Mauritania African Region

I. Epidemiological profile Population (UN Population Division) 2017 % Parasites and vectors High transmission (>1 case per 1000 population) 2.8M 64 Major plasmodium species: P.falciparum: 100 (%) , P.vivax: 0 (%) Low transmission (0-1 case per 1000 population) 1.6M 36 Major anopheles species: An. gambiae, An. arabiensis, An. pharoensis Malaria free (0 cases) 0 - Reported confirmed cases (health facility): 20 105 Estimated cases: 238.3K [94.7K, 445.1K] Total 4.4M Confirmed cases at community level: - Confirmed cases from private sector: - Reported deaths: 67 Estimated deaths: 1.5K [1.3K, 1.7K]

II. Intervention policies and strategies Yes/ Year Intervention Policies/Strategies Medicine Year adopted No adopted Antimalaria treatment policy ITN ITNs/LLINs distributed free of charge Yes 1998 First-line treatment of unconfirmed malaria AS+AQ - ITNs/LLINs distributed to all age groups Yes - First-line treatment of P. falciparum AL; AS+AQ - IRS IRS is recommended Yes - For treatment failure of P. falciparum - - DDT is used for IRS No - Treatment of severe malaria QN - Larval control Use of Larval Control No 2013 Treatment of P. vivax - - IPT IPT used to prevent malaria during pregnancy Yes 2008 Dosage of primaquine for radical treatment of P. vivax 0.25 mg/Kg (14 days) Diagnosis Patients of all ages should receive diagnostic test Yes 2011 Type of RDT used P.f + P.v specific (Combo) Malaria diagnosis is free of charge in the public sector Yes 2009 Therapeutic efficacy tests (clinical and parasitological failure, %) Treatment ACT is free for all ages in public sector Yes 2009 Medicine Year Min Median Max Follow-up No. of studies Species is The sale of oral artemisinin-based monotherapies (oAMTs) - AS+AQ 2012-2012 1.8 1.8 1.8 28 days 2 P. falciparum banned CQ 2012-2012 0 0 0 28 days 2 P. vivax Single dose of primaquine (0.25 mg base/kg) is used as No - gametocidal medicine for P. falciparum Resistance status by insecticide class (2010-2017) and use of class for malaria vector control (2017) Primaquine is used for radical treatment of P. vivax Yes 2014 Insecticide class Years (%) sites1 Vectors2 Used3 G6PD test is a requirement before treatment with primaquine Yes 2014 Carbamates 2015-2015 0% (3) - No Directly observed treatment with primaquine is undertaken No - Organochlorines - - - No System for monitoring of adverse reaction to antimalarials exists Yes 2009 Organophosphates 2015-2015 0% (2) - No Surveillance ACD for case investigation (reactive) - - Pyrethroids 2015-2015 66.67% (3) An. gambiae s.l. Yes

ACD at community level of febrile cases (pro-active) - - 1Percent of sites for which resistance conﬁrmed and total number of sites that reported data (n) Mass screening is undertaken Yes - 2Principal vectors that exhibited resistance Uncomplicated P. falciparum cases routinely admitted Yes - 3Class used for malaria vector control in 2017 Uncomplicated P. vivax cases routinely admitted Yes - Case and foci investigation undertaken No Case reporting from private sector is mandatory Yes 2014

III. Charts Sources of ﬁnancing Government expenditure by intervention in 2017 10M

4M Contribution($USm)

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 Insecticides & spray materials ITNs Diagnostic testing Others WHO/UNICEF USAID/PMI Worldbank (USD) Antimalarial medicines Monitoring and evaluation Global Fund (USD) Government contribution Human resources & technical assistance Management and other costs

IV. Coverage Coverage of ITN and IRS Cases tested and treated in public sector 100 100

75 75

50 50 (%) Population

25 25

0 0 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 Suspected cases tested Antimalarials distributed vs reported cases ACTs distributed vs reported P. f. cases % of households >= 1 ITN (Modelled) At risk protected with IRS Primaquine distributed vs reported P. v. cases % of the population who slept under an ITN the previous night (survey) % <5 fever cases who had a ﬁnger/ heel stick (survey) % of the population with access to an ITN (survey) ACTs as % of all antimalarials received by <5 (survey)

Source: DHS 2011, 2015, MICS 2011, 2015 Source: MICS 2007, 2011, 2015 V. Impact Cases treated Test positivity 100% 100%

75% 75%

50%

(%) 50% Tests (%)

25% 25%

0% 0%

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 % fever cases <5 seeking treatment at public HF (survey) Reporting completeness Slide positivity rate RDT positivity rate

Source: MICS 2015

V. Impact Conﬁrmed malaria cases per 1000 and ABER Malaria admissions and deaths 0.5 2.5 25k 500

0.4 2 20k 400

0.3 1.5 15k 300 Deaths ABER (%)

10k 200 0.2 1 Admissions Cases per 1000 Cases

5k 100 0.1 0.5

0k 0 0 0

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 Admissions (all species) Admissions (P. vivax)) Deaths (all species) ABER Cases(all species) Cases (P. vivax) Deaths (P. vivax))

World Malaria Report 2018