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.

Ethnic differences in cancer incidence among the Guyanese population

BACKGROUND: Globally, cancer is identified as a leading cause of morbidity and mortality. Trends suggest that ethnic and lifestyle factors are influential to its occurrence. In Guyana, cancers have been a leading cause of mortality over the period 2003 to 2012. However, the influence of ethnicity in the occurrence of cancer has not been examined extensively. OBJECTIVE: To investigate the occurrence of cancer among the different ethnicities in Guyana from 2003–2012. METHODS: Data from 2003–2012 from the population based Guyana Cancer Registry were analysed. Frequencies were determined for each cancer by patient demographics and cancer characteristics. Incidence and mortality rates were calculated using Guyana’s resident 2002 population. RESULTS: Of 6518 new cancers, 3956 were in females and 2561 in males. Mean age of females was 55.4 years, SD16.4 and males 62.2 years, SD 18.7 (p < 0.0001). Guyanese Chinese had the highest annual rate (129.9 per100 000); Afro-Guyanese had the highest absolute numbers(2892, 44.4%) and second highest annual incidence(127.4 per 100 000), followed by Indo-Guyanese 2505(37.9%; annual incidence 76.8 per 100 000) and Guyanese of mixed race 510 (7.8%). Male Afro-Guyanese were disproportionately affected by prostate cancer while the females had the highest rates of uterine and second highest rates of breast and cervical cancers. Guyanese Chinese had the highest rates of cervical cancer. Conclusion: Further research is needed to determine risk factors for cancers by ethnicity and aggressive campaigns need to be implemented targeting those risk factors to reduce the burden of disease.

A ten-year profile of cancer in Guyana from 2003–2012

OBJECTIVE: Only one cancer report (2000–2004) on Guyana has ever been published. We sought to establish the profile of cancers in Guyana to assist policy-makers indeveloping a comprehensive cancer programme. SUBJECTS AND METHODS: Data from 2003–2012 from the population-based Guyana Cancer Registry were analysed. Frequencies were determined for each cancer by patient demographics and cancer characteristics. Incidence and mortality rates were calculated using Guyana’s resident 2002 population. RESULTS: A total of 6518 incident cancers were recorded:3956 in females and 2561 in males. Mean age of females was 55.4 years, SD 16.4 and males 62.2 years, SD 18.7 (p< 0.0001). Average annual incidence was 86.8 per 100 000 population (females 105.4, males 68.1), age standardized rate was 139.3 per 100 000 population. In females, the leading sites were breast 1074, cervix uteri 1014 and corpus uteri 325; and in males, prostate 865, colo-rectum 206 and lung 157. By ethnicity, 44.4% of cases were in Afro-Guyanese and 38.4% in Indo-Guyanese. Death occurred in 52.3% (45% of females, 65% of males), for an average annual mortality rate of 48 per 100 000 population(females 47.6 and males 43.4). Lifetime risk of developing cancer was one in eight for females and one in 16 for males. CONCLUSION: Cancers placed a significant burden on the Guyanese population during 2003–2012. Females were affected at a younger age than males. Afro-Guyanese were affected more than other ethnic groups. Significant prevention, treatment and control efforts are required to reduce the morbidity and mortality associated with cancers.

Estimated cost analysis for demand-driven family health outreaches in Guyana in 2014

OBJECTIVE: To review the cost implications of demand driven health outreaches made in 2014 in terms of need, saliency and benefits. SUBJECTS AND METHODS: In 2014, there were 85 medical outreach visits to seven of the 10 administrative regions provided by five entities including the government. The costing methodology was to randomly select two outreaches by each entity and then quantify the direct cost, vis-à-vis drugs and medical supplies, voluntary counseling and testing (VCT), visual inspection of cervix using acetic acid (VIA), dental, blood banking and optical services, and the cost of indirect services such as transportation, meals and stipend. RESULTS: The direct cost was GY $101 755 075 while the indirect costs amounted to GY $3 464 925 (US $17026.66) in total. Therefore, the total estimated aggregate cost for the demand-driven medical outreaches in 2014 in Guyana amounted to GY $105 220 000 (US $517 051.58). CONCLUSIONS: The cost involved in the provision of the demand-driven medical outreach service could have provided support for nine health centres or 36 health posts for one full year. Coupled with the fact that the service is mainly along the coastal areas, where the need for such services is less, it is suggested that government either suspend these activities pending a full review or have limited outreach visits to the interior in the interim.

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.

Health @ 50 in Guyana: Progress health report 1966-2016

The document highlights the achievements made in the public health system in Guyana as well as the challenges faced during the past fifty years. It provides an analysis of the country context, the health systems and services, the epidemiological profile, the achievements and challenges, and the health targets for the next fifty years. The Epidemiological profile addresses diseases surveillance and disease profile, including measles, malaria, tuberculosis, HIV/AIDS, dengue, cardiovascular, hypertension, diabetes and cancer.

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

National plan for the elimination of cholera in Haiti 2013-2022: short term plan 2013-2015

In October 2010, a cholera epidemic, like that of the January 12 earthquake, unexpectedly struck our country. The general population was still recovering and bandaged from injuries inflicted by the earthquake. This epidemic brought to light all the weaknesses of the Haitian health system. Lacking expertise and resources to fight major endemic diseases, this new cholera epidemic gave rise to widespread panic. Officials of all categories (political and technical) rapidly realized that they must roll up their sleeves and manage the situation in order to prevent a rampant increase in the number of deaths and allow the population to rebuild their health. Once again the Friends of Haiti did not compete in this struggle. They rallied tohelp bridge the gap, while transferring their knowledge and expertise to Haitian technical staff. Today, with the commitment of the Haitian state, and the support of all partners, the country is taking a second breath. It sees the future differently because cholera, despite its virulence and lethality, is under control and can be eliminated. In this context, on 11 January 2012, Presidents Michel Joseph Martelly of the Republic of Haiti and Lionel Fernandez of the Dominican Republic committed to undertake actions that could lead to the elimination of cholera by 2022. This committment was restated on 9 October 2012 in Santo Domingo by the Ministers of Health of the two countries. This document, prepared by the Ministry of Public Health and Population in collaboration with partners, is designed to provide a sustainable response by addressing the problem of disposing of cholera in three phases: short, medium and long term, and in four areas of action: water and sanitation, epidemiological surveillance, health promotion for behavior change, and care of infected persons in health institutions. Its strict application by everyone will help us achieve the goal to eliminate cholera by 2022.

Independent Inquiry into Inequalities in Health Report

Although average mortality has fallen over the past 50 years, unacceptable inequalities in health persist. For many measures of health, inequalities have either remained the same or have widened in recent decades. These inequalities affect the whole of society and they can be identified at all stages of the life course from pregnancy to old age. The weight of scientific evidence supports a socioeconomic explanation of health inequalities. This traces the roots of ill health to such determinants as income, education and employment as well as to the material environment and lifestyle. It follows that our recommendations have implications across a broad front and reach far beyond the remit of the Department of Health. Some relate to the whole Government while others relates to particular Departments.