Malaria Control and Elimination

Bioko Island Malaria Control Project (BIMCP) Phase III

Country: Equatorial Guinea

Funders: The Government of Equatorial Guinea, Marathon Oil, Noble Energy, Sonagas, GEPetrol and Atlantic Methanol (AMPCO)

Duration: 2014-2018

When Marathon Oil Corporation began operating its oil and gas operations Equatorial Guinea, its workforce and that of the surrounding community on Bioko Island was greatly impacted by malaria illness and deaths. As a result, Marathon Oil came to lead a consortium funding local malaria control efforts through a production-sharing agreement with the Government of Equatorial Guinea, and with participation by other generous donors (AMPCO, Noble Energy, GEPetrol and Sonagas). MCDI has implemented a series of integrated malaria control measures to substantially reduce morbidity and mortality caused by malaria on Bioko Island, Equatorial Guinea since 2003 under the Bioko Island Malaria Control Project (BIMCP). Currently in its third five-year phase (2014-2018), the project’s interventions build on those established during Phase I (2004-2008) and Phase II (2009-2013) and are centered on indoor residual spraying, the distribution of long-lasting insecticidal nets, intermittent preventive therapy for pregnant women, malaria case management, epidemiological surveillance, vector monitoring, advocacy, informative, education and communication (IEC) and behavior change communication (BCC), and other focal activities stratified according to geographic areas of higher or persistent transmission. In the past, the BIMCP has also served as a proving ground for novel approaches such as mass screen and treat (MSAT), focal screen and treat (FSAT), larval source management, and environmental management. In coordination with the national malaria control program, the project has made a strong commitment to investing in human resource development, capacity building and horizontal integration, so as to prepare the Ministry of Health and Social Welfare to assume responsibility for sustaining the malaria control activities. The BIMCP is implemented with technical assistance from the London School of Hygiene and Tropical Medicine (LSHTM) on serological analysis and the design of an annual Malaria Indicator Survey, the Liverpool School of Tropical Medicine (LSTM) for metabolic resistance to insecticides and a disease data management system, and Texas A&M University as a partner in molecular-level analysis of mosquito samples collected on the island. Operational research has been conducted in a variety of technical areas, with regular publication of results.

Major BIMCP Achievements:

  • By 2016, malaria transmission reduced by nearly 76% among children 2 to 14 years old;
  • 81% reduction of the parasite prevalence (from 45% in 2004 to 8.5% in 2016);
  • All-cause mortality among children under five years old reduced by 64% (largely attributable to malaria control interventions);
  • From 2004 to 2016, the prevalence of infection with p. falciparum among children 2 to <5 years of age has fallen from 45% to approximately 8.2%;
  • 98.7% reduction of severe anemia in under 5 years old (from 15% in 2004 to 3% in the 2010–2012 period and 0.19% in 2016);
  • 98% reduction of entomological inoculation rate (from more than 1,000 before 2004 to 14 in 2015);
  • Improved access to diagnostic services and malaria treatments and continues to provide LLINs and IPTp to pregnant women visiting antenatal care facilities;
  • Developed the first African malaria slide archive for microscopy QA/accreditation;
  • ACTs successfully introduced to replace chloroquine as the first line anti-malarial on Bioko Island;
  • One of the three main malaria vector species (An. funestus) was eliminated;
  • Established a rigorous M&E system that includes a health information system to provide the MOHSW with comprehensive information on vector surveillance, malaria cases treated, and women receiving IPTp along with an electronic inventory system;
  • Implemented the Disease Data Management System (DDMS) that has served as the data platform for the National Malaria Control Program and the project;
  • Conducts annual MIS since 2004 using initially a paper and computerized data processing system, from 2005–2013 a PDA-based data processing system, and an Android tablet-based data processing system (from 2014 until today in 2016);
  • Implements the Campaign Information Management System (CIMS) - an Android-based mHealth tablet application that was developed for BIMCP and EGMVI and is being used to plan, manage and monitor the mass top-up distribution of LLINs, bi-annual IRS campaigns;

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