIA CASES
    22,871
    22.5k OPD | 349 IPD | 2 Deaths
    COMPLETENESS
    90.0%
    Target ≥ 80%
    TIMELINESS
    90.0%
    Target ≥ 80%
    BLOODY DIARRHOEA
    859
    0 Deaths
    MEASLES (WK39)
    113
    Localized Outbreaks
    EBS SIGNALS
    35
    13 Verified Events

    I. Main Epidemiological Feature: Malaria Disease Burden in Epi Week 39

    National Feature Epi Week 39 Summary

    Malaria Dominates Outpatient Burden with 22,871 Reported Cases

    During Epidemiological Week 39, Malaria represented the single largest contributor to morbidity across health facilities in Malawi, recording 22,871 cases nationwide. Outpatient consultations (OPD) accounted for 22,522 cases, while 349 severe cases required inpatient admission (IPD).

    • Total Fatalities: 2 inpatient malaria deaths were officially reported in Week 39 (1 death in Salima DHO and 1 death in another health facility).
    • High Burden Zones: Southern lower shire districts (Blantyre, Chikwawa, Mulanje, Mwanza, Neno) and lake-shore districts (Mangochi, Nkhata-Bay, Salima, Nkhotakota) accounted for over 65% of the total national caseload.
    • Inpatient Severity Highlight: Neno DHO recorded an exceptionally high ratio of inpatient admissions (83 severe cases out of 825 total reported cases), signaling potential delays in seeking care or high clinical severity.
    Strategic Action Directives

    Vector Control & Indoor Residual Spraying (IRS): High-density transmission districts (Blantyre, Mangochi, Chikwawa, Nkhata-Bay) must accelerate vector control readiness and long-lasting insecticidal net (LLIN) continuous distribution ahead of the seasonal rainfall increase.

    Community Case Management (mCCM): Health Facility Focal Persons and Health Surveillance Assistants (HSAs) must ensure unbroken stock of Rapid Diagnostic Tests (mRDTs) and Artemisinin-based Combination Therapies (ACTs) at village clinic levels to prevent outpatient cases from deteriorating into severe, fatal malaria.

    Top 10 High-Burden Malaria Districts (Epi Week 39)

    Comparing Outpatient (OPD) and Inpatient (IPD) Cases across District Health Offices

    Top District (OPD) Blantyre (4,063)
    Highest IP Burden Neno DHO (83 IP)
    Inpatient Deaths 2 Deaths (Salima/IPD)

    II. Health System Reporting Performance

    1. National Reporting Trend (W28 – W39)

    Analysis & Insights

    Analytics: This chart illustrates the national IDSR reporting completeness and timeliness trajectory from Epidemiological Week 28 through Week 39. A noticeable decline occurred in the current reporting cycle, with completeness dropping from 95% in Week 38 down to 90%. Timeliness also saw a parallel drop to 90%, though both metrics still hover safely above the 80% national minimum target.

    Insights: The concurrent dip in both completeness and timeliness indicates a systemic, albeit likely temporary, disruption in data submission at the health facility level. This decline interrupts a previously steady streak of high performance (regularly hitting 97-98%).

    Recommendations: IDSR Coordinators and Zonal Epidemiology Officers must ensure timely verification and validation of data immediately after health facility focal persons or data clerks enter it into the OHSP. Targeted follow-ups are required to reverse this declining trend.

    2. Zonal Reporting Rates (Week 39)

    Analysis & Insights

    Analytics: The bar chart breaks down the reporting rates across the major health zones, including Central Hospitals. Most zones achieved exceptional rates, with Central East, Central West, North, South East, and South West easily surpassing the 80% threshold. However, Central Hospitals struggled specifically with timeliness, recording a low 75%, despite achieving 100% completeness.

    Insights: The delay within Central Hospitals suggests structural workflow bottlenecks. While the data is eventually being compiled (100% completeness), the administrative burden, high patient volumes, or slow internal data collation processes are causing critical delays in submission to the national platform.

    Recommendations: Direct administrative intervention is required at Central Hospitals (particularly Mzuzu CH) to streamline their reporting pipelines. Dedicating specific personnel solely to timely IDSR data entry, rather than combining it with general clinical duties, may alleviate this lag.

    III. Event-Based Surveillance (EBS)

    3. Community EBS Signal Verification Status

    Analysis & Insights

    Analytics: During Week 39, the community surveillance network reported 35 Event-Based Surveillance (EBS) signals across 7 districts. Following investigation, 13 signals (37.1%) were verified as true public health events, 21 signals (60%) could not be verified, and 1 signal (2.8%) was discarded.

    Insights: A 60% non-verification rate points to a high volume of “noise” within the community reporting system this week. While a sensitive system is preferred over a restrictive one, investigating unverified signals heavily consumes the time and resources of District Rapid Response Teams (DRRTs).

    Recommendations: Community health workers and informants require clearer guidelines and refined case definitions to improve the accuracy of their initial alerts. DRRTs must continue to conduct swift risk assessments for all verified signals without delay to ensure localized events do not escalate.

    4. Verified EBS Signals by Risk Level

    Analysis & Insights

    Analytics: Risk assessments were conducted for the 13 successfully verified events. The distribution reveals that 4 events (31%) were classified as High Risk, 5 events (38%) as Moderate Risk, and 4 events (31%) as Low Risk.

    Insights: Having nearly a third (31%) of verified events classified as High Risk is a significant concern, requiring immediate public health mobilization. The prominent categories of alerts included sudden weakness of limbs (AFP alerts) and unexplained bleeding, which historically trigger elevated risk protocols.

    Recommendations: DRRTs must prioritize the immediate deployment of field epidemiologists to the 4 high-risk event sites. Continuous monitoring of the moderate-risk events is also necessary to ensure they do not escalate into wider outbreaks.

    IV. Epidemic Prone & Priority Diseases

    5. Priority Notifiable Conditions Case Distribution

    Analysis & Insights

    Analytics: Excluding Malaria (which dominates total overall volume with 22,871 cases), diarrhoea with blood accounted for the highest priority epidemic alert with 859 cases. This was followed by suspected Measles (113 cases), Adverse Events Following Immunization (AEFI – 99 cases), Typhoid fever (95 cases), Severe Acute Respiratory Infections (SARI – 63 cases, with 3 deaths), and Meningococcal meningitis (5 cases).

    Insights: The escalating burden of bloody diarrhoea (859 cases) combined with Typhoid fever points toward severe environmental health failures, likely linked to compromised water sources or deteriorating sanitation ahead of the rainy season.

    Recommendations: Mchinji, Lilongwe, and Blantyre DHOs must launch targeted, aggressive interventions against Typhoid and enteric diseases. This should include immediate community water testing, robust WASH campaigns, and the distribution of water treatment supplies in heavily affected catchments.

    6. Measles Outbreak: Cumulative Cases by District

    Analysis & Insights

    Analytics: Localized measles outbreaks continue across several districts in 2026. Nsanje leads with 499 cumulative cases, closely followed by Balaka (494), Chikwawa (387), Dedza (375), and Mulanje (67). Over 85% of confirmed cases have occurred in children under 15 years old.

    Insights: Over 70% of these cases are among individuals who are unvaccinated or have an unknown vaccination status. The persistent outbreaks in places like Nsanje, Balaka, and Dedza highlight deep-rooted immunity gaps and an accumulation of susceptible pediatric cohorts that routine systems have failed to capture.

    Recommendations: The Expanded Programme on Immunisation (EPI) must strengthen routine immunization coverage and adapt outreach strategies to immediately close immunity gaps. Active case searching must continue in localized hotspot catchment areas like Ngabu, Ndamera, and Kalembo.

    V. Special Interventions & Performance Bottlenecks

    7. Polio Vaccination Campaign Coverage

    Analysis & Insights

    Analytics: Following the detection of cVDPV2, Malawi has executed intensive nOPV2 vaccination rounds. Round 1 achieved 103% coverage (6.22M vaccinated); Round 2 hit 106% (6.63M); Round 3 reached 105% (7.06M); and the recent Round 4 (August 11-14) achieved 103% (7.29M vaccinated).

    Insights: Consistently surpassing 100% administrative coverage proves the campaigns are successfully capturing highly transient populations, cross-border children, and unregistered demographics. This aggressive saturation strategy is vital to eradicating circulating vaccine-derived poliovirus type 2.

    Recommendations: Advocacy and coordination with MoH leadership and partners must continue as the National Emergency Operations Centre (EOC) transitions from emergency campaign mode to strengthening highly sensitive Acute Flaccid Paralysis (AFP) surveillance nationwide.

    8. Underperforming Reporting Units (Week 39)

    Analysis & Insights

    Analytics: While the national average dropped to 90% for both completeness and timeliness, specific districts performed exceptionally poorly. Karonga DHO managed only 67% on both metrics. Likoma DHO fell to critical levels with 39% completeness and 33% timeliness. Mzuzu Central Hospital registered 0% for timeliness.

    Insights: The severe collapse in reporting from Likoma and Mzuzu Central Hospital indicates total hardware/connectivity failure, or a complete absence of personnel assigned to OHSP data entry during Week 39. These specific failures heavily skewed the national average downward.

    Recommendations: Karonga, Likoma, Zomba DHO, and Mzuzu Central Hospital must immediately improve on both the timeliness and completeness of their reports. Zonal supervisors should initiate direct contact with these facilities to resolve connectivity or staffing bottlenecks.

    VI. Targeted District & Programmatic Recommendations

    1. Malaria Vector Control & mCCM

    Blantyre, Mangochi, Chikwawa, Nkhata-Bay, and Neno DHOs must reinforce vector control measures, ensure unbroken supply chains for mRDTs and AL/ACT drugs, and intensify village clinic screening to mitigate inpatient severe malaria transitions.

    2. Enteric Disease & WASH Response

    Mchinji, Lilongwe, and Blantyre DHOs are directed to launch aggressive, targeted WASH interventions against the rising tide of Typhoid and bloody diarrhoea. This must include immediate community water source testing and strict sanitation enforcement.

    3. Immunization & Outbreak Control

    All DRRTs must eliminate delays in conducting field risk assessments for verified community signals. The Expanded Programme on Immunisation (EPI) must drastically strengthen routine immunization coverage to close pediatric immunity gaps driving Measles outbreaks.

    Official IDSR Documentation

    Access the full official PDF bulletin for Epidemiological Week 39, 2026, including detailed district-level performance tables and annexes.

    PUBLISHED BY

    Moses Nyambalo Phiri

    Ministry of Health, Lilongwe, Malawi

  • Malawi Port of Entry (PoE) Self-Screening Process.

    Malawi Port of Entry (PoE) Self-Screening Process.

    Malawi Port of Entry (PoE) Self-Screening Process

    A streamlined digital health check for all arriving travellers.

    Kamuzu International Airport, Lilongwe, Malawi
    Featured Port of Entry
    Kamuzu International Airport (KIA) — Lilongwe, Malawi

    To ensure a smooth and safe arrival, Malawi has implemented a streamlined digital health declaration system. Please follow the steps below to complete your health check before arriving at the Port of Entry.

    Phase 1: Complete the Health Declaration

    1 Open the Form

    Visit the official self-screening address on a connected device. Official Portal: https://mwpoehealth.ecsahc.com/self-screen

    2 Enter Trip Details

    Select your point of entry, arrival date, route, and recent travel history.

    3 Enter Your Details

    Use your travel document name (Passport or ID) and provide reachable contact details.

    4 Answer Health Questions

    Accurately declare any symptoms you have today and any relevant recent exposures.

    Phase 2: Generate and Scan the QR Pass

    5 Review and Submit

    Check your entries, provide consent, complete the human check verification, and then submit.

    6 Save the QR Pass

    The completion screen generates a QR code and a reference number; ensure you save this image.

    7 Show the Pass

    Present the saved QR image to the Port Health Officer upon your arrival.

    8 Officer Screens

    The officer scans your QR pass to retrieve answers and complete primary or secondary screening. If scanning fails, present your reference number. If you do not have a pass, the officer will screen you directly at the post.

    Note for Travellers: For a complete visual guide of the mobile interface and screening flows, please refer to the official institutional guide:
    Access the Self-Screening Portal

    Authored & Published By

    Moses Nyambalo Phiri

    Public Health Institute of Malawi

    Ministry of Health.

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  • Malawi Strengthens Early Warning System by Pairing EIOS Refresher Training with Community Health Hotline.

    Malawi Strengthens Early Warning System by Pairing EIOS Refresher Training with Community Health Hotline.

    Malawi Strengthens Early Warning System by Pairing EIOS Refresher Training with Community Health Hotline | PHIM
    25 September 2026 4 min read Lilongwe
    PHIM EIOS Refresher and CCPP Hotline Training Workshop in Lilongwe
    Workshop Feature
    Participants during the EIOS and CCPP Hotline Event-Based Surveillance Training in Lilongwe. Photo: Moses Nyambalo Phiri

    To significantly enhance the country’s capacity to detect and respond to emerging public health threats before they escalate, the Public Health Institute of Malawi (PHIM) conducted a comprehensive five-day training workshop from 21 to 25 September 2026 at the Lifestyle Boutique – Lilongwe Hotel.

    The initiative uniquely combined a refresher course in Epidemic Intelligence from Open Sources (EIOS) for public health surveillance officers with specialized Event-Based Surveillance (EBS) capacity building for staff operating the national Chipatala Cha Pa Phone (CCPP) health hotline.

    Why Early Warning Matters

    Epidemic Intelligence from Open Sources (EIOS) is a web-based, state-of-the-art platform supported by the World Health Organization (WHO) and international health partners. It enables public health teams to systematically scan formal news outlets, social networks, blogs, and digital media to pick up early signals of potential disease outbreaks and biological risks—often well before traditional clinical reporting systems capture them.

    EIOS serves as a critical pillar within Malawi’s Integrated Disease Surveillance and Response (IDSR) framework. However, maintaining high-level surveillance capabilities requires routine practice and continuous skill reinforcement.

    Aligning with Global Best Practice

    Skills naturally fade without continuous practice. Malawi’s refresher training mirrors global best practices where nations periodically consolidate EIOS capabilities. For example, Sri Lanka’s 2026 EIOS training built upon its foundational 2023 course to establish a dedicated EBS core team and refine standard operating procedures for signal triage, verification, documentation, and reporting.

    Two Components, One Integrated System

    The five-day intensive workshop brought together approximately 40 key stakeholders and was structured into two distinct but complementary phases:

    1 Days 1–3: EIOS Refresher for Officers

    PHIM surveillance officers engaged in real-time simulated health events and hands-on exercises to master the full signal management pathway:

    • Identification & Screening of mass web data
    • Assessment & Verification with local context
    • Analysis of public health risk severity
    • Documentation & Escalation to decision-makers
    2 Days 4–5: EBS for CCPP Hotline Staff
    Chipatala Cha Pa Phone Hotline EBS Training Session

    Community members are often the first to observe unusual illness clusters or animal deaths. Chipatala Cha Pa Phone operators were trained to:

    • Recognize predefined EBS signals during routine calls
    • Capture core epidemiological details accurately
    • Escalate threats promptly to district & national focal points
    • Log actionable signals separately from routine inquiries

    Building on Existing National Infrastructure

    A key principle of this initiative is sustainability. Rather than creating redundant or parallel reporting channels, PHIM is strategically integrating the established Chipatala Cha Pa Phone (929) hotline into Malawi’s formal Event-Based Surveillance architecture.

    This linkage broadens the nation’s early warning inputs, dramatically accelerates threat detection and response times, and directly supports Malawi’s international commitments under the International Health Regulations (IHR 2005).

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    Official Documentation

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    Authored & Published By

    Moses Nyambalo Phiri

    Public Health Institute of Malawi

    Ministry of Health, Republic of Malawi