Malaria elimination in Haiti by the year 2020: an achievable goal?

Paul Jacques Boncy,Dwayne Baxa,Linda Kaljee,Alexandre Existe,Jean Frantz Lemoine,Philippe Brasseur,Paul Adrien,Eric Prieur,John B Dame ,Chelsea S Lutz ,Massimiliano S Tagliamonte ,P Henry ,Bernard A Okech ,Maha A El Badry ,Dana Parke ,Connie J Mulligan ,Natael Fénelon ,Tamar E Carter ,Valery Madsen Beau De Rochars ,C P Raccurt ,Marcus J Zervos

doi:10.1186/s12936-015-0753-9

Abstract

Haiti and the Dominican Republic, which share the island of Hispaniola, are the last locations in the Caribbean where malaria still persists. Malaria is an important public health concern in Haiti with 17,094 reported cases in 2014. Further, on January 12, 2010, a record earthquake devastated densely populated areas in Haiti including many healthcare and laboratory facilities. Weakened infrastructure provided fertile reservoirs for uncontrolled transmission of infectious pathogens. This situation results in unique challenges for malaria epidemiology and elimination efforts. To help Haiti achieve its malaria elimination goals by year 2020, the Laboratoire National de Santé Publique and Henry Ford Health System, in close collaboration with the Direction d’Épidémiologie, de Laboratoire et de Recherches and the Programme National de Contrôle de la Malaria, hosted a scientific meeting on “Elimination Strategies for Malaria in Haiti” on January 29-30, 2015 at the National Laboratory in Port-au-Prince, Haiti. The meeting brought together laboratory personnel, researchers, clinicians, academics, public health professionals, and other stakeholders to discuss main stakes and perspectives on malaria elimination. Several themes and recommendations emerged during discussions at this meeting. First, more information and research on malaria transmission in Haiti are needed including information from active surveillance of cases and vectors. Second, many healthcare personnel need additional training and critical resources on how to properly identify malaria cases so as to improve accurate and timely case reporting. Third, it is necessary to continue studies genotyping strains of Plasmodium falciparum in different sites with active transmission to evaluate for drug resistance and impacts on health. Fourth, elimination strategies outlined in this report will continue to incorporate use of primaquine in addition to chloroquine and active surveillance of cases. Elimination of malaria in Haiti will require collaborative multidisciplinary approaches, sound strategic planning, and strong ownership of strategies by the Haiti Ministère de la Santé Publique et de la Population.

Highlights

Haiti and the Dominican Republic, which share the island of Hispaniola, are the last locations in the Caribbean where malaria still persists [1]
In Haiti, malaria infections have been found to be predominantly caused by Plasmodium falciparum [1], but Plasmodium malariae appears sporadically [14]
This antimalarial is considered to the present day by the Ministère de la Santé Publique et de la Population (MSPP—Haitian Ministry of Public Health and Population) as the first-line drug of choice for treating uncomplicated malaria

Summary

Introduction

Haiti and the Dominican Republic, which share the island of Hispaniola, are the last locations in the Caribbean where malaria still persists [1]. The laboratory is a critical resource for elimination of malaria in Haiti by serving to support surveillance, research, and intervention work conducted in concert with the MSPP, University of Florida scientists, U.S Department of Defense, and other collaborating investigators in studying and preventing insect borne diseases in Haiti.

Results

Conclusion