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Malaria on the move

Sunday, June 17, 2018

The Americas have witnessed a substantial decline in malaria-related morbidity (62 per cent) and mortality (61 per cent) during the last 15 years as part of the Global Malaria Action Plan, according to the WHO 2016 World Malaria Report.

The World Health Organization (WHO) observed that Venezuela was the first country to eradicate malaria in 1961.
However, it is now an alarming exception, displaying an unprecedented 365 per cent increase in malaria cases between 2000 and 2015. In 2016, Venezuela reported 240,613 official cases.

In 2017 there was a worrying increase of 68 per cent in the cumulative number of cases compared to the previous year with the total number of cases reported by October 21 being 319,765.

The Toronto-based ICASO ‘Triple Threat’ (2017) report on malaria, TB and HIV, noted that malaria cases have overloaded frontier healthcare infrastructure in neighbouring Colombia and Brazil where 81 per cent and 78 per cent respectively of imported malaria cases have originated in Venezuela in 2016.

Malaria is transmitted by the Anopheles mosquito.

There are more than 400 different species of Anopheles mosquitoes and roughly 30 are malaria vectors of major importance.

The intensity of transmission depends on factors related to the parasite, the vector, the human host, and the environment. ‘Strains’ of the disease therefore abound.

The WHO African Region continues to carry a disproportionately high share of the global malaria burden.

In 2016, the region was home to 90 per cent of malaria cases and 91 per cent of malaria deaths.

Some 15 countries—all in sub-Saharan Africa, except India— accounted for 80 per cent of the global malaria burden.

Children under five are particularly susceptible to infection, illness, and death, with more than two thirds (70 per cent) of all malaria deaths occurring in this age group.

The number of under-five malaria deaths has declined from 440,000 in 2010 to 285,000 in 2016. However, malaria remains a major threat taking the life of a human every two minutes.

Venezuela, South Sudan, Yemen, and Nigeria are four countries presently experiencing a malaria surge.

Marianella Herrera, Head of Venezuela’s Health Observatory in Caracas, and Venezuelan malaria expert Maria Eugenia Grillet both concur that, in Venezuela, the rise of the old vector disease is fuelled by poor procurement of insecticides, medicines, and diagnostic tools; weak surveillance; internal migration associated with illegal gold mining in the south-east at the border with Brazil; and a weakened public health care service when the Misión Barrio Adentro, staffed by Cuban doctors, was insufficiently integrated into the substantive practice.

With up to 37,000 people crossing the borders daily into neighbouring countries, the vector disease is on the move.

The San Felix health centre in Venezuela is overwhelmed by the ill. Patients are breaking the anti-malarial pill into four quarters to share with family members, while others traffic the drug at premium prices.

The State claims that sanctions are hindering Venezuela’s ability to pay for medicine.

In March this year, the Government of T&T created an inter-ministerial committee—comprising representatives from the Ministry of Heath, Customs and Excise, National Security, Tourism, the Caribbean Public

Health Agency, the Pan American Health Organisation, and the Tobago House of Assembly—to look into the spread of the vector disease.

The ‘Lima Group’, which comprises several OAS states bordering Venezuela but excluding T&T, agreed to convene a high-level meeting with health authorities within the group to coordinate actions in the area of public health and strengthen cooperation to address the epidemiological emergency and to outline a protocol to support the supply of medicines by independent institutions, as well as epidemiological surveillance actions in Venezuela and its neighbouring countries, particularly due to the reappearance of diseases such as measles, malaria, and diphtheria.

Predatory mosquitoes in the genus Toxorhynchites that are carnivorous are the most common arthropods that have been used for control of ‘container-breeding’ mosquitoes.

Toxorhynchites mosquitoes do not consume blood.

The adults subsist on carbohydrate-rich materials, such as honeydew, or saps and juices from damaged plants, fruit, and nectar.

The larvae of Toxorhynchites splendens consume the larvae of the dreaded Aedes aegypti. The combination of carnivorous larvae and innocuous adults is a very attractive biological control mechanism alongside Long-Lasting Insecticidal Nets (LLINs) and Indoor Residual Spraying (IRS).

Educating a new generation of entomologists for forensic science, the ecology and economics of pests and pollinators and for the surveillance of vector diseases is a priority.


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