Evaluation of the Effectiveness of Malaria Surveillance System in Southern Libya and It's Impact on Public Health in the Context of Irregular Migration

Abstract

Background: Malaria still poses an important public health threat in Libya, complicated by the ongoing influx of irregular migrants through its southern borders. Although Libya was certified free of malaria in 1973, recent cases have occurred, mostly associated with travel to adjacent countries where malaria is endemic.
Objects: The aim of this study is to assess the effectiveness of malaria surveillance in southern Libya. And its capacity to address threats posed by irregular migration.
Materials and Methods: A cross-sectional study was conducted to evaluate the malaria surveillance system in southern Libya, using standard questionnaires from CDC guidelines, distributed to monitoring and rapid response teams, supported by official reports. The analysis included 2022 laboratory data from Sabha Medical Center using rapid tests and peripheral blood smears were analyzed to characterize the epidemiological profile.
Results: a total of 79-suspected cases in 2022, including 48 confirmed infections. Of these, 37 (77%) were Libyan citizens and 11 (23%) were irregular migrants from Chad, Niger, Nigeria, Sudan and Ghana. Most cases were documented at Sabha Medical Center, with the 20-30 age group being the most affected (29%). It is worth noting that 79% of patients had recently traveled to Chad, Niger, or Nigeria, which are malaria-endemic areas. Plasmodium falciparum accounted for 75% of infections. The monitoring system's performance was 54%, and it was rated as "unacceptable" with a critical score of 0.18. Major shortcomings included delays in reporting, incomplete data, and instability, especially at border crossings. The emergence of malaria is due to cross-border migration from endemic countries and a weak effective public health surveillance system.
Conclusion: There is a fundamental and systemic dysfunction across most operational and organizational domains. The capacity to safeguard public health or to manage acute emergencies is extremely limited. Addressing this requires expanding the scope of surveillance coverage, strengthening data analysis, and enforcing inspection at the southern border entry points. It also necessitates targeted traveler education and improved diagnostic capabilities to prevent local transmission of malaria.