Sustained malaria control in Suriname after 3 years of effective interventions

Abstract

Background: Suriname along with Guyana and French Guyana have contributed with a high concentration of malaria cases in the region. In Suriname, 10% of the population lives in malaria endemic areas. Falciparum malaria is the predominant parasite followed by Plasmodium vivax and Plasmodium malariae, representing an important public health problem. Effective control measures have impacted malaria morbidity and mortality and changed the epidemiological profile in the country in the last 5 years. We assessed the achievements in malaria interventions in Suriname after 3 years of scaling up control measures. Methods: National malaria data per year was obtained from the national malaria surveillance system. Artemisinin-derivatives combination therapy (ACT) was implemented in 2004 and in 2006, a combination of interventions were implemented in different strata. Insecticide-treated long lasting nets (LLNs), aggressive active case detection (ACD), media campaign (IEC/BCC), Indoor residual spraying (IRS), Mass screening and treatment, Primaquine, passive surveillance and impregnation/re-impregnation were carried out in the interior of the country. Malaria diagnosis was performed with light microscopy and rapid diagnostic tests. Results: After the national implementation of ACT in the country (2004-2005), a 33% reduction of malaria cases was recorded. By 2006, evidence-based interventions were implemented: LLNs (coverage 95%), IRS (60% coverage high risk areas), IEC/BCC (>15 people reached), ACD (20.000+ people screened). Malaria morbidity dropped from 15006 cases in 2003 to 1498 cases in 2008. Malaria-related hospitalizations declined dramatically (>70%) between 2006-2008 and no deaths due to malaria have been reported since 2006. A reduction of 92% of the number of P.falciparum infections was recorded between 2003-2008. Conclusion: Malaria morbidity and mortality have decline significantly in Suriname and this reduction, was higher when interventions were combined (2006-2008). Coverage of most malaria control interventions were above 95%. The burden of malaria in Suriname has significantly changed, reaching the Roll Back Malaria objectives and Millennium Development Goals targets in a very short time. The national malaria epidemiological profile was changed focusing now on “hot spots” among gold miners in remote areas.This is the first country in the Amazon basin that have decided to go for elimination of malaria at the national level. Abstracts for SupplementInternational Journal of Infectious DiseasesVol. 14Preview Full-Text PDF Open Archive