136 | WORLD MALARIA REPORT 2013

Ghana African Region

III. Financing
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Government Global Fund World Bank USAID/PMI WHO/UNICEF Others
C
o
n
t
r
i
b
u
t
i
o
n

(
U
S
$
m
)
140
120
100
80
60
40
20
0
Insecticides & spray materials
ITNs
Diagnostic testing
Antimalarial medicines
Monitoring and evaluation
Human resources & technical assistance
Management and other costs
Funding source(s): Government, Global Fund, PMI/ USAID, Other Bilaterals, UNICEF, WHO, Other
IV. Coverage

0
20
40
60
80
100
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
P
o
p
u
l
a
t
i
o
n

(
%
)
With access to an ITN (model)
All ages who slept under an ITN With access to an ITN (survey)
At risk protected with IRS
Source: DHS 2003, DHS 2008
0
20
40
60
80
100
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
C
a
s
e
s

(
%
)
Suspected cases tested
P. falciparum cases potentially treated with ACT P. vivax cases potentially treated with primaquine
Cases potentially treated with any antimalarial
V. Impact
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
P
o
s
i
t
i
v
i
t
y

r
a
t
e

(
%
)
A
B
E
R

(
%
)
ABER (Micr. & RDT) RDT positivity rate Slide positivity rate
100
80
60
40
20
0
25
20
15
10
5
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
A
d
m
i
s
s
i
o
n
s
2 000
1 750
1 500
1 250
1 000
750
500
250
0
D
e
a
t
h
s
35
30
25
20
15
10
5
0
Admissions (all species)
Deaths (all species)
Admissions (P. vivax)
Deaths (P. vivax)
Sources of nancing Expenditure by intervention in 2012
Coverage of ITNs and IRS Cases tested and potentially treated (public sector)
Malaria test positivity rate and ABER Proportion of malaria cases due to P. vivax
I. Epidemiological prole
Population (UN Population Division) 2012 %
High transmission (>1 case per 1000 population)
Low transmission (01 cases per 1000 population)
Malaria-free (0 cases)
Total
25 400 000
0
0
25 400 000
100
0
0
Parasites and vectors
Major plasmodium species: P. falciparum (100%), P. vivax (0%)
Major anopheles species: An. gambiae, funestus, arabiensis
Programme phase: Control
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
C
a
s
e
s

p
e
r

1
0
0
0
Cases (all species) Cases (P. vivax)
160
140
120
100
80
60
40
20
0
0
20
40
60
80
100
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
C
a
s
e
s

d
u
e

t
o

P
.

v
i
v
a
x

(
%
)
Conrmed cases (per 1000) Malaria admissions and deaths (100 000)
II. Intervention policies and strategies
Intervention Policies/strategies
Yes/
No
Year
adopted
ITN ITNs/LLINs distributed free of charge
ITNs/LLINs distributed to all age groups
Yes
Yes
2004
2010
IRS IRS is recommended
DDT is used for IRS
Yes
No
2005

Larval control Use of larval control Yes 1999

IPT IPT used to prevent malaria during pregnancy Yes 2003
Diagnosis Patients of all ages should receive diagnostic test
Malaria diagnosis is free of charge in the public sector
Yes
No
2008

Treatment ACT is free for all ages in public sector

Artemisinin-based monotherapies withdrawn
Single dose of primaquine (0.25 mg base/kg) is used as gametocidal
medicine for P. falciparum
Primaquine is used for radical treatment of P. vivax
G6PD test is a requirement before treatment with primaquine
Directly observed treatment with primaquine is undertaken
System for monitoring of adverse reaction to antimalarials exists
No
Yes
No
No
No
No
Yes

2010

2001
Intervention Policies/strategies
Yes/
No
Year
adopted
Surveillance ACD for case investigation (reactive)
ACD at community level of febrile cases (pro-active)
Mass screening is undertaken
Uncomplicated P. falciparum cases routinely admitted
Uncomplicated P. vivax cases routinely admitted
no
No
No
No
No

Antimalaria treatment policy Medicine

Year
adopted
First-line treatment of unconrmed malaria
First-line treatment of P. falciparum
For treatment failure of P. falciparum
Treatment of severe malaria
Treatment of P. vivax
Dosage of primaquine for radical treatment of P. vivax
AS+AQ
AL; AS+AQ
QN
QN

2004
2004
2004
2004

Type of RDT used P.f only

Therapeutic e cacy tests (clinical and parasitological failure, %)
Medicine Year Min Median Max Follow-up No. of studies Species
AS+AQ
AL
20032006
20032007
0
1.7
4.3
4
14
13.8
28 days
28 days
4
5
Impact: Insu ciently consistent data to assess trends
Insufcient data
0
00.1
0.11.0
1.010
Conrmed cases
per 1000 population/
Parasite prevalence
(PP)
PP
>75
0
Insufcient data
no cases
Very low PP
020
2040
4060
6080
80100
Proportion of cases
due to P. falciparum