Wednesday , January 20 2021

Malaria, a disease without eradication

Anopheles female single-legged mosquitoes can transmit the parasite that causes malaria or malaria. The mosquito does not know boundaries or boundaries. Their honor seeks blood to feed their offspring and go from body to body that transmits the disease in a very difficult cycle to eliminate. But not impossible

In Panama, malaria is a weakened disease, and the largest number of cases is reported in indigenous populations.

The parasites that transmit malaria are five species, according to the Pan American Health Organization (PAHO), but the two most dangerous are Plasmodium vivax and Plasmodium falciparum, the latter can worsen the patient's health and cause death.

The health secretary's epidemiological records show that Plasmodium vivax and Plasmodium falciparum circulate in the country and that when comparing the cases of people who presented the disease until October this year with those reported last year for the same month, the number of cases rose 48. In 2017 there were 531, while this year the figure rises to 579.

This recent report also shows that the increase in malaria is within the expected, as Plasmodium vivax erupted in Tuira River communities, Province Darién, in the Guna Yala region (La Miel, Puerto Obaldía and Playón Chico) and in the region of Ngäbe Buglé and Colón.

The challenge

In response to this situation, Minsa and Gorgas Memorial Institute for Health Studies (IECGES) took up the challenge of eradicating malaria 2020 as part of the Strategic Plan for Malaria Abolition (PEEM), signed in April last year, the health authorities and representatives of PAHO, where the necessary measures proposed to achieve elimination of cases in the country.

Among the actions that must be taken are the case's active search, integrated approach, community orientation and intra-domicile spraying.

In fact, data from epidemiology show that until October October, 549 autochthonous cases and 30 imported cases of malaria have been reported. And in 2017 there were 599 autochthonous cases and 31 imported cases, ie a total of 630 people presented the disease.

In this regard, the Minsa Department of Epidemiology reported that the disease case remains in the domestic areas because they have not been able to eliminate the harmful foci.

In addition, the key issue they have encountered is the linguistic difference between the population of indigenous groups and healthcare officers coming to these regions with prevention and control programs.

Epidemiological officials reported that during the meetings with the units they showed the gaps in diagnosis, treatment, research and response, why PEEM relied on these aspects.

Deputy Minister of Health, Eric Ulloa, declared that, as a country, we will not move forward, not just against the mosquito battle, the vector; but in the active search of cases, for which we have to work with society, promoters, associations to actively seek cases and treat them quickly to reduce the transfer.

He added that there are some barriers, including the spread of endemic sites, endemic areas located in international borders, among other socio-cultural characteristics of indigenous peoples.

Suggestions and studies

Meanwhile, the Icges researcher is Nicanor Obaldía III recommended a multi-sectoral approach involving MINSA, the Department of Housing, the Ministry of Internal Affairs, among other units, to target efforts towards endemic focuses (improvement of housing and drainage systems, as well as the preparation and elimination of breeding sites for mosquitoes).

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

The researcher pointed out that this proposal aims at determining genetic diversity and population structure to understand the epidemiology or dynamics of the diseases, as well as the biology of its transmission, which are key factors for the implementation of a successful elimination program.

The Obaldia III confirmed that the preliminary findings of the investigation warranted Genetic diversity and population structure of human malaria parasites in Panama They indicate that the parasite of Plasmodium vivax circulated in Panama in 2007-2012 was in a "clonal" phase (highly related genetic or cross-linked), which indicates a low diversity, consequently low transmission. These results show progress towards elimination.

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