Bulletin Analysis The national reporting completeness for Week 2 reached a commendable 95.0%, demonstrating strong engagement from most districts. This metric reflects the percentage of expected reports that were successfully entered into the One Health Surveillance Platform (OHSP). However, several key districts like Mangochi and Mzimba South are identified as needing urgent improvement to reach the 100% target. Consistent reporting is the backbone of our early warning system and ensures no local outbreaks are missed. District health management teams are urged to support their data clerks in maintaining these high standards. Without complete data, the PHIM cannot accurately allocate resources or assess the true public health burden across the country. We congratulate the districts that achieved 100% and set a benchmark for the rest of the nation.

Bulletin Analysis Timeliness of reporting for Week 2 stands at 87.3%, which is below the desired national performance threshold of 100%. Timeliness is measured by the submission of reports by the designated deadline each Monday, allowing for rapid national analysis. The bulletin highlights that central facilities, including Kamuzu Central Hospital and QECH, must streamline their internal data flows to improve their reporting speed. Delays in reporting directly hinder the National IDSR Secretariat’s ability to trigger immediate responses to emerging threats. Each hour of delay potentially increases the risk of unchecked disease transmission within the community. We are monitoring the barriers to timely submission, including technical issues on the OHSP platform and staff availability. All facility focal persons are reminded that “Time is Health” in the context of surveillance.

Bulletin Analysis A total of 19 Event-Based Surveillance (EBS) signals were captured during this reporting period, representing a vital layer of our surveillance architecture. EBS focuses on capturing unstructured information about public health events that may not be captured by routine indicator-based reporting. All 19 signals were verified, indicating that the community and health workers are highly vigilant in spotting unusual occurrences. The District Rapid Response Teams (DRRTs) are now tasked with conducting formal risk assessments for every verified event. These signals range from clusters of unknown illnesses to environmental hazards that pose a risk to human health. Strengthening EBS detection at the community level remains a priority for the upcoming quarter. We encourage all districts to continue utilizing the toll-free lines and community structures to report these signals.

Bulletin Analysis Malaria continues to dominate the morbidity profile of Malawi, with 52,213 cases reported in Week 2 alone. Alarmingly, this high case volume was accompanied by 6 confirmed deaths, emphasizing the need for early diagnosis and treatment. Most districts are currently seeing high transmission rates, typical of the current seasonal trends. The PHIM recommends that all health facilities ensure a steady supply of Rapid Diagnostic Tests (RDTs) and Artemisinin-based Combination Therapy (ACTs). Public health messaging should focus on the consistent use of insecticide-treated nets (ITNs) and seeking medical care within 24 hours of fever onset. Surveillance data shows that children under five and pregnant women remain the most vulnerable populations. Continued monitoring of case fatality rates is essential to evaluate the quality of inpatient care.

Bulletin Analysis During Week 2, 1,186 cases of bloody diarrhoea were reported, along with 4 related deaths. This condition is a sensitive indicator for serious enteric pathogens, including those that cause dysentery and cholera. Given the ongoing cholera outbreaks in some regions, every case of bloody diarrhoea must be treated with high clinical suspicion. Health workers are instructed to collect stool samples for laboratory confirmation to identify the specific causative agents. Infection Prevention and Control (IPC) measures must be strictly enforced at the facility level to prevent nosocomial transmission. Safe water, sanitation, and hygiene (WASH) interventions at the community level are the primary defense against these waterborne diseases. The Ministry of Health is working with partners to distribute chlorine and hygiene kits in the most affected districts.

Bulletin Analysis Typhoid fever remains a significant concern with 69 cases reported this week, showing a slight upward trend compared to previous weeks. This disease is closely linked to poor sanitation and contaminated food or water sources. Clinical teams are advised to maintain high suspicion for patients presenting with prolonged fever and gastrointestinal symptoms. Accurate laboratory diagnosis via blood culture is encouraged wherever possible to guide appropriate antibiotic therapy. We are also monitoring for signs of antimicrobial resistance, which has been observed in Typhoid strains in the region. Public health teams should investigate clusters of cases to identify common sources of contamination. Improvements in urban and peri-urban water systems are long-term requirements to reduce this burden.

Bulletin Analysis Two maternal deaths were reported during Epidemiological Week 2, serving as a somber reminder of the challenges in maternal health. Every maternal death is considered a public health emergency under the IDSR framework and must be reported within 24 hours. A comprehensive Maternal Death Surveillance and Response (MDSR) audit is mandatory for these cases to identify the root causes. These audits look at “three delays”: delay in seeking care, delay in reaching a facility, and delay in receiving appropriate care. The findings from these audits are crucial for implementing systemic changes to prevent future tragedies. We must continue to promote institutional deliveries and ensure that basic emergency obstetric care is available 24/7. Strengthening the referral chain between primary health centers and district hospitals remains a top priority.

Bulletin Analysis Severe Acute Respiratory Infection (SARI) surveillance identified 59 cases this week, resulting in 2 deaths. This results in a Case Fatality Rate (CFR) of 3.4%, which requires close monitoring to ensure it does not escalate. SARI surveillance is critical for monitoring the circulation of influenza-like illnesses and potential new respiratory pathogens. All SARI cases should have oropharyngeal or nasopharyngeal swabs collected for virological testing at the national laboratory. Early detection of respiratory outbreaks is essential for preventing wide-scale transmission, especially in crowded environments. Clinical management should focus on early supportive care and oxygen therapy for severe cases. The PHIM is keeping a close watch on these trends as we move through different seasonal patterns.

Bulletin Analysis The 91 cases of Adverse Events Following Immunization (AEFI) reported this week demonstrate a highly active and transparent safety monitoring system. Most of these events were reported as minor reactions, which are expected occurrences in any large-scale vaccination program. High AEFI reporting rates indicate that health workers are properly trained to observe and record any unusual health events post-vaccination. This data is vital for maintaining public trust in the national immunization program. Each serious AEFI is thoroughly investigated by a dedicated committee to determine causality. We commend the districts for their diligence in maintaining these safety standards. Continuous communication with parents and caregivers about what to expect after vaccination helps in managing these events effectively.

Bulletin Analysis While there were zero new confirmed Mpox cases in Week 2, the system successfully generated four distinct Mpox alerts. This signifies that the surveillance system is sensitive enough to catch potential cases for further investigation. Mpox remains a disease of international concern, and Malawi must maintain high levels of vigilance at points of entry and within communities. Health workers are reminded to look for symptoms such as unexplained acute rash, fever, and lymphadenopathy. Prompt isolation of suspected cases and collection of lesion swabs for PCR testing are standard operating procedures. Public awareness campaigns should continue to emphasize the importance of reporting any unusual skin conditions. We are working closely with regional partners to share data and coordinate prevention efforts.

Bulletin Analysis Two cases of Acute Flaccid Paralysis (AFP) were reported this week, which are critical for our ongoing Polio-free certification efforts. Every case of AFP in a child under 15 years must be investigated with two stool samples collected 24 hours apart. Furthermore, five cases of Meningococcal meningitis were reported, highlighting the need for rapid diagnostic response. Meningitis can spread quickly in close-contact settings, and immediate laboratory confirmation is required to initiate the correct antibiotic treatment. CSF samples should be transported in Trans-Isolate (TI) medium to ensure the viability of the bacteria. Districts should ensure they have adequate supplies of the necessary collection kits and transport media. Early detection and response to these cases are key to preventing large-scale outbreaks.

Bulletin Analysis The Expanded Programme on Immunisation (EPI) data suggests that while routine coverage is stable, outreach strategies need strengthening. Some clusters of vaccine-preventable diseases, such as measles, have been linked to “zero-dose” children who have never been reached by the system. It is vital to map out hard-to-reach areas and schedule regular mobile clinics to bridge the coverage gap. Immunization is the most cost-effective public health intervention available and is the primary tool for reducing child mortality. Cold chain maintenance at the facility level must be monitored daily to ensure vaccine potency. Community leaders and traditional authorities are key partners in encouraging families to complete the full vaccination schedule. We aim for at least 95% coverage for all primary vaccines to maintain herd immunity.