Table 1 WHO criteria for classifying Mayotte according to the malaria program phase, (source: WHO malaria report [15])

Malaria situation in areas with most intense transmission

(1) Recently endemic country with zero local transmission for at least three years or (2) Country on the Register or Supplementary list that has ongoing local transmission*

Test positivity rate

≤5% among suspected malaria patients (PCD) throughout the year

Yes

API in the district with the highest number of cases/1000 population/year (ACD and PCD)**, average over the last two years

<5 (less than 5 cases/1,000 population)

<1 (less than 1 case/1,000 population)

Yes

Total number of reported malaria cases nationwide

A manageable number e.g. <1000 cases nationwide (local & imported)

Yes

Case management

Imported malaria. Maintain capacity to detect malaria infection and manage clinical disease

Imported malaria. Maintain capacity to detect malaria infection and manage clinical disease

 All cases detected in the private sector are microscopically confirmed

National policy being rolled out

Yes

Yes

Yes

 All cases detected in the public sector are microscopically confirmed

National policy being rolled out

Yes

Yes

Yes

 Nationwide microscopy quality assurance system covers public and private sector

Initiated

Yes

Yes

Yes

 Radical treatment with primaquine for P. vivax

National policy being updated

National policy fully implemented

Yes

Yes

 Treatment with ACT plus single dose of primaquine for P. falciparum

National policy being updated

National policy fully implemented

Yes

National policy being updated

Surveillance

 Malaria is a notifiable disease nationwide (<24–48 h)

Laws and systems being put in place

Yes

Yes

Yes

 Centralized register of cases, foci and vectors

Initiated

Yes

Yes

Yes

 Malaria elimination database

Initiated

Yes

Certification process (optional)

Yes

 Active case detection in groups at high risk or with poor access to services (“proactive” case detection)

Initiated

Yes

In residual and cleared-up foci, among high risk population groups

Initiated

 Case and foci investigation and classification (including “reactive” case detection and entomological investigation)

Initiated

Yes

Yes

Yes