Equatorial Guinea African Region

I. Epidemiological profile Population (UN Population Division) 2017 % Parasites and vectors High transmission (>1 case per 1000 population) 1.3M 100 Major plasmodium species: P.falciparum: 100 (%) , P.vivax: 0 (%) Low transmission (0-1 case per 1000 population) 0 - Major anopheles species: An. gambiae, An. melas Malaria free (0 cases) 0 - Reported confirmed cases (health facility): 15 725 Estimated cases: 435.1K [268.8K, 652.8K] Total 1.3M Confirmed cases at community level: - Confirmed cases from private sector: - Reported deaths: - Estimated deaths: 669 [530, 806]

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 2007 First-line treatment of unconfirmed malaria AS+AQ 2004 ITNs/LLINs distributed to all age groups No - First-line treatment of P. falciparum AS+AQ 2004 IRS IRS is recommended Yes 2005 For treatment failure of P. falciparum QN 2004 DDT is used for IRS No 2015 Treatment of severe malaria AS 2004 Larval control Use of Larval Control No 2013 Treatment of P. vivax - - IPT IPT used to prevent malaria during pregnancy Yes - Dosage of primaquine for radical treatment of P. vivax Diagnosis Patients of all ages should receive diagnostic test Yes 2005 Type of RDT used - Malaria diagnosis is free of charge in the public sector Yes 2005 Therapeutic efficacy tests (clinical and parasitological failure, %) Treatment ACT is free for all ages in public sector Yes 2008 Medicine Year Min Median Max Follow-up No. of studies Species is The sale of oral artemisinin-based monotherapies (oAMTs) 2014 AS+AQ 2010-2011 0 2.3 4.9 28 days 3 P. falciparum banned Single dose of primaquine (0.25 mg base/kg) is used as No - Resistance status by insecticide class (2010-2017) and use of class for malaria vector control (2017) gametocidal medicine for P. falciparum Insecticide class Years (%) sites1 Vectors2 Used3 Primaquine is used for radical treatment of P. vivax No - Carbamates 2011-2014 0% (2) - No G6PD test is a requirement before treatment with primaquine No - Organochlorines 2014-2014 100% (1) An. coluzzii No Directly observed treatment with primaquine is undertaken No - Organophosphates 2014-2014 0% (1) - Yes System for monitoring of adverse reaction to antimalarials exists No - Pyrethroids 2011-2014 100% (4) An. gambiae s.l. Yes Surveillance ACD for case investigation (reactive) No - 1Percent of sites for which resistance confirmed and total number of sites that reported data (n) ACD at community level of febrile cases (pro-active) No - 2Principal vectors that exhibited resistance Mass screening is undertaken Yes - 3Class used for malaria vector control in 2017 Uncomplicated P. falciparum cases routinely admitted Yes - Uncomplicated P. vivax cases routinely admitted No - Case and foci investigation undertaken No Case reporting from private sector is mandatory No -

III. Charts Sources of ﬁnancing Government expenditure by intervention in 2017 15M

12.5M

10M

7.5M

5M Contribution($USm)

2.5M

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 Source: DHS 2011 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

V. Impact Conﬁrmed malaria cases per 1000 and ABER Malaria admissions and deaths 250 50 25k 125

200 40 20k 100

150 30 15k 75 Deaths ABER (%)

10k 50 100 20 Admissions Cases per 1000 Cases

5k 25 50 10

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