Weekly IDSR Bulletin

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.