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  • IDSR Epidemiological Bulletin – Week 32.

    IDSR Epidemiological Bulletin – Week 32.

    IDSR Bulletin Dashboard – Week 32, 2026

    Weekly IDSR Bulletin

    Epidemiological Week 32 (3-9 August, 2026)

    Status: Official Release Published: 14 August 2026

    Editorial Team

    Dr. Matthew Kagoli
    Mrs. Flora Dimba
    Wiseman Chimwaza
    Mr. Austin Zgambo
    Mr. Noel Khunga
    Mr. James Jere
    COMPLETENESS
    98.0%
    TIMELINESS
    97.0%
    BLOODY DIARRHOEA
    577
    EBS SIGNALS
    77
    MEASLES (WK32)
    104
    MPOX (CUMULATIVE)
    158

    I. Health System Reporting Performance

    1. National Reporting Trend (W21 – W32)

    Analysis & Insights

    Analytics: This chart illustrates the national IDSR reporting completeness and timeliness trajectory from Epidemiological Week 21 through Week 32. In the current reporting cycle, completeness remained exceptionally high at 98.0%, holding steady from the previous week. Simultaneously, timeliness experienced a positive upward shift, ascending from 93.0% in Week 31 to 97.0% in Week 32, well above the 80% minimum threshold.

    Insights: The sustained high levels of reporting completeness coupled with the sharp improvement in timeliness indicate a highly responsive and stabilized One Health Surveillance Platform (OHSP) network. The system demonstrates robust resilience, suggesting that data clerks and facility focal points have successfully embedded prompt data entry into their routine workflows, minimizing latency at the national compilation level.

    Recommendations: To maintain this excellent performance, national and zonal health management teams should continue providing periodic refresher training for new data entry personnel. It is also advised to maintain active maintenance contracts for IT infrastructure at the district level to ensure internet connectivity and hardware availability do not become future bottlenecks.

    2. Zonal Reporting Rates (Week 32)

    Analysis & Insights

    Analytics: The bar chart breaks down the reporting rates across the major health zones, including Central Hospitals, during Week 32. Central Hospitals achieved a perfect 100% in both metrics. The South West and South East zones closely followed with exceptional numbers, while the North and Central West zones maintained strong compliance. Every single zone surpassed the national target threshold of 80%.

    Insights: The uniformity of high reporting rates across all geographic and administrative health zones highlights equitable capacity distribution. Unlike periods where remote zones severely lagged, the current data suggests that localized supervision and infrastructural investments have successfully bridged historical digital divides across the Malawian health system.

    Recommendations: Zonal Epidemiology Officers should establish peer-to-peer mentorship programs, allowing top-performing districts within the Central Hospitals and South West zones to share their internal data validation and submission workflows with facilities in the Northern and Central East zones to harmonize efficiencies.

    II. Event-Based Surveillance (EBS)

    3. Community EBS Signal Verification Status

    Analysis & Insights

    Analytics: During Week 32, the community surveillance network reported a total of 77 Event-Based Surveillance (EBS) signals originating from 10 districts. Following immediate investigation, 45 signals (58%) were officially verified as true public health events, 26 signals (34%) could not be verified, and 6 signals (7%) were outright discarded as false alarms.

    Insights: A verification rate of 58% signifies a highly sensitive community surveillance network that is successfully capturing potential threats at the grassroots level. However, the substantial proportion (34%) of unverified signals suggests that some community informants may be reporting vague or unsubstantiated information, which consumes valuable time for rapid response teams.

    Recommendations: The Ministry of Health should refine community informant training modules, focusing on standardizing the criteria for identifying and reporting suspected events. Providing clearer case definitions to community leaders will likely reduce the noise-to-signal ratio and decrease the burden of investigating unverified alerts.

    4. Verified EBS Signals by Risk Level

    Analysis & Insights

    Analytics: This chart categorizes the 45 successfully verified EBS events by their assessed public health risk levels. The data shows that 24 events (53%) were classified as Low Risk, 11 events (25%) as Moderate Risk, 6 events (13%) as Very Low Risk, and a critical 4 events (9%) were escalated to High Risk status demanding urgent action.

    Insights: The distribution indicates that while the majority of verified events pose a minimal immediate threat to public safety, the presence of 4 high-risk events represents active, severe public health anomalies that could quickly trigger localized outbreaks or mass casualty situations if not aggressively contained.

    Recommendations: District Rapid Response Teams (DRRTs) must prioritize the immediate deployment of field epidemiologists and environmental health officers to the epicenters of the 4 high-risk events. Furthermore, continuous stockpiling of emergency response kits should be maintained to ensure zero delays when a low-risk event unexpectedly escalates.

    III. Epidemic Prone & Priority Diseases

    5. Priority Disease Alerts (Week 32)

    Analysis & Insights

    Analytics: This visual captures the burden of priority notifiable conditions during the week. Diarrhoea with blood dominated the alerts with 577 cases. This was followed by suspected Measles (104 cases), Typhoid fever (72 cases), Severe Acute Respiratory Infections (SARI – 64 cases), Adverse Events Following Immunization (AEFI – 60 cases), and Meningococcal meningitis (9 cases).

    Insights: The overwhelming prominence of bloody diarrhoea and typhoid fever underscores a severe and ongoing vulnerability within the national water, sanitation, and hygiene (WASH) infrastructure. Meanwhile, the high count of measles cases indicates persistent immunity gaps in the pediatric population, making them susceptible to rapid viral transmission.

    Recommendations: Environmental health departments must urgently collaborate with water boards to test and chlorinate community water sources in high-burden districts to curb enteric diseases. Simultaneously, clinical teams should ensure routine stool cultures are collected to monitor for potential antimicrobial-resistant strains of Shigella or Salmonella Typhi.

    6. Cumulative Mpox Cases by District

    Analysis & Insights

    Analytics: The chart displays the cumulative distribution of the 158 confirmed Mpox cases recorded since Epi-week 12 of 2025. Lilongwe district is the primary epicenter, accounting for 119 cases (75.8% of the national total). Other districts like Ntcheu (9 cases), Karonga (8 cases), and Blantyre/Mangochi/Salima/Mzimba South (4 cases each) show significantly lower, sporadic transmission.

    Insights: The extreme concentration of Mpox cases in Lilongwe suggests intense localized, potentially urban, transmission networks. The lack of explosive spread to other major urban centers like Blantyre indicates that while the virus is circulating, the cross-district transmission vectors are relatively constrained or currently well-monitored.

    Recommendations: The National Public Health Institute should concentrate Infection Prevention and Control (IPC) resources and intensive contact tracing primarily within Lilongwe’s health facilities. Furthermore, risk communication campaigns regarding Mpox symptoms and isolation protocols should be heavily broadcasted in Lilongwe’s high-density areas.

    IV. Vaccine-Preventable Diseases & Outbreaks

    7. Measles Outbreak: Cumulative Cases by Hotspot

    Analysis & Insights

    Analytics: Localized measles outbreaks have been recorded throughout 2026. Nsanje reports the highest cumulative burden with 211 cases, followed by Dedza (90 cases), Balaka (82 cases), Chikwawa (38 cases), and Mulanje (11 cases). Over 70% of these confirmed cases occurred in unvaccinated individuals or those with unknown vaccination status, predominantly under 15 years old.

    Insights: The concentration of cases in specific districts like Nsanje and Dedza, combined with the high rate of unvaccinated patients, reveals localized failures in routine childhood immunization programs. These persistent immunity gaps have created highly susceptible pediatric cohorts that are now sustaining active viral transmission.

    Recommendations: The Expanded Programme on Immunisation (EPI) must immediately conduct targeted Supplemental Immunization Activities (SIAs), commonly known as mop-up campaigns, heavily focused on the under-15 populations in Nsanje, Dedza, and Balaka to rapidly close the immunity gaps and halt further spread.

    8. OCV Campaign: Doses Administered in Blantyre

    Analysis & Insights

    Analytics: In response to the Cholera threat, an Oral Cholera Vaccine (OCV) campaign was executed in Blantyre (August 3-7). The chart highlights doses administered across key health facility catchments. Bangwe achieved massive uptake with 80,200 doses, followed by Zingwangwa (26,250 doses) and Ndirande (26,000 doses). Total administrative coverage hit an impressive 100%.

    Insights: The exceptional volume of vaccines administered, particularly in densely populated catchments like Bangwe and Ndirande, reflects highly effective community mobilization and logistical planning. Achieving 100% coverage indicates that public trust in the cholera intervention is strong and vaccine hesitancy was successfully mitigated.

    Recommendations: Health promotion teams should formally document the specific Social and Behaviour Change (SBC) strategies utilized in Bangwe and Ndirande. These proven community engagement tactics should be standardized and deployed as blueprints for future emergency vaccination campaigns across other districts.

    9. Polio Vaccination Campaign Coverage by Round

    Analysis & Insights

    Analytics: Following the declaration of a Polio outbreak, Malawi launched aggressive nOPV2 vaccination campaigns. The data tracks the coverage percentages: Round 1 achieved 103% (6.2M vaccinated), Round 2 achieved 106% (6.6M vaccinated), and Round 3 reached 105% (7.06M vaccinated). Round 0 provided an initial 1.7M doses.

    Insights: Consistently surpassing 100% administrative coverage across multiple rounds indicates that the campaigns successfully reached not only the targeted resident pediatric populations but also transient, unregistered, or cross-border children. This aggressive saturation is a highly effective strategy for eradicating circulating vaccine-derived poliovirus type 2 (cVDPV2).

    Recommendations: As the country concludes emergency campaign rounds, the Ministry of Health must seamlessly transition this momentum into strengthening routine immunization infrastructure. Active Acute Flaccid Paralysis (AFP) surveillance must remain highly sensitive to ensure no residual transmission goes undetected in the post-campaign phase.

    10. Underperforming Districts vs National Average

    Analysis & Insights

    Analytics: While the national average stands at 98% for completeness and 97% for timeliness, two specific districts struggled in Week 32. Balaka DHO recorded only 61% for both completeness and timeliness, severely missing the 80% mark. Chikwawa DHO achieved 100% completeness but failed the timeliness metric, registering at 78%.

    Insights: The stark contrast between the national average and the performance of Balaka and Chikwawa points to localized, non-systemic issues. In Balaka, the dual failure suggests severe staffing shortages or total hardware/connectivity collapses. In Chikwawa, perfect completeness but delayed timeliness indicates data is being collected but processing workflows are bottlenecked.

    Recommendations: The National IDSR Secretariat should immediately dispatch technical support teams to Balaka to diagnose and resolve the critical failures in their reporting pipeline. For Chikwawa, district health management must audit internal data validation workflows to eliminate the administrative delays slowing down their OHSP submissions.

    V. Targeted District & Facility Recommendations

    1. Data Reporting & Compliance Interventions

    Balaka DHO and Chikwawa DHO must implement immediate corrective measures. Balaka requires a comprehensive overhaul of its current data entry workflow to bring both completeness and timeliness back above 80%. Chikwawa must focus on accelerating data validation to improve timeliness. Zonal officers must oversee these improvements directly.

    2. Enteric Disease Containment

    Kasungu, Lilongwe, Mchinji, Rumphi, Mangochi, Blantyre, Chikwawa, Neno, and Thyolo DHOs are directed to launch aggressive, targeted interventions against the rising tide of Typhoid and bloody diarrhoea. This must include immediate community water testing, broad distribution of chlorine, and strict hygiene enforcement in local markets and schools.

    3. Outbreak & Signal Investigation

    All District Rapid Response Teams (DRRTs) must eliminate delays in conducting field risk assessments for verified community signals. Furthermore, districts managing localized Measles outbreaks (Nsanje, Dedza, Balaka, Chikwawa, Mulanje) must intensify active case searching and ensure adequate cold-chain capabilities are maintained for supplemental vaccines.

    Official Documentation

    Access the full PDF bulletin for Epidemiological Week 32, 2026, including detailed district-level performance tables and data annexes. You can verify and cross-reference these statistics in the official document named IDSR Bulletin_Week 32_Malawi.pdf.

    Authored & Published By

    Moses Nyambalo Phiri

    Public Health Institute of Malawi

    Ministry of Health, Republic of Malawi

  • Call for applications for the APHR Traineeship Programme.

    Call for applications for the APHR Traineeship Programme.

    PHIM Laboratory Team
    Official Call for Applications

    Applied Public Health Research (APHR) Traineeship Programme

    PHIM-RKI Partnership Programme (October 2026 – December 2028)

    Building institutional capacity and developing a dedicated cohort of research multipliers across PHIM’s core operational divisions.

    Target Audience

    Early- to Mid-Career Staff

    BSc / MSc Qualifications

    Duration

    2 Years (Oct 2026 – Dec 2028)

    3 Workshops + Mentorship

    Cohort Size

    9 Selected Trainees

    R&D, Epi & NPHL Divisions

    Application Deadline

    09 September 2026

    Submit by 23:59 CAT

    Programme Overview

    The Public Health Institute of Malawi (PHIM), in collaboration with the Robert Koch Institute (RKI)—Germany’s national public health institute—is pleased to invite applications from eligible PHIM staff for the Applied Public Health Research (APHR) Traineeship Programme.

    Implemented under the framework of the Team Europe Initiative supporting the Public Health Institute of Malawi (TEI PHIM) and co-funded by the European Union and the German Federal Ministry for Economic Cooperation and Development (BMZ), this 2-year capacity-building programme is designed to strengthen applied public health research competencies across PHIM’s key operational areas.

    Train-the-Trainer (ToT) Multiplier Approach

    The APHR Traineeship aims to establish a high-caliber cohort of public health professionals who will not only advance their own research competencies but also act as trainers and mentors (“multipliers”), systematically cascading knowledge, methodologies, and skills within their respective divisions.

    Partner Institutions & Funding Attribution

    This initiative is jointly organized and supported by leading public health and development entities:

    PHIM Logo

    PHIM

    Public Health Institute of Malawi – Host institution & lead operational body.

    RKI Logo

    Robert Koch Institut

    Germany’s national public health institute – Technical collaboration & mentorship partner.

    GIZ Logo

    GIZ

    Deutsche Gesellschaft für Internationale Zusammenarbeit GmbH – Implementation partner.

    Implemented under Team Europe Initiative (TEI PHIM) Co-funded by the European Union & German Federal Ministry (BMZ)

    What Trainees Gain

    • Free, competency-based training in applied public health research.
    • Hands-on experience leading research projects of direct national relevance.
    • Mentorship from experienced national and international public health researchers.
    • Peer-reviewed publication: Expert support to publish research findings.
    • Policy engagement: Guidance in translating evidence into policy briefs and dialogues.
    • Certificate of Participation upon successful completion.

    What is Expected

    • Full participation across the 2-year programme duration.
    • Attend 3 in-person training workshops and adjacent cohort meetings.
    • Active engagement in monthly online seminars and mentoring sessions.
    • Completion of self-paced e-learning modules and coursework.
    • Conduct a small-scale applied research project in a team setting.
    • Cascade knowledge and skills to colleagues within PHIM.

    Curriculum Framework & Research Areas

    The programme provides a broad, competency-based curriculum grounded in the WHO Global Competency and Outcomes Framework (2024), tailored specifically to PHIM’s operational research priorities. It addresses core competencies under the Essential Public Health Function 11 (EPHF 11) across the complete research cycle:

    Priority Setting
    Protocol Development
    Ethics & Governance
    Data & Analysis
    Scientific Writing
    Knowledge Translation

    Three Strategic Focal Research Areas

    Aligned with Malawi’s National Health Research Agenda II (2023–2030), trainees will execute team projects in one of the following key pillars:

    Area 1

    Universal Health Coverage (UHC)

    Addressing health systems, equitable access, and essential healthcare delivery.

    Area 2

    RMNCH

    Reproductive, Maternal, Newborn, and Child Health clinical & population research.

    Area 3

    Health Security

    Surveillance, disease outbreak readiness, emergency response, and diagnostics.

    Indicative Time Commitment

    Applicants must ensure they can allocate sufficient time to complete all traineeship components alongside their operational duties:

    Programme Activity Estimated Time Commitment
    3 In-Person Workshops + Cohort Meetings Approx. 7 days each (8 hours/day)
    Live Online Group Sessions & Webinars 2 hours per month
    Self-Directed E-Learning & Exercises At least 2 hours per month
    Applied Research Activities At least 4 hours per month
    Cascading Training at PHIM (ToT) Preparation & delivery schedule TBC

    Eligibility Criteria & Cadre Scope

    PHIM Divisional Representation & Cadre Scope

    Open to active early- to mid-career technical officers, researchers, lab scientists, and public health staff serving in PHIM’s 3 core operational divisions: Research and Development (R&D), Epidemiology and Surveillance, or National Public Health Laboratories (NPHL).

    Educational Background

    Must hold a Bachelor’s or Master’s degree in public health, epidemiology, biomedical science, medicine, or a related discipline. Note: Candidates who already hold a PhD will not be considered.

    Research Motivation & Commitment

    Demonstrate a strong interest in applied public health research and commit to participating in all traineeship activities across the full 2-year timeline.

    Multiplier Potential & Capacity

    Willingness and professional standing (or demonstrated potential) to serve as a trainer and cascade learning to colleagues within their division.

    Supervisor Endorsement

    Provide written confirmation and signature from your direct supervisor agreeing to grant protected time for all programme activities.

    Application Checklist

    Complete packages must be submitted by email before the deadline.

    • Expression of Interest: Max 500 words addressing motivation, alignment with role, commitment, focal area choice, and cascading plan.
    • Curriculum Vitae (CV): Up-to-date, maximum 2 pages highlighting qualifications and experience.
    • Participant Application Form: Completed and signed (Annex 1).
    • Supervisor Endorsement: Official signature on Section F of the form.
    Download Application Form (.docx)

    Key Programme Timeline

    1

    26 August 2026

    Applications Open

    Call launched across PHIM divisions.

    2

    09 September 2026

    Submission Deadline

    All documents must be received by 23:59 CAT.

    3

    09–25 September 2026

    Selection Review Process

    Competitive evaluation by PHIM-led committee.

    4

    28 September 2026

    Applicants Notified

    Selected cohort of 9 trainees announced.

    October 2026

    Traineeship Commencement

    Programme runs through December 2028.

    Submission & Enquiries

    Submit all complete application components or send general inquiries to the Programme Coordinator:

    Contact Person

    Ms. Bessie Phiri

    phim-rki@health.gov.mw

    Participation is free of charge. Workshop travel and project research expenses are fully covered by the programme.

    Joint Partnership & Technical Collaboration

    Public Health Institute of Malawi (PHIM) · Robert Koch Institute (RKI) · Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ)

    Authored & Published By

    Penjani Phiri & Moses Nyambalo Phiri

    Public Health Institute of Malawi

    Ministry of Health, Republic of Malawi

  • IDSR Epidemiological Bulletin – Week 27.

    IDSR Epidemiological Bulletin – Week 27.

    IDSR Bulletin Dashboard – Week 27, 2026

    Weekly IDSR Bulletin

    Epidemiological Week 27 (29 June – 5 July, 2026)

    Status: Official Release Published: July 15, 2026

    Editorial Team

    Dr. Matthews Kagoli
    Mrs. Flora Dimba
    Mr. Settie Kanyanda
    Mr. Austin Zgambo
    Mr. Selemani Ngwira
    Mr. James Jere
    Mr. Noel Khunga
    Mr. Vincent Kamforzi
    Mr. Lwitikano Kaira
    Mrs. Ella Chamanga
    COMPLETENESS
    95.0%
    TIMELINESS
    80.0%
    MALARIA
    18,603
    EBS SIGNALS
    48
    TYPHOID
    42
    CHOLERA (S)
    0

    I. Performance & Surveillance

    Reporting Completeness & Timeliness Analysis

    Detailed Bulletin Analysis

    The national reporting performance for Epidemiological Week 27 has registered a stable completeness rate of 95.0% (remaining unchanged from Week 26). However, reporting timeliness on the One Health Surveillance Platform (OHSP) experienced a sharp drop, sliding from 93.0% in Week 26 down to 80.0% in Week 27. This sudden slide highlights mounting subnational administrative friction and clinical platform entry bottlenecks, reducing the timeliness of integrated alert tracking across the territory.

    At the subnational level, completeness remains high. All health zones and Central Hospitals successfully met the minimum target of 80% completeness (Central East, Central West, South West, and Central Hospitals all achieved 100.0%, while North achieved 92.2% and South East achieved 98.2%). However, timeliness parameters revealed severe regressions: Central Hospitals reached only 50.0% timeliness, and the South East Zone registered only 70.2% timeliness, both failing to meet the national minimum threshold of 80%.

    At the district reporting level, out of the 33 designated national reporting sites, 24 (73%) successfully achieved the target of 80% or greater on both surveillance metrics. Key sites failing specific thresholds have changed in Week 27. Districts including Nkhotakota, Machinga, Nsanje, Zomba, Mzuzu Central Hospital, and Queen Elizabeth Central Hospital failed to surpass reporting timeliness targets. Additionally, Likoma (100.0% completeness, 33.0% timeliness), Balaka (100.0% completeness, 48.0% timeliness), and Rumphi (94.0% completeness, 50.0% timeliness) failed to meet the minimum target for both completeness and timeliness metrics.

    To reverse this operational lag and preserve optimal platform sensitivity, the National IDSR Secretariat directs immediate remedial measures. IDSR coordinators and Zonal Epidemiology Officers must ensure timely verification and validation of clinical data immediately after facility focal points submit weekly forms. District Health Officers in underperforming zones, particularly Likoma, Balaka, Rumphi, Nkhotakota, Machinga, Nsanje, Zomba, Mzuzu CH, and QECH, must implement administrative audits to eliminate data entry delays and platform entry bottlenecks.

    II. Disease Morbidity

    Malaria Morbidity & Mortality

    Detailed Bulletin Analysis

    Malaria continues to stand as the dominant clinical and priority condition under active surveillance in Malawi, with Epidemiological Week 27 recording a national burden of Confirmed cases totaling 18,603 (including OPD and IPD cases) alongside 1 associated inpatient death. High-burden districts represent key transmission hotspots requiring continuous vector control monitoring, particularly Chikwawa DHO (1,880 cases), Mangochi DHO (1,843 cases), Blantyre DHO (1,497 cases), and Lilongwe DHO (1,109 cases).

    When contrasted with the preceding baseline in Epidemiological Week 26, the malaria data reveals an encouraging decrease of 8.67% in weekly cases (dropping from 20,369 down to 18,603 cases). Most significantly, confirmed inpatient deaths declined from 5 in Week 26 to 1 in Week 27, suggesting stable therapeutic timing and rapid response by clinical case management teams across central facilities during this cycle.

    To sustain this downward transmission trend and prevent fatal outcomes, we recommend that the National Malaria Control Program continues to coordinate antimalarial supply chain audits to ensure uninterrupted stocks of ACTs and RDTs. Clinical supervisors should conduct a rigorous mortality audit on the single recorded death to ensure therapeutic timing protocols were met. Concurrently, Health Surveillance Assistants (HSAs) must continue scale up community awareness campaigns emphasizing early care-seeking behaviors for febrile illnesses.

    Enteric Diseases (Typhoid & Diarrhoea)

    Detailed Bulletin Analysis

    The surveillance of waterborne enteric pathogens in Epidemiological Week 27 has flagged persistent transmission risks. Waterborne enteric diseases remain highly prevalent, with Diarrhoea with blood (Bloody Diarrhoea) cases recorded at 663 and Typhoid fever cases recorded at 42 (OPD and IPD Typhoid cases). Waterborne disease transmission remains a persistent threat, demanding a rapid transition from passive clinical tracking to active environmental health interventions.

    When compared to the baseline figures from Epidemiological Week 26, the enteric profile shows a mixed trajectory. Typhoid fever cases decreased by 10.6%, declining from 47 cases in Week 26 down to 42 cases in Week 27. Conversely, Bloody Diarrhoea cases rose slightly, moving from 629 cases to 663 cases. Geographically, a notable concentration of Typhoid cases remains localized within Mchinji DHO (25 cases) and Lilongwe DHO (9 cases), representing the primary share of the national enteric load in Week 27.

    Based on these findings, we recommend that Blantyre and Mchinji DHOs implement targeted interventions against Typhoid being reported in the districts. Stool and blood cultures must be collected from suspected cases to monitor potential antimicrobial resistance patterns and guide precise therapy. Concurrently, environmental health officers must implement localized water treatment protocols, distribute chlorine solutions, and conduct hygiene sanitization campaigns to break enteric transmission chains.

    III. Critical Alerts & Mortality

    Cholera and Mpox Status

    Detailed Bulletin Analysis

    Epidemiological Week 27 recorded zero (0) new suspected cholera cases, zero (0) new confirmed cases, and zero (0) deaths, reflecting strong containment. On the zoonotic disease front, Mpox surveillance detected zero (0) new confirmed cases and two (2) alerts. This keeps the cumulative national total stable at 158 confirmed cases and 4 cross-border cases since the outbreak began in April 2025. Lilongwe district represents 75.8% (119 cases) of the national load with a case fatality rate (CFR) of 0.63% (1 death on 10 August 2025).

    A comparison with Epidemiological Week 26 shows that Cholera suspected cases dropped from 1 in Week 26 to 0 in Week 27. Since the season started on 1 November 2025, Malawi has recorded a cumulative total of 3,009 cholera cases, including 319 laboratory-confirmed cases and 460 epidemiologically linked cases, alongside 5 deaths (CFR 0.65%). Geographically, 26 of Malawi’s 29 districts have reported at least one suspected case. Meanwhile, Mpox transmission remained completely silent, matching the zero confirmed case baseline from the previous week.

    To maintain this Cholera downward trend, the National Incident Management System must continue to direct emergency water, sanitation, and hygiene (WASH) resources to high-incidence hotspots. Oral Cholera Vaccine (OCV) campaigns in selected hotspot districts have achieved a total of 612,477 doses administered (101.3% coverage). For Mpox, District Rapid Response Teams (DRRTs) must remain alert, enforcing active cross-border screening and coordinating with Mozambique and Tanzania to ensure immediate detection of any imported cases.

    SARI & Respiratory Mortality

    Detailed Bulletin Analysis

    Severe Acute Respiratory Infections (SARI) presented 82 clinical cases and zero (0) inpatient deaths during Epidemiological Week 27. The severe respiratory burden continues to affect central districts, with Kamuzu Central Hospital (KCH) reporting 40 SARI cases (48.8% of the national load). Other districts with active respiratory caseloads include Nkhotakota DHO (7 cases), Neno DHO (7 cases), and Dowa DHO (6 cases). This concentration highlights the need for continuous sentinel respiratory surveillance and clinical preparedness in tertiary facilities.

    When evaluated against the preceding baseline in Epidemiological Week 26, the SARI surveillance data displays a slight upward shift in morbidity but positive progress in clinical mortality. National SARI cases rose from 71 cases in Week 26 to 82 cases in Week 27. Concurrently, SARI-associated deaths fell from 1 down to 0. This lack of clinical mortality is encouraging, yet clinical teams must remain highly vigilant to identify and respond to seasonal respiratory pathogens, such as Influenza A/B or RSV.

    We recommend that clinical teams at Kamuzu Central Hospital and other sentinel hospitals continue to systematically collect nasopharyngeal swabs from SARI patients for PCR diagnostic analysis. Healthcare facilities must ensure that pediatric oxygen delivery systems, clinical nebulizers, and essential respiratory therapeutics remain fully functional. Furthermore, clinicians must continue to document and report SARI cases on the OHSP, allowing public health teams to identify and respond to any new respiratory anomalies quickly.

    IV. Vaccine Preventable Diseases

    Measles & VPD Surveillance Distribution

    Detailed Bulletin Analysis

    Vaccine-Preventable Disease (VPD) surveillance remains a high-priority public health activity. In Week 27, Malawi reported 73 new suspected measles alerts, bringing the cumulative alerts to 1,690 with 695 confirmed measles-rubella cases in 2026. Cumulative laboratory-confirmed cases are distributed across 24 districts, with Balaka reporting the highest proportion at 20.9% (80 cases) and Nsanje at 17.8% (68 cases). Under the IDSR framework, Acute Flaccid Paralysis (AFP) surveillance recorded 0 cases, and Meningococcal meningitis recorded 12 cases (with 0 deaths), highlighting the need for active case searching.

    When compared to Epidemiological Week 26, weekly Measles alerts rose slightly, moving from 69 cases to 73 cases. AFP alerts fell from 5 cases in Week 26 to 0 cases in Week 27. Conversely, suspected Meningococcal meningitis cases rose slightly, moving from 9 cases in Week 26 up to 12 cases in Week 27, requiring immediate laboratory verification. Polio outbreak containment remains a high priority following the confirmation of 16 environmental sewage isolates since January 2026, with Round 3 of the nOPV2 campaign completed, achieving 105% coverage.

    We recommend that the Expanded Programme on Immunisation (EPI) continues targeting high-burden districts, particularly Balaka, Nsanje, and Chikwawa, with supplemental vaccination and outreach, while Dedza and Machinga districts require close monitoring. For vaccine safety parameters, district surveillance networks must coordinate with national labs. To prevent poliovirus spread, active community-level surveillance must be prioritized alongside preparations for subsequent vaccination campaigns, and the measles situation in Balaka district must receive focused attention.

    V. Summary of Recommendations

    1. Reporting Quality & District Targets

    Rumphi, Balaka, and Likoma DHOs must implement immediate data validation procedures to improve completeness and timeliness back to target levels of greater than or equal to 80%, while Nkhotakota, Machinga, Nsanje, Zomba, Mzuzu Central Hospital, and Queen Elizabeth Central Hospital must focus specifically on timeliness.

    2. Enteric & Outbreak Targeted Interventions

    Blantyre and Mchinji DHOs are directed to implement targeted interventions against Typhoid fever being reported in the districts, while Balaka, Chikwawa, and Nsanje districts must receive focused attention regarding their measles situation. Nkhata-bay DHO should investigate community-reported signals.

    3. AEFI Safety Investigation

    Mzimba-North district is directed to perform a detailed vaccine safety investigation on the 35 reported Adverse Events Following Immunization (AEFI) out of 64 nationally to maintain high community trust in routine childhood immunizations.

    Official Documentation

    Access the full PDF bulletin for Epidemiological Week 27, 2026, including detailed district-level performance tables and data annexes. You can verify and cross-reference these statistics in the official document named IDSR Epi Bulletin_Week 27_Malawi.pdf.

    Authored & Published By

    Moses Nyambalo Phiri

    Public Health Institute of Malawi

    Ministry of Health, Republic of Malawi