National malaria programme strategic plan 2015-2020

Malaria is a major health problem in Guyana and this report charts the path for malaria control, prevention and elimination over the period 2015-2020. The National Malaria Strategic Plan 2015-2020 is committed to reducing the overall burden of malaria in Guyana by 50% in the affected areas. To achieve this goal, the document addresses the development of the national strategy; the role of stakeholders; a situational analysis; the response to malaria and related gaps and challenges; the guiding principles and strategic framework; monitoring and evaluation; the financial investments and gap analysis; and the implementation and management of the programme.

Ministry of Health Malaria Program Suriname: Annual report 2017: Towards malaria elimination -- Test, treat and track

Suriname was responsible for the highest concentration of Plasmodium falciparum malaria in the Americas prior to 2006. Since 2006 the country experienced a significant decrease in malaria incidence, reaching near elimination levels by 2009. The country is currently listed by the World Health Organization (WHO) among the countries with the potential to eliminate malaria by 2020. The 2017 Annual Report of the Ministry of Health Malaria Program of Suriname outlines the ongoing, nationally adopted strategies aimed at achieving the elimination of Malaria by the target date, especially in light of diminishing funding from international aid organizations

National vector control program 2018-2019 operational plan

Operational plan of Belize's 2018-2019 National Vector Control Program. This shows the strategies used for improved health services and their outcomes in reducing vector borne diseases (Malaria, Dengue, Zika and Chikungunya).

Map showing roads, airstrips, police outposts/stations, mining and forest stations in Guyana

Map of Guyana utilizes a colour key to identify the number of locations where malaria microscopy is done; the main malaria hot spots; and the main health facilities.

A comprehensive needs assessment to identify priority program targets for mosquito vector control and related diseases in Belmopan, Belize

This was a mixed-methods study aimed to comprehensively assess factors associated with mosquito control in Belmopan, Belize, in order to better inform stakeholders on the effectiveness of their efforts. A knowledge, attitudes, and perceptions (KAP) survey was employed within the four target communities of San Martin, Salvapan, Maya Mopan, and Las Flores. Additional epidemiological and entomological data was provided by relevant stakeholders. A total of 228 households were surveyed among the four target communities. Only 1/3 of respondents were able to demonstrate proficient knowledge. Knowledge was attained mostly through TV, Ministry of Health, hospital, and radio sources. Over 90% of respondents believed that mosquitos and the diseases they carry were a real issue for the community. Respondents living in Salvapan and Las Flores were more likely to have contracted Dengue Fever, Malaria, Chikungunya, or Zika than in other areas. Fan usage and regularly cleaning the yard were the two most employed practices for preventing mosquito bites and breeding. Approximately 85% of those surveyed viewed insecticide spraying to be effective. This assessment provides valuable insight into the needs of at- risk communities in regards to vector control. An increased focus on community outreach, education, and behavioral change can greatly impact the effectiveness of current vector control efforts. Stakeholders must work together and pool resources in order to effectively employ control interventions. Continued evaluation and community involvement is necessary to control mosquitos and prevent disease outbreaks...(AU)

Estimated effects of climate variables on transmission of malaria, dengue and leptospirosis within Georgetown, Guyana

OBJECTIVE: To analyse meteorological data (temperature, rainfall and relative humidity) and vector-borne diseases (malaria, dengue and leptospirosis) to determine trends that may exist between and among variables within the Georgetown area. SUBJECTS AND METHODS: This study took on a retrospective approach which used data from the Ministry of Health and Ministry of Agriculture, Hydro-meteorological Department, to assess the true nature of the relationship between climate and vector-borne diseases (malaria, dengue and leptospirosis) within the Georgetown area. Correlation and regression analysis was done using SPSS version 13. RESULTS: The results yielded weak positive correlation between climate variables and vector-borne disease withstrongest correlation between P falciparum and Pmalariae. Leptospirosis showed positive correlation withhumidity and dengue showed positive correlation with all three climate variables measured. Projections showed that with a 1 increase in temperature, 1% increase in relative humidity and 50 mm increase in rainfall, there would be significant increases in malaria and leptospirosis. CONCLUSIONS: There have been theories that suggest a connection between climate variables and vector-borne disease but conclusive evidence does not exist. In this present study, the need for research that yields more unwavering results is highlighted. There is no doubt that climate variables influence vector-borne diseases. Therefore, it is recommended that an interdisciplinary approach be taken to ensure reliability and foster a better understanding between climate variables and vector-borne diseases.

Malaria

The report traces the efforts of the National Malaria Eradication Programme to eliminate the disease from as early as 1959 and up to 2015. Statistics to support the reduction of malaria in the coastal and other regions include the cases of malaria in Guyana between 1991-2013; the correlation between malaria cases and the price of gold; and cases of malaria by age and ethnicity in 2014.

Malaria treatment guideline for health facilities in Guyana

In response to the malaria challenge in Guyana, the Ministry of Public Health of Guyana outlines the best standardized treatment of malaria for the public and private sector by promoting the development of one strategy for early diagnosis and treatment for malaria patients. This is a review of the first version developed in 2004 which now includes updated content on further complicated treatment guidelines and malaria in pregnancy. The manual includes the epidemiological situation of malaria in Guyana up to 2014; the antimalarial treatment policy; and the timely diagnosis and adequate doses of the treatment for complicated and uncomplicated malaria cases

The field evaluation of a push-pull system to control malaria vectors in northern Belize, Central America

BACKGROUND: Campaigns for the continued reduction and eventual elimination of malaria may benefit from new and innovative vector control tools. One novel approach being considered uses a push-pull strategy, whereby spatial repellents are used in combination with outdoor baited traps. The desired effect is the behavioural manipulation of mosquito populations to elicit movement of vectors away from people and into traps. METHODS: Here, a prototype push-pull intervention was evaluated using an experimental hut methodology to test proof-of-principle for the strategy against two natural vector populations, Anopheles albimanus and Anopheles vestitipennis in Belize, Central America. A Latin square study design was used to compare mosquito entry into experimental huts and outdoor traps across four different experimental conditions: 1) control, with no interventions; 2) pull, utilizing only outdoor traps; 3) push, utilizing only an indoor spatial repellent; and 4) push-pull, utilizing both interventions simultaneously. RESULTS: For An. vestitipennis, the combined use of an indoor repellent and outdoor baited traps reduced average nightly mosquito hut entry by 39% (95% CI: [0.37 ­ 0.41]) as compared to control and simultaneously increased the nightly average densities of An. vestitipennis captured in outdoor baited traps by 48% (95% CI: [0.22 ­ 0.74]), compared to when no repellent was used. Against An. albimanus, the combined push-pull treatment similarly reduced hut entry, by 54% (95% CI: [0.40 ­ 0.68]) as compared to control; however, the presence of a repellent indoors did not affect overall outdoor trap catch densities for this species. Against both anopheline species, the combined intervention did not further reduce mosquito hut entry compared to the use of repellent alone. CONCLUSIONS: The prototype intervention evaluated here clearly demonstrated that push-pull strategies have potential to reduce human-vector interactions inside homes by reducing mosquito entry, and highlighted the possibility for the strategy to simultaneously decrease human-vector interactions outside of homes by increasing baited trap collections. However, the variation in effect on different vectors demonstrates the need to characterize the underlying behavioral ecology of target mosquitoes in order to drive local optimization of the intervention…(AU)

Communication strategy for malaria control 2014-2016

Malaria remains a public health problem in Guyana, particularly in the hinterlands. Malaria prevention centers on control and treatment options provided by the National Malaria Program through the Ministry of Public Health. This makes communication an essential tool for positive outcomes of all options offered in malaria prevention and control by the National Malaria Program. The National Malaria Communication Strategy is to guide the development, implementation, and monitoring of the communication and behavior change component of malaria prevention and control. The National Malaria Communication Strategy is aligned to support the National Malaria Strategic Plan for 2015-2020. It is our hope that all actors who use this strategy will find it useful in their interventions and most importantly in the promotion of interventions that are meant to eliminate malaria in this country.

Manual on integrated vector management for community health workers and voluntary collaborators in Belize

The objectives of the presentation are to enable participants to identify: the vectors of malaria, dengue, chikungunya and chagas diseases; the signs and symptoms for malaria, dengue, chagas and chikungunya diseases; and the transmission cycle for malaria, dengue, chikungunya and chagas diseases.

Vector control services: malaria supply chain management in facilities standard operations manual

Use of malaria medicines is essential and critical in our response to the malaria situation in Guyana. It is part of the final link between patients and health services. Availability of malaria medicines and diagnostic supplies can only be realized by improving the opportunity to manage these commodities in an efficient manner. For these reasons, this manual will address all aspects of the pharmaceutical management cycle. The manual provides basic information for the successful operation of the supply chain for Malaria Medicines and Supplies. The intention is to use this manual for training and orientation of health workers in best practices of the drug management cycle, in pursuit of securing performance improvements to the malaria program.

A comparison of two commercial mosquito traps for the capture of Malaria vectors in northern Belize, Central America

To achieve maximum success from any vector control intervention, it is critical to identify the most efficacious tools available. The principal aim of this study was to evaluate the efficacy of 2 commercially available adult mosquito traps for capturing Anopheles albimanus and An. vestitipennis, 2 important malaria vectors in northern Belize, Central America. Additionally, the impact of outdoor baited traps on mosquito entry into experimental huts was assessed. When operated outside of human-occupied experimental huts, the Centers for Disease Control and Prevention (CDC) miniature light trap, baited with human foot odors, captured significantly greater numbers of female An. albimanus per night (5.1 6 1.9) than the Biogents SentinelTM trap baited with BG-LureTM (1.0 6 0.2). The 2 trap types captured equivalent numbers of female An. vestitipennis per night, 134.3 6 45.6 in the CDC trap and 129.6 6 25.4 in the Sentinel trap. When compared to a matched control hut using no intervention, the use of baited CDC light traps outside an experimental hut did not impact the entry of An. vestitipennis into window interception traps, 17.1 6 1.3 females per hour in experimental huts vs. 17.2 6 1.4 females per hour in control huts. However, the use of outdoor baited CDC traps did significantly decrease the entry of An. albimanus into window interception traps from 3.5 6 0.5 females per hour to 1.9 6 0.2 females per hour. These results support existing knowledge that the underlying ecological and behavioral tendencies of different Anopheles species can influence trap efficacy. Furthermore, these findings will be used to guide trap selection for future push­ pull experiments to be conducted at the study site...(AU)

Manual of standard operating procedures for microscopic diagnosis of Malaria

The Basic Malaria Microscopy Manuals, Manual of Standard Operating Procedures for Malaria Microscopic Diagnosis and Training Manual Tutor's Guide, for conducting microscopic diagnosis of malaria in Guyana was developed jointly by the Ministry of Health and the Pan American Health Organization (PAHO/WHO) through the RAVREDA-AMI Project. These Manuals are necessary to ensure all partners involved in the multitask holder approach to the control of malaria in Guyana follow the principles of best practices globally tailored to suit the local epidemiologic, social and clinical aspects of malaria control in the country.

Short communication: concomitant malaria and filariasis infections in Georgetown, Guyana

Lymphatic filariasis and malaria are endemic in Guyana, South America. To determine the prevalence of concomitant infections, we conducted a 1-year survey of febrile patients attending the malaria (day) and filariasis (night) clinics in Georgetown. In all, 1278 thick blood smears were collected; 769 for filariasis, of which 103 were positive for Wucheria bancrofti, and three for both W. bancrofti and malaria parasites; and 509 for malaria, 21 of which tested positive for malaria and 17 for both malaria and filariasis. The age groups and sex of the infected persons with malaria and W. bancrofti are descibed. These results suggest that the incidence of concomitant infections in Guyana may be quite low but efforts should be made to reduce the disease burden in Georgetown, Guyana (AU)

Epidemiology of acute hepatitis in the Stann Creek District of Belize, Central America

Hepaptits is common in the Stann Creek District of Southern Belize to determine the etiologies, incidence and potential risk factors for acute jaundice, we conducted active surveillance for cases. Cases of jaundice diagnosed by a physician within the previous 6 weeks were enrolled. Evaluation included a questionnaire and laboratory tests for Hepatitis A, B. C, D, and E, a blood film for malaria, and a serologic test for syphilis. Etiologies of jaundice among 62 evaluable patients included acute hepatitis A, 6 (9.7 percent), acute hepatitis B, 49 (79.0 percent) hepatitis non-A-E, 2 (3.2 percent), and malaria, 5 (8.1 percent). There were no cases of acute hepatitis E. One patient each with antibody to hepatitis C and D were detected. The annualized incidence of hepatitis A was 0.26 per 1000. All cases of hepatitis A were in children 4-16 years of age. The annualized incidence of hepatitis B, 2.17 per 1000, was highest in adults aged 15-44 years (4.4 per 1000) and was higher in men (36 cases; 3.09 per 1000) than women (13 cases; 1.19 per 1000). Four (31 percent) of the women with hepatitis B were pregnant. The annualized incidence was significantly higher in Mestizo (6.18 per 10000 and Maya (6.79 per 1000) than Garifuna (0.38 per 1000) or Creole (0.36 per 1000). Persons with Hepatitis B were significantly more likely to be born outside of Belize (82 percent), had been in Belize < 5 years (73 percent), and lived and worked in rural areas (96 percent) than was the general population. Of those o 14 years of age with Hepatitis B, only 36 percent were married. Few persons admitted to transfusions, tattoos, IV drug use, multiple sexual partners, visiting prostitutes, or sexually transmitted diseases. Only 1 of 49 had a reactive test for syphilis. Six patients were hospitalized (including 3 with acute hepatitis B and one with Hepatitis A), and none to our knowledge died. Acute hepatitis B is the most common cause of viral hepatitis in the Stann Creek District, but the modes of transmission remain obscure. Infants, women attending prenatal clinics, and new workers are potential targets for immunization with Hepatitis B vaccine. (AU)

Reactivation of plasmodium malariae infection in a Trinidadian man after neurosurgery

Malaria often presents as an acute febrile illness with fever, headache, rigors, anemia, and splenomegaly. The only malaria parasite associated with cerebral complications, Plasmodium falciparum usually blocks cerebral capillaries because of its endothelial adhesiveness. Infections with P. marlariae can persist for decades and are associated with splenomegaly and the nephrotic syndrome but not with cerebral complications. We describe P. malariae infection that was reactivated after neurosurgery after decades of latency. Infections with P. malariae may be asymptomatic and can be reactivated decades after the initial infection. The epidemiologic significance of asymptomatic cases of P. malariae infection has been well documented during outbreaks in Trinidad and Tobago and Grenada. Most of the symptomatic cases were detected by microscopial analysis, whereas the asymptomatic cases were diagnosed with the use of immunofluorescence antibody assays. Subclinical infections in humans may serve as the source of the protozoa in mosquitoes. Consequently, it is recommended that a sensitive technique that is based on the polymerase chain reaction be used to screen persons for persistent malaria infections, especially those who live in regions where the disease was once common but has since been eradicated

Concomitant malaria and filariasis infections in Georgetown, Guyana

OBJECTIVE: To determine the prevalence of concomitant malaria and bancroftian filariasis among febrile patients in Georgetown, Guyana, South America. METHODOLOGY: From January to December 1997, all patients visiting the Georgetown Malaria and Filariasis Clinics were enrolled in the study. At the Filariasis Clinic, nocturnal thick blood smears prepared from blood taken between 8:00 pm and 12:00 midnight were dried and stored overnight. At the Malaria Clinic, thick blood smears were taken during the period 8:30 am to 4:00 pm, representing the diurnal study. All slides were stained using the standard Giemsa protocol and microscopically examined for the presence of filariasis and malaria. RESULTS: Of 1,267 persons, 83 percent were of African descent, 10 percent were of East Indian descent, and 7 percent were mixed or of other ethnic origins. Sixty-one per cent (769/1267) of smears were prepared from nocturnal blood samples whereas 509/1267 (40 percent) were diurnal samples from the Malaria Clinic. One hundred and three of 769 nocturnal blood smears were positive for only W bancrofti and 3 smears contained mixed infections, W bancrofti and malaria parasites. Only 21/509 diurnal blood smears had malaria parasites while 17 persons had both malaria and microfilaria parasites. CONCLUSION: The 20 cases of concomitant infection of malaria and bancroftian filariasis in this study may represent the first report of the occurrence of this phenomenon in Guyana.(AU)