Thursday , December 9 2021

Malaria, a disease without eradication



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Anopheles single-bite female mosquitoes can transmit a parasite that causes malaria or malaria. Komarac knows no boundary or border. Their wives seek blood to feed their offspring and go from body to body transmitting the disease in a very difficult cycle to eliminate them. But not impossible

In Panama, malaria is a persistent disease, and most cases are reported in autochthonous populations.

Malaria parasites are five species, according to the Pan American Health Organization (PAHO), but two of the most dangerous are Plasmodium vivac and Plasmodium falciparum, and this latter can aggravate the patient's health and lead to death

Epidemiological records of the Ministry of Health (Mins) show that Plasmodium vivak and Plasmodium falciparum are circulating in the country and that when comparing cases of people presenting the disease by October this year with those reported last year for the same month, there has been an increase of 48 cases. In 2017 it was 531, while this year the number increased to 579.

This latest report also suggests that an increase in the number of people with malaria is within the expected range, as Plasmodium vivak epidemics existed in the communities of the Tuira River, the Darien Province, in the Guna Iala region (La Miel, Puerto Obaldia and Chico) and in the Ngabe Bugle region and Colon.

Challenge

Faced with this situation, the Mins and Gorgas Health Research Institute (IECGES) has taken on the challenge of eradicating malaria in 2020 under the Strategic Plan for Elimination (PEEM) malaria, signed in April by health authorities and PAHO representatives, in which propose the necessary actions to achieve the elimination of autochthonous cases in the country.

Among the measures to be taken is the active search of cases, an integral approach, community orientation and intra-domicile spraying.

In fact, Epidemiology data show that 549 autochthonous cases and 30 imported malaria cases were reported by October last year. During 2017, there were 599 autochthonous cases and 31 cases of imports, or a total of 630 persons presented the disease.

In this regard, the Ministry of Epidemiology of Mins has reported that cases of illness continue to exist in indigenous areas because they were unable to eliminate the malaria hotspot.

In addition, the key problem they encountered is the linguistic difference between indigenous populations and health officials coming to these regions with prevention and control programs.

Officials for epidemiology reported that during the workshops with the entities showed deficiencies in diagnosis, treatment, research and response, which is why PEEM rely on these aspects.

Deputy Health Minister Eric Ulloo explained that as a country we will not make progress, not only against the fight of mosquitoes, the vector; but in an active search for cases, for which we have to work with the community, promoters, and active search for cases, and treat them quickly to reduce transmission.

He added that there are some obstacles, such as the dispersion of endemic sites, endemic areas located at international borders, socio-cultural characteristics of the autochthonous population, among others.

Suggestions and studies

In the meantime, Icges is a scientist Nicanor Obaldia III recommended a multisectoral approach involving MINSA, the Ministry of Housing Affairs, the vice-presidential ministry for autochthonous relations, among other things, to direct efforts on endemic hotspots (improving the housing and drainage system, and fumigation and removal of mosquito breeding sites).

He claimed that they are conducting a study they hope to be part of the basis for proposing the establishment of a system of molecular epidemiological surveillance of imported or recovered parasites in Panama and Mesoamerica. [desde la península de Yucatán en México, Centroamérica y Panamá].

The researcher emphasized that this proposal aims to determine the genetic diversity and structure of the population in order to understand the epidemiology or disease dynamics, as well as the biology of its transmission, which are key elements for implementing a successful elimination program.

De Obaldia III confirmed that the preliminary results of the research implied Genetic diversity and population structure of human malaria parasites in Panama they indicate that during 2007-2012. The Plasmodium vivak parasite that circled in Panama was in a "cloning" phase (highly linked genetically or crossed), indicating low diversity and, consequently, a small transmission. These results confirm the progress towards elimination.

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