Analytics: National IDSR reporting demonstrated a significant recovery in Epidemiological Week 40. Both completeness and timeliness rebounded sharply from 90% in Week 39 back to 95%, maintaining performance well above the 80% national threshold.

Insights: The quick restoration of reporting rates highlights successful follow-up interventions by zonal epidemiologists and IDSR coordinators following the dip in Week 39.

Recommendations: Maintain robust data validation pipelines on the One Health Surveillance Platform (OHSP) to ensure sustained timeliness and data quality.

Analytics: All health zones, as well as Central Hospitals, successfully met or exceeded the 80% target. Central Hospitals and South West Zone achieved 100% on both completeness and timeliness. Central West achieved 96%, North 95%, South East 94%, and Central East 88%.

Insights: Central Hospitals recorded a full recovery in timeliness (reaching 100% up from 75% in Week 39), resolving the bottleneck previously noted in referral tertiary centers.

Recommendations: Provide targeted supervisory support to Central East zone to elevate its reporting rates closer to the >95% benchmark achieved by other zones.

Analytics: In Week 40, 39 EBS signals were submitted from 9 reporting districts. Following verification by District Rapid Response Teams (DRRTs), 12 signals (31%) were confirmed as true public health events, 25 signals (64%) were unverified, and 2 signals (5%) were discarded.

Insights: Signals related to sudden limb weakness/fever with rash represented the majority of community alerts (26 total signals reported), reflecting high community awareness regarding polio and measles surveillance.

Recommendations: DRRTs should ensure timely, documented risk assessments for all verified events and continue refining signal triggers with community health workers.

Analytics: Risk assessments were conducted for 11 of the 12 verified events. The findings indicate that 5 events (46%) were classified as High Risk, 2 (18%) as Moderate Risk, 2 (18%) as Low Risk, and 2 (18%) as Very Low Risk.

Insights: The high proportion of High Risk events (46%) underscores active public health threats across districts, requiring immediate field investigations and response interventions.

Recommendations: Priority rapid response deployment must be maintained for the 5 high-risk event sites to prevent further disease transmission.

Analytics: Diarrhoea with blood generated the highest alert volume among epidemic-prone diseases (752 cases, 0 deaths). SARI followed with 143 cases and 1 death. Typhoid fever recorded 90 cases (50 in Mchinji, 15 in Blantyre, 10 in Lilongwe), AEFI registered 82 cases, Measles alerts recorded 48 cases, Meningococcal meningitis 6 cases (1 death in Nsanje), Maternal deaths 5 cases, and AFP 1 case.

Insights: Typhoid fever cases remain concentrated in Mchinji DHO (50 cases) and Blantyre DHO (15 cases). Severe Acute Respiratory Infections (SARI) recorded 1 death at Kamuzu Central Hospital.

Recommendations: Intensify water quality testing and sanitation control measures in Mchinji, Lilongwe, and Blantyre. Maintain active case searching for respiratory and meningeal signs in referral centers.

Analytics: In Week 40, 18 new confirmed cases were reported (3 lab-confirmed in Zomba, 15 epi-linked in Nsanje). Cumulatively, Nsanje leads with 514 cases, Balaka 494 cases, Chikwawa 387 cases, Dedza 375 cases, Mulanje 67 cases, Zomba 26 cases, Mchinji 14 cases, and Machinga 3 cases.

Insights: Over 70% of confirmed cases occur in unvaccinated individuals or those with unknown vaccination status, and >85% are under 15 years of age. Outbreaks in Balaka, Machinga, and parts of Nsanje have been contained (no new cases >42 days), while active transmission persists in Golomoti (Dedza), Ngabu (Chikwawa), Ndamera (Nsanje), Mbiza/Mulanje DH (Mulanje), and Matawale (Zomba).

Recommendations: EPI must strengthen routine childhood immunization outreach in active hotspot catchment areas to close identified immunity gaps.

Analytics: Cumulative coverage figures across the 5 executed nOPV2 rounds highlight sustained high performance: Round 0 (1.71M doses administered), Round 1 (103% – 6.22M), Round 2 (106% – 6.64M), Round 3 (105% – 7.07M), and Round 4 (103% – 7.29M).

Insights: A total of 18 variant polioviruses (plus 1 imported case from Mozambique) have been isolated since the January 2026 outbreak declaration. Environmental surveillance remains active in Blantyre and surrounding sites.

Recommendations: Maintain heightened AFP surveillance sensitivity across all health facilities and border entry points.

Analytics: Out of 33 reporting sites, 30 (91%) met the ≥80% national target. Only 3 reporting sites failed to meet the target for both completeness and timeliness: Balaka DHO (67%), Dowa DHO (73%), and Machinga DHO (78%).

Insights: Likoma DHO, Karonga DHO, and Mzuzu Central Hospital—which were underperforming in Week 39—successfully rebounded to meet and exceed national benchmarks in Week 40.

Recommendations: Zonal Epidemiology Officers should engage Balaka, Dowa, and Machinga DHOs to resolve data reporting delays and ensure full compliance on OHSP.

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.

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.

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.

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.

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.

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.

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.

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.