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Author: Moses Nyambalo Phiri

  • IDSR Epidemiological Bulletin – Week 46.

    IDSR Epidemiological Bulletin – Week 46.

    Malawi IDSR Infographic (Week 46, 2025)

    Editorial Team

    Dr. Matthews Kagoli Mrs. Mtisunge Yelewa Mr. Austin Zgambo Mr. Sikhona Chipeta Mr. James Jere Mr. Noel Khunga

    Weekly IDSR Bulletin

    Epidemiological Week 46 (10-16 November, 2025)

    Published By

    Moses Nyambalo Phiri

    Public Health Institute of Malawi

    National Surveillance Performance

    The Integrated Disease Surveillance and Response (IDSR) system continues to perform strongly. In Week 46, reporting completeness reached 94.8%. However, Central Hospitals significantly underperformed at 50%, highlighting a critical need for data integration support at tertiary facilities.

    Reporting Completeness
    94.8%
    +0.4% vs Week 45
    Reporting Timeliness
    91.9%
    -2.4% vs Week 45
    Performance Analysis The Central West zone achieved near-perfect scores (99.4% completeness), while the North Zone maintained high standards (98.0%). The drop in timeliness suggests potential logistical or connectivity challenges in specific districts that need addressing.

    Priority Disease Alerts

    Malaria remains the highest burden (20,796 cases, 16 deaths). Notably, Rabies alerts saw a significant rise to 11 suspected cases this week.

    Alert Insights Diarrhoea with blood cases slightly decreased to 1,077 but remain high. SARI cases increased to 65 with 4 deaths, reinforcing the need for respiratory surveillance. Meningitis cases also rose slightly to 7.

    Outbreak Spotlight: Mpox

    Surveillance remains active with 3 new confirmed cases and 40 suspected alerts in Week 46. The cumulative confirmed total is now 139.

    Epidemic Curve

    Trend Analysis While the major wave has subsided, the occurrence of 3 new cases indicates persistent low-level transmission. Continued vigilance and contact tracing are essential to prevent a resurgence.

    Demographic Impact

    Recovery Status 131 cases (94.2%) have successfully recovered. Currently, active management involves isolating confirmed cases to break chains of transmission.

    Outbreak Spotlight: Measles

    Measles outbreaks are evolving. While Balaka remains the epicenter, Machinga and Nsanje have seen increases in case numbers (24 and 22 respectively). Total cases: 126.

    Geographic Clusters

    Hotspots The rise in cases in Nsanje (22) and Machinga (24) signals widening local transmission in the Southern region, requiring intensified vaccination campaigns.

    Vaccination Status

    Data Gap The majority of cases still have unknown vaccination status. Strengthening routine immunization data capture is critical for outbreak analysis.

    Event-Based Surveillance (EBS)

    39 signals were reported this week. The risk profile has diversified, now identifying events classified as Very High Risk (2) and Very Low Risk (1).

    1

    Detection

    39 signals reported (Decrease from 49 in Wk 45).

    2

    Verification

    9 signals (23.1%) verified as genuine public health events.

    3

    Response

    2 Very High Risk events identified requiring urgent intervention.

    Risk Profile Breakdown

    Signal Triage 30 signals (77%) remain unclassified. The presence of “Very High” risk signals emphasizes the importance of the verification process.
    Download Official Bulletin (PDF)

    © 2025 Public Health Institute of Malawi. All Rights Reserved.

  • IDSR Epidemiological Bulletin – Week 45.

    IDSR Epidemiological Bulletin – Week 45.

    Malawi IDSR Infographic (Week 45, 2025)

    Editorial Team

    Dr. Matthews Kagoli Mrs. Mtisunge Yelewa Mr. Austin Zgambo Mr. Sikhona Chipeta Mr. James Jere Mr. Noel Khunga

    Weekly IDSR Bulletin

    Epidemiological Week 45 (November, 2025)

    Published By

    Moses Nyambalo Phiri

    Public Health Institute of Malawi

    National Surveillance Performance

    The Integrated Disease Surveillance and Response (IDSR) system serves as the backbone of Malawi’s public health security. In Week 45, the system maintained high reporting standards, ensuring timely data for rapid decision-making.

    Reporting Completeness
    94.4%
    -3.3% vs Week 44
    Reporting Timeliness
    94.3%
    +4.8% vs Week 44
    Performance Analysis The North Zone set the benchmark with 98.7% reporting rates. While the national average remains strong, targeted interventions are required for Central Hospitals, which reported at 75%, slightly below the 80% national target.

    Priority Disease Alerts

    Beyond Malaria (20,110 cases), the system actively tracked several critical conditions. Immediate investigations were launched for all alerts to prevent community spread.

    Alert Insights Bloody Diarrhoea triggered the highest volume of alerts (1,122 cases), necessitating water quality assessments. SARI (Severe Acute Respiratory Infections) showed a concerning mortality rate (6 deaths among 44 cases), highlighting the severity of current respiratory pathogens.

    Outbreak Spotlight: Mpox

    Containment efforts are showing success. Zero new confirmed cases were reported this week, though surveillance remains heightened with 25 suspected alerts investigated.

    Epidemic Curve

    Trend Analysis Transmission has significantly slowed following the peak in August/September. The flatlining curve in November indicates effective containment strategies.

    Demographic Impact

    Risk Groups The outbreak has disproportionately affected economically active groups: Business persons (25%), Students (22%), and Miners (21%).

    Outbreak Spotlight: Measles

    Active response continues for localized measles clusters. A total of 117 cases have been managed since August, with vaccination campaigns intensified in affected districts.

    Geographic Clusters

    Hotspots Balaka District accounts for >50% of all cases (62 cases), identifying it as the primary priority area for supplementary immunization activities.

    Vaccination Status

    Data Gap 75% of cases have an unknown vaccination history. This data gap is a critical challenge for verifying vaccine efficacy vs. coverage failure.

    Event-Based Surveillance (EBS)

    Community engagement has surged, with reported signals tripling from the previous week (14 to 49). This demonstrates improved sensitivity at the community level.

    1

    Detection

    49 signals reported by community members and health workers.

    2

    Verification

    11 signals (22%) verified as genuine public health events; 38 pending or discarded.

    3

    Response

    3 High Risk events triggered immediate RRT deployment. 6 Moderate, 2 Low.

    Risk Profile Breakdown

    Signal Triage The high number of “Unclassified” signals (78%) suggests a need for faster initial verification protocols to clear the backlog.
    Download Official Bulletin (PDF)

    © 2025 Public Health Institute of Malawi. All Rights Reserved.

  • Chitipa – Cohort 24 Completes Frontline Field Epidemiology Training Programme.

    Chitipa – Cohort 24 Completes Frontline Field Epidemiology Training Programme.

                PHIM News: Chitipa – Cohort 24 FETP Frontline Graduation                    
                   

    PHIM Strengthens District Health Security: Cohort 24 Completes Frontline Field Epidemiology Training Programme

           

    Lilongwe, Malawi – 7 November 2025

           

                The Public Health Institute of Malawi (PHIM) today celebrated a major milestone in strengthening national public health systems with the graduation of Cohort 24 from the Field Epidemiology Training Programme (FETP) Frontline. A total of 18 dedicated public health and allied professionals from Chitipa District successfully completed the intensive three-month, in-service training, culminating in a scientific dissemination workshop where they presented real-world findings from their field projects.        

           

                This event marks the continuous success of the FETP, a critical workforce development initiative implemented by the Ministry of Health and Population through PHIM, with foundational financial and technical support from the United States Centres for Disease Control and Prevention (CDC) and the International Training and Education Centre for Health (I-TECH). Since its adoption in 2016, the programme has been central to building a sustainable and skilled capacity for timely detection and response to health threats across the country.        

           

    The Foundation of National Health Security

           

                The FETP utilises a three-tier training approach—Basic (Frontline), Intermediate (nine months), and Advanced (two years)—to cultivate expertise at every level of Malawi’s health system. Cohort 24 focused on the Frontline tier, whose primary goal is to improve the quality of the Integrated Disease Surveillance and Response (IDSR) system and encourage the practical use of data for decision-making at the community and district levels.        

           

                The core principle of the FETP model is learning-by-doing: 80% of the course is dedicated to field work, where participants immediately apply classroom competencies—such as outbreak investigation, descriptive epidemiological analysis, surveillance system problem analysis, and scientific communication—to real public health challenges in their districts.        

           

    Chitipa Cohort Leads the Way in One Health Collaboration

           

                Cohort 24 specifically targeted staff from Chitipa District Hospital, local health facilities, and, significantly, personnel from Agriculture extension Planning areas. This integrated approach is vital to strengthening One Health collaboration, recognising that the health of humans is intimately connected to the health of animals and the environment. By training staff across sectors in Chitipa, PHIM is equipping the district with the multi-disciplinary skills needed to address emerging and complex zoonotic threats effectively at the grassroots level.        

           

    Scientific Dissemination: Field Studies Driving Policy Change

           

                The graduation ceremony was not just a formal recognition of achievement, but a crucial scientific forum. The 18 graduates presented the findings of their three-month research projects, which often lead to actionable interventions adopted by district health management teams. Health managers and heads of departments from across the country were in attendance, ensuring the immediate uptake and dissemination of these vital public health findings.        

           
    Graduation ceremony for PHIM FETP Cohort 24

    Cohort 24 graduates and mentors at the scientific dissemination workshop.

               

    Highlights from the Scientific Presentations

                            
                   
                       
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    Investigation of a Diarrhoea Cluster in Mbandira EPA

                       
                       

    Investigated an acute watery diarrhoea cluster, identifying the source and at-risk populations. Findings informed targeted WASH interventions, preventing further spread.

                   
                   
                       
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    Assessment of IDSR Data Quality for Measles in Chitipa South

                       
                       

    Conducted a data quality audit of the measles surveillance system, identifying gaps in completeness and timeliness. Recommendations improved reporting procedures and early warning sensitivity.

                   
                   
                       
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    Analysis of Malaria Case Trends in Agricultural Extension Planning Areas (EPA)

                       
                       

    Analyzed five years of malaria incidence data in key EPAs, identifying seasonal and geographic hotspots. The analysis guided targeted resource allocation for ITN distribution and larviciding.

                   
                   
                       
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    Evaluation of Routine Immunization Coverage in Rural Health Facilities

                       
                       

    Assessed routine immunization coverage for children under two in underserved areas. The study identified access barriers, leading to the implementation of a mobile outreach clinic schedule.

                   
                                    
                       
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    Evaluation of Tuberculosis Case Reporting Timeliness

                       
                       

    Assessed timeliness of Tuberculosis case reporting from diagnosis to national system entry. Recommended digital tools to expedite case notification and improve control measures.

                   
                   
                       
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    Rabies Post-Exposure Prophylaxis (PEP) Availability Audit

                       
                       

    Audited Rabies Post-Exposure Prophylaxis (PEP) availability and stock management at district health facilities. Findings ensure district readiness for animal bite incidents, reinforcing One Health collaboration.

                   
               
           
           

    Capacity Building: The Core Objectives Achieved 

           

                The graduation is a tangible demonstration of PHIM’s commitment to achieving the core objectives of the Frontline FETP, which include:        

           
                 
    • Improved Data Use: Increased appreciation among public health workers for the role of data in monitoring community health and informing decisions.
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    • Enhanced Surveillance: Improved quality and use of surveillance data for disease and outbreak detection, strengthening the link between field epidemiology and laboratory services.
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    • Rapid Response: Improved capacity to investigate and respond to public health events of importance, ensuring that local outbreaks are detected and prevented from spreading within and outside the country.
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    Partner Acknowledgements

           

                The continued success of the Field Epidemiology Training Programme is made possible through the robust and sustained partnership between PHIM, the Ministry of Health, and our key technical and financial partners. We extend our sincere gratitude to:        

           
               
                    CDC Logo            
               
                    I-TECH Logo            
           
           
           

                PHIM extends its heartfelt congratulations to the 18 graduates of Cohort 24 and looks forward to their continued service as frontline defenders of public health in Malawi.