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On 15 February 2017 the Pan American Health Organisation (PAHO) released an Epidemiological Alert
detailing increased malaria transmission in endemic municipalities of some countries in the Americas during 2016.
In summary:
Venezuela has reported significant increases in malaria. In 2016 there were 240 613 cases, this represents a 76% increase over the same period of the previous year. Of those cases, 75% were due to P. vivax, 19% due to P. falciparum, and 6% of cases from mixed infections.
Colombia reported an increase in the number of malaria cases, and an increase in the proportion of Plasmodium falciparum cases in comparison to those caused by Plasmodium vivax. In 2016, a total of 83 356 malaria cases were reported, of which 57% were P.falciparum, 39.7% were P.vivax, and 3.3% were mixed infections.
Ecuador reported 926 cases of malaria in 2016, of which 69% were P.vivax and 31% were P.falciparum. From late April 2016 the number of reported malaria cases surpassed those reported in 2014 and 2015. The four provinces with the highest number of malaria cases in 2016 were Morona Santiago with 38% cases reported, Pastaza with 24%, Orellana 17% and Esmeraldas with 14% of the cases.
Costa Rica reported two autochthonous cases of P.vivax malaria in the Province of Limón in late November 2016, no autochthonous had been reported in the previous three years. A further two autochthonous cases were reported the locality of Saborío mid December 2016.
Cuba notified PAHO of two confirmed autochthonous cases of P. Vivax malaria in the province of Cienfuegos during January 2017. The cases were related to an imported case from Guyana.
In response:
PAHO warned of the risk of outbreaks, increased cases and deaths in endemic areas, as well as potential re-introduction of malaria in areas where transmission was previously interrupted. PAHO also urged Member States to strengthen surveillance, detection and treatment of cases in at risk populations and known areas of transmission. PAHO suggested the increase in malaria transmission in some countries could be related to environmental phenomena that has historically determined a cyclical occurrence of malaria in the Americas. However, the report acknowledged that in 2015 and 2016, social and economic factors, such as mining and increased migration flow into environments that are supportive of malaria transmission. Additionally, the weakening of malaria diagnosis networks was cited as another critical factor in the malaria trend of the last two years.
Travellers should be advised that mosquito bite avoidance should always be considered as the first line of defence against malaria and other mosquito-borne infections.
Clinicians should adhere to current guidance for malaria chemoprophylaxis (SMAG and/or ACMP in UK).
