Malawi’s Community-Led Response Contained First Mpox Case in Mangochi

By 11 July 2025, Malawi’s Public Health Institute had documented 59 confirmed cases, concentrated in Lilongwe and Mangochi, with a few isolated cases in other districts.

When Malawi confirmed its first case of mpox on 16 April 2025, the country joined a growing list of African nations grappling with the disease since its designation as a Public Health Emergency of International Concern (PHEIC) by the World Health Organization (WHO) in August 2024.

By 11 July 2025, Malawi’s Public Health Institute had documented 59 confirmed cases, concentrated in Lilongwe and Mangochi, with a few isolated cases in other districts. But behind these statistics lies a remarkable story of resilience: how one village in Mangochi contained its first mpox case without letting the disease spread further.

The First Case in Mangochi

On 19 April 2025, a 2-year-old boy from Ntiyala Village, Traditional Authority Mponda, was brought to the Koche Community OPD Clinic with a rash, fever, and headache.

Health Surveillance Assistant (HSA) Walinase Mughogho recalled:

“After assessment by the clinician, mpox was suspected. The child was isolated, and a sample sent to Mangochi District Hospital later confirmed the case. We immediately began contact tracing, starting with children who had been in contact with him.”

With no dedicated isolation facility in the district, the child was treated at home. This posed a serious challenge: stopping the virus would require strong community involvement.

Empowering the Community

The Koche Clinic, HSAs, and village leadership quickly mobilized. Community members were advised to avoid sharing clothes, bathing in streams, overcrowding, and to improve hygiene practices, including safe food handling and handwashing.

Village Development Committee member Chilapula Simba explained how local structures were activated:

“We held an emergency meeting with village leaders and HSAs. Together, we launched a door-to-door awareness campaign to explain what mpox is, how it spreads, and how to prevent it. We emphasized support for the affected family and discouraged discrimination.”

This proactive approach proved decisive. The family received community support, not stigma, and no new cases emerged from the village.

District-Level Emergency Response

At the district level, Stanley Rashid, Mangochi’s Integrated Disease Surveillance and Response (IDSR) officer, said health officials moved swiftly:

“We convened an emergency meeting as soon as the clinic reported the case. An emergency response management system was activated, with each pillar given clear responsibilities—surveillance, case management, and health promotion.”

• Surveillance teams began active contact tracing.

• Case management teams monitored and supported the child at home.

• Health promotion teams partnered with Liranguka Community Radio, which broadcast mpox information and fielded live questions from listeners.

Collaboration with WHO and Partners

Following the village-level response, WHO and partner organizations visited Mangochi to document lessons learned. HSAs, clinic staff, and district officials stressed the importance of multi-level collaboration—from village leaders to national authorities.

Mughogho reflected on the lessons:

“The turning point was our ability to work together—HSAs, Koche Clinic, Mangochi District Hospital, and the community. But we also learned that spreading information widely remains a challenge. We need more posters, more community radio engagement, even drama performances to reach everyone.”

Building Capacity for the Future

Since the outbreak declaration, Mangochi has trained health workers in mpox surveillance and case management, while also conducting an after-action review to identify gaps in preparedness.

As of August 2025:

• Mangochi has reported only three confirmed cases.

• No mpox-related deaths have been recorded nationwide.

A Model of Collective Action

The experience in Mangochi demonstrates that mpox can be contained and prevented through community solidarity, timely action, and clear communication.

Mughogho summed it up best:

“This experience has taught us that it takes all of us—health workers, families, community leaders, and local structures—to stop the spread. And when we do, we win together.”