Abstract
Suriname has cleared malaria from its capital city and coastal areas mainly through the successful use of chloroquine and DDT (dichloro-diphenyl-trichloroethane) during the Global Malaria Eradication programme that started in 1955. Nonetheless, malaria transmission rates remained high in the interior of the country for a long time. An impressive decline in malaria cases was achieved in the past few years, from 14,403 registered cases in 2003 to 1,371 in 2009. The introduction of artemisinin-based combination therapy (ACT) in 2004 has further fuelled the decrease in the number of infections with Plasmodium falciparum. The only population group still heavily burdened with malaria is gold mining industry workers. Interestingly, an important part of malaria cases diagnosed and treated in Suriname originate from border regions. Therefore, practical initiatives of combined efforts between neighbouring countries must be scaled up in order to effectively attack these specific areas. Furthermore, it is of vital importance to keep investing into the malaria control programme and public awareness campaigns. Especially the correct use of ACT must be promoted in order to prevent the emergence of resistance. However, effective preventive measures and adequate therapeutic options are on their own not enough to control, let alone eliminate malaria. Changing personal and social behaviour of people is particularly difficult, but crucial in making the current success sustainable. With this in mind, research on successfully implemented interventions, focusing on behavioural modifications and methods of measuring their effectiveness, must be expanded.
Highlights
IntroductionPlasmodium falciparum has been the most prevalent malaria species for a long time
Introduction of artemisinin-based combination therapy (ACT) InSuriname, Plasmodium falciparum has been the most prevalent malaria species for a long time
Historical background The first malaria in Suriname was most likely imported through enslaved people that were shipped from western Africa around the year 1620
Summary
Plasmodium falciparum has been the most prevalent malaria species for a long time This can partly be explained by the fact that most Maroon inhabitants of the inland regions, called Bush Negroes descendants of runaway slaves - lack the Duffy antigen, an erythrocyte surface receptor that Plasmodium vivax needs to invade red blood cells [17]. The decision to make the switch to an ACT for the treatment of uncomplicated P. falciparum malaria was in accordance with WHO recommendations [19,20,21] It proves to be highly effective at this stage, but the question is for how long this will be the case in view of first hints at emerging artemisinin resistance from South-East Asia [22].
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