Abstract
BackgroundSuriname has experienced a significant change in malaria transmission risk and incidence over the past years. The country is now moving toward malaria elimination. The first objective of this study is to describe malaria epidemiological trends in Suriname between 2000 and 2016. The second objective is to identify spatiotemporal malaria trends in notification points between 2007 and 2016.MethodsNational malaria surveillance data resulting from active and passive screening between 2000 and 2016 were used for the temporal trend analysis. A space–time cluster analysis using SaTScan™ was conducted on Malaria Programme-data from 2007 to 2016 comparing cases (people tested positive) with controls (people tested negative).ResultsSuriname experienced a period of high malaria incidence during 2000–2005, followed by a steep decline in number of malaria cases from 2005 onwards. Imported malaria cases, mostly of Brazilian nationality and travelling from French Guiana, were major contributors to the reported number of cases, exceeding the national malaria burden (94.2% of the total). Most clusters in notification points are found in the border area between Suriname and French Guiana. Clustering was also found in the migrant clinic in Paramaribo.ConclusionsSuriname has successfully reduced malaria to near-elimination level in the last 17 years. However, the high malaria import rate resulting from cross-border moving migrants is a major challenge for reaching elimination. This requires continued investment in the national health system, with a focus on border screening and migrant health. A regional approach to malaria elimination within the Guianas and Brazil is urgently needed.
Highlights
Suriname has experienced a significant change in malaria transmission risk and incidence over the past years
1622 malaria cases and 3094 negatives were identified in people without a blood smear result but with a rapid diagnostic tests (RDTs) result
This resulted in a total of 73,415 confirmed malaria cases over the study period, of which 66,386 cases were autochthonous
Summary
Suriname has experienced a significant change in malaria transmission risk and incidence over the past years. This study aims to describe the malaria morbidity and mortality trends and the geographical distribution of malaria in Suriname, taking into account the most probable origin of infection, for the period 2000 to 2016. It aims to assess the spatiotemporal trends of malaria diagnosed in the health system notification points using data from the Suriname surveillance programme from 2007 to 2016. The space–time cluster analysis of notification points will help identify priority service points, and allow for determination of risk population characteristics in these service points This in turn enables better-targeted investments and interventions
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