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National Center For Infectious Diseases
Prevention and Control
DR Ibrahim Kraza Damascus. June 2005
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Background

• Malaria was endemic in libya until 1973 where it
  was declared by WHO to be a country free of
  malaria.
  
• The situation continued like this unil 1976 where
  there was an epidemic of febrile illness among
  petroleum company workers in hoone ,clinical
  presentation was like malaria , blood slides of
  all 12 cases (2 pakistanian ,10 libyan ) were
  positive for falciparum malaria ,reconfirmed in a
  referral lab. In Tripoli ,patients were treated
  ,and chemoprophylaxis given for the limited
  surroundings .
• No more cases reported in the whole country for
  10 years later.
  

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Background cont..

• ? In 1986 only imported cases started to appear
  and most of them from african countries and
  bangladish,and india .
  
• In 2003 in addition to 44 imported cases
  reported , few cases reported thought to be an
  indigenous in southern areas (sebha province) ,
  as a responce to that symposium conducted in
  sebha with collaboration to advisors from
  endemic counries and professionals in malaria
  epidemiology, and after strict epidemiological
  investigations in the areas where the case
  reported , concluded finally to be an introduced
  cases.

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Tripoli
Sebrata
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Tobruk
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Zawia
Benghazi
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Sirt
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Obari
Sebha
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Malarial Cases Distribution in Libya during 2004
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Age Distribution of Malarial Reported Cases
___ Median 27 Years
- - - Mean 27.7 12.9 Years
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• Gender 12 M 3 F.
• All cases confirmed microscopically.
• All cases are imported, except for one case
  thought to be an introduced.
  

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Nationality Distribution for Malarial Cases
during 2004 in Libya
Nigerian 2
Libyan 7
Sudanian 6
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Travel History for Reported Malarial Cases in
Libya in 2004
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Types of Malaria parasite in relation to travel
history
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Distribution of Malarial Cases according to
Months of the Year ( 2004 )
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Elimination strategy by year 2004

• Training , retraining of personnel.
• Sensitization of medical decision makers
  medical personnel as well towards malaria as it
  doesnt create a problem at present time.
  
• Improving surviellance system.

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Elimination strategy objectives

• To prevent reemergence of malaria transmission in
  the country.
  
• To control imported malaria.

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Elimination Strategy Activities

• Activities of consolidation (in areas at risk)
• ?.Case detection (active passive ).
• ?.Vector control measures.
• Prevention of imported malaria
• ?. Case detection .
• ?. chemoprophylaxis.

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Plan of action for 2004Objectives

• To strengthen and maintain the stopping of the
  transmission in the high risk areas.
  
• To control imported malaria.

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Activities and achievements

• Intensifying the active case detection in areas
  at risk .
  
• National survey for (15) selected counties for
  one year to be conducted before the end of june
  2006, for recent epidemiological and
  entomological map.

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Tripoli
AL-ATroon
Shaksouk
Derna
AL-Khms
Kersa
Joush
Kasr Elhaj
Ras Ahlal
Benghazi
Tigi
Taurga
Drej
A.Sergenti A.Multicolor A.Coustani A.Gambiae
A.Broussesi A.Hispniola A.Matasi A.Turkhudi A.
Superpictus A.maculipenis A.Lambranchiae A.Sach
arrovi A.maculipenis
Girriat Sharkiah
GirriatGharbia
Zella
Medwin
Uenzirickr
Ishkida
Aggar
Brack
Ghorda
Guttai
Idri
Berghin
Duesa
Techerciba
Deisa
Sebha
Germa
Oubari
Guddwa
Gharagh
Ghat
Zwela
Traghen
Serdalas
Zizau
Aggar Atabat
Tmesa
EL-Berket
Fongur
Tessau
Gawat
Mourzouk
UM EL-Hamam
Ghatroun
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Activities and achievements ( Conti.. )

• A represenative blood samples will be taken
  from population of 15 provinces including camps
  of immigrants from Chad, Niger, Muritania, and
  other African countries ,to be examined by rapid
  test for malaria to know the magnitude of the
  problem and to take action accordingly.

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Activities and achievements cont.

• Strengthening the surviellance system in all 33
  provinces in the country.
  
• Training and retraining activities
• condensed course for one week at December 2004
  conducted for laboratory diagnosis of malaria for
  16 lab. Technicians from 15 provinces at risk.
  
• condensed course for one week at December 2004
  for 16 health workers who will be involved in the
  survey mentioned earlier .
  
• continuous health education .

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• Reduced sensibility of health managers and
  decision makers towards malaria .
  
• Less availability of professional personnel in
  clinical and laboratory diagnosis of malaria
  apart from main hospitals in big cities .
  
• Reduced public cooperation in taking
  chemoprophylaxis when travelling to endemic
  countries.
  
• Uncontrolled movement of immigrants from endemic
  countries through unpatroled boarders.

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