Guinea-Bissau African Region I. Epidemiological profile Population (UN Population Division) 2017 % Parasites and vectors High transmission (>1 case per 1000 population) 1.9M 100 Major plasmodium species: P.falciparum: 100 (%) , P.vivax: (%) Low transmission (0-1 case per 1000 population) 0 - Major anopheles species: An. gambiae, An. funestus Malaria free (0 cases) 0 - Reported confirmed cases (health facility): 89 784 Estimated cases: 108K [40.2K, 263.4K] Total 1.9M Confirmed cases at community level: 3062 Confirmed cases from private sector: 6003 Reported deaths: 296 Estimated deaths: 688 [591, 783] 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 2005 First-line treatment of unconfirmed malaria AL - ITNs/LLINs distributed to all age groups No - First-line treatment of P. falciparum AL - IRS IRS is recommended No 2006 For treatment failure of P. falciparum QN - DDT is used for IRS No - Treatment of severe malaria AS;QN - Larval control Use of Larval Control No Treatment of P. vivax - - IPT IPT used to prevent malaria during pregnancy Yes 2005 Dosage of primaquine for radical treatment of P. vivax Diagnosis Patients of all ages should receive diagnostic test Yes 2008 Type of RDT used P.f only Malaria diagnosis is free of charge in the public sector Yes 2008 Therapeutic efficacy tests (clinical and parasitological failure, %) Treatment ACT is free for all ages in public sector Yes 2015 Medicine Year Min Median Max Follow-up No. of studies Species is The sale of oral artemisinin-based monotherapies (oAMTs) 2006 AL 2012-2015 5 5 5 28 days 1 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 - - - No G6PD test is a requirement before treatment with primaquine No - Organochlorines - - - No Directly observed treatment with primaquine is undertaken No - Organophosphates - - - No System for monitoring of adverse reaction to antimalarials exists No - Pyrethroids - - - No Surveillance ACD for case investigation (reactive) - - 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 No - 3Class used for malaria vector control in 2017 Uncomplicated P. falciparum cases routinely admitted - - Uncomplicated P. vivax cases routinely admitted - - Case and foci investigation undertaken No Case reporting from private sector is mandatory Yes 1992 III. Charts Sources of financing Government expenditure by intervention in 2017 12.5M 10M 7.5M 5M Contribution($USm) 2.5M 0M 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: MICS 2006, 2010, 2014 Source: MICS 2006, 2010, 2014 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 2014 V. Impact Confirmed malaria cases per 1000 and ABER Malaria admissions and deaths 100 50 25k 600 80 40 20k 500 60 30 15k 400 Deaths ABER (%) 10k 300 40 20 Admissions Cases per 1000 5k 200 20 10 0k 100 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.