Study of the epidemiological behavior of malaria in the Darien Region, Panama. 2015–2017


Autoři: Lorenzo Cáceres Carrera aff001;  Carlos Victoria aff002;  Jose L. Ramirez aff003;  Carmela Jackman aff004;  José E. Calzada aff005;  Rolando Torres aff001
Působiště autorů: Department of Medical Entomology, Gorgas Memorial Institute of Health Studies, Panama City, Panama aff001;  Malaria Program, Ministry of Health, Panama City, Panama aff002;  Crop Bioprotection Research Unit, National Center for Agricultural Utilization Research, Agricultural Research Service, United States Department of Agriculture, Peoria, Illinois, United States of America aff003;  Epidemiology Department of the Darién Region, Ministry of Health, Panama City, Panama aff004;  Direcction of Research and Technological Development, Gorgas Memorial Institute of Health Studies, Panama City, Panama aff005
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224508

Souhrn

Background

Malaria is endemic in Darién and an assessment of the different factors affecting its epidemiology is crucial for the development of adequate strategies of surveillance, prevention, and disease control. The objective of this study was to determine the main characteristics of the epidemiological behavior of malaria in the Darien region.

Methods

This research was comprised of a retrospective analysis to determine the incidence and malaria distribution in the Darien region from 2015 to 2017. We evaluated malaria indicators, disease distribution, incidence (by age group and sex), diagnostic methods, treatment, and control measures. In addition, we examined the cross-border migration activity and its possible contribution to the maintenance and distribution of malaria.

Results

During the period of 2015–2017, we examined 41,141 thick blood smear samples, out of which 501 tested positive for malaria. Plasmodium vivax was responsible for 92.2% of those infections. Males comprised 62.7% of the total diagnosed cases. Meanwhile, a similar percentage, 62.7%, of the total cases were registered in economically active ages. The more frequent symptoms included fever (99.4%) and chills (97.4%), with 53.1% of cases registering between 2,000 and 6,000 parasites/μl of blood. The annual parasitic incidence (API) average was 3.0/1,000 inhabitants, while the slide positivity rate (SPR) was 1.2% and the annual blood examination rate (ABER) 22.5%. In Darién there is a constant internal and cross-border migration movement between Panama and Colombia. Malaria control measures consisted of the active and passive search of suspected cases and of the application of vector control measures.

Conclusion

This study provides an additional perspective on malaria epidemiology in Darién. Additional efforts are required to intensify malaria surveillance and to achieve an effective control, eventually moving closer to the objective of malaria elimination. At the same time, there is a need for more eco-epidemiological, entomological and migratory studies to determine how these factors contribute to the patterns of maintenance and dissemination of malaria.

Klíčová slova:

Diagnostic medicine – Economics of migration – Epidemiology – Malaria – Malarial parasites – Parasitic diseases – Plasmodium – Panama


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PLOS One


2019 Číslo 11