Weekly IDSR Bulletin
Epidemiological Week 42 (12th – 18th October, 2026)
Editorial Team & Contributors
I. Main Epidemiological Feature: Disease & Event Burden in Epi Week 42
Malaria Reaches 24,027 Cases with 2 Deaths as EBS Signals Rise to 50
In Epidemiological Week 42, Malaria generated 24,027 cases nationwide alongside 2 fatalities. Public health surveillance also logged 34 new Measles alerts, 974 cases of bloody diarrhoea, 100 SARI cases, 64 Typhoid cases, 56 AEFI cases, 9 Maternal deaths, 6 Meningococcal meningitis cases, and 1 Neonatal tetanus case.
Case Management & Triage: Health facilities must reinforce early severe malaria clinical protocols and ensure continuous supply of mRDTs, parenteral Artesunate, and ACTs.
Immunization Coverage: EPI teams must target persistent localized measles transmission pockets in Nsanje, Balaka, Dedza, and Chikwawa districts.
Priority Disease & Condition Alerts (Epi Week 42)
Distribution of reported priority conditions and outpatient/inpatient alerts nationwide
II. Health System Reporting Performance
1. National Reporting Trend (W28 – W42)
Analytics: National IDSR reporting recorded a slight decrease in Epidemiological Week 42, with completeness dropping from 95% to 94% and timeliness decreasing from 95% to 93% on the One Health Surveillance Platform (OHSP).
Insights: Despite minor fluctuations, both metrics remain significantly above the minimum national benchmark of 80%, demonstrating sustained resilience in weekly data collection.
Recommendations: Active supervisory tracking and system support must be maintained across all DHOs to prevent further dips and maintain target compliance.
2. Zonal Reporting Rates (Week 42)
Analytics: All health zones and Central Hospitals met or exceeded the 80% national reporting threshold. Central Hospitals and South West achieved 100% completeness and timeliness. South East logged 98% completeness and 100% timeliness, Central East scored 95% completeness and 100% timeliness, Central West achieved 91% completeness and 100% timeliness, while North achieved 82% completeness and 100% timeliness.
Insights: Timeliness reached 100% across all health zones and referral central hospitals during Week 42.
Recommendations: Focus support on Northern Zone DHOs to elevate completeness closer to the 95%+ standard achieved by neighboring zones.
III. Event-Based Surveillance (EBS)
3. Community EBS Signal Verification Status
Analytics: During Epidemiological Week 42, a total of 50 EBS signals were submitted from 10 reporting districts. Verification efforts confirmed 29 signals (58%) as true public health events, while 20 signals (40%) were unverified and 1 signal (2%) was discarded.
Insights: Signals concerning children with sudden limb weakness or fever and skin rash accounted for 18 of the 50 community signals (9 confirmed as events), indicating high alert levels for vaccine-preventable diseases.
Recommendations: District Rapid Response Teams (DRRTs) must prioritize rapid field investigations and documented risk management plans for all verified events.
4. Verified EBS Signals by Risk Level
Analytics: Comprehensive risk assessments were conducted for all 29 verified community events. Results show 5 events (17%) categorized as Very High Risk, 5 (17%) as High Risk, 8 (28%) as Moderate Risk, and 11 (38%) as Low Risk.
Insights: Over one-third (34%) of verified community events present High or Very High public health risk, requiring immediate response protocols.
Recommendations: Ensure rapid DRRT deployment to the 10 High and Very High risk event locations to mitigate community transmission risks.
IV. Epidemic Prone & Priority Conditions Performance
5. Measles Outbreak: Cumulative Cases in Key Hotspots
Analytics: In Epidemiological Week 42, 34 new epi-linked cases were recorded. Cumulative outbreak totals since early 2026 stand at Nsanje with 523 cases (84 lab-confirmed), Balaka with 494 cases (74 lab-confirmed), Chikwawa with 387 cases (38 lab-confirmed), and Dedza with 375 cases (13 lab-confirmed).
Insights: Localized measles transmission continues in catchment areas like Golomoti (Dedza), Ngabu (Chikwawa), and Ndamera (Nsanje), whereas outbreaks in several Balaka and Machinga health facilities have been contained.
Recommendations: Intensify routine childhood immunization coverage and supplementary immunization campaigns targeting susceptible children under 15 years.
6. Reporting Performance by Site (Underperforming Units)
Analytics: Out of 33 reporting sites, 30 (90%) achieved the national target of ≥80% for both completeness and timeliness. Three DHOs failed to meet target benchmarks: Machinga DHO and Karonga DHO failed timeliness targets, while Balaka DHO failed on both completeness (78%) and timeliness (78%).
Insights: Dowa DHO successfully recovered performance above the 80% threshold in Week 42, leaving Machinga, Karonga, and Balaka as key priority intervention sites.
Recommendations: Zonal epidemiology focal persons should directly assist Balaka, Karonga, and Machinga DHOs to resolve electronic reporting delays on OHSP.
V. Targeted District & Programmatic Recommendations
1. District Reporting Compliance
Karonga, Balaka, and Machinga DHOs must urgently streamline data upload workflows to ensure weekly completeness and timeliness return to the ≥80% national benchmark on OHSP.
2. Severe Malaria Management
All District Health Offices must enforce strict clinical triage and severe malaria management to prevent fatalities and maintain stock security for mRDTs, parenteral Artesunate, and ACTs.
3. Outbreak Surveillance & EPI Response
DRRTs and EPI must conduct immediate risk assessments for verified community signals and strengthen routine immunization and outreach strategies to halt localized measles transmission.
