Monday , July 26 2021

Malaria, a disease without eradication

Female anopheles mosquitoes with a single bite can transmit parasites that cause malaria or malaria. Mosquitoes don't know the limits or limits. Females seek blood to feed their offspring and go from body to body transmitting diseases in cycles that are very difficult to remove. But it is not impossible

In Panama, malaria is a stalker disease, and the largest number of cases is reported to indigenous people.

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 condition and cause death

Epidemiological records from the Ministry of Health (Minsa) show that Plasmodium vivax and Plasmodium falciparum circulate in the country, and that when comparing cases of people presenting disease until October this year with those reported last year for the same month, there was an increase of 48 cases. In 2017 there were 531, while this year the number rose to 579.

This latest report also shows that an increase in people with malaria is expected, because there has been a Plasmodium vivax outbreak in the Sungai Tuira community, Darién province, in the Guna Yala region (La Miel, Puerto Obaldía and Playón Chico) and in the Ngäbe Buglé and Colón regions .

The challenge

Facing this situation, Minsa and the Gorgas Memorial Institute for Health Studies (IECGES) took up the challenge of eradicating malaria in 2020 as part of the Strategic Plan for Elimination (PEEM) of Malaria, signed last April between the health authorities and PAHO representatives, where needed to be proposed to achieve the elimination of indigenous cases in this country.

Among the steps that must be taken are active search of cases, integral approaches, community orientation and intra-domiciliary spraying.

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

In this sense, the Minsa Epidemiology Department reports that cases of the disease persist in indigenous areas because they have not been able to eliminate the focus of malaria.

In addition, the main problem they encountered was language differences between indigenous population groups and health officials who came to this area with prevention and control programs.

Epidemiology officials report that during workshops with entities, they show gaps in diagnosis, treatment, research and responses, which is why PEEM relies on these aspects.

Deputy Minister of Health, Eric Ulloa, explained that as a country we would not progress, not only against mosquito fights, vectors; but in active search for cases, where we have to work with communities, promoters, with associations to actively look for cases and treat them quickly to reduce transmission.

He added that there were several obstacles, such as the spread of local endemic, endemic areas located on international borders, the socio-cultural characteristics of the indigenous population, among others.

Advice and study

Meanwhile, Icges scientists Nicanor Obaldía III recommend a multi-sectoral approach involving MINSA, the Ministry of Housing, Deputy Minister of Indigenous Affairs, among other entities, to direct efforts towards an endemic focus (improve housing and drainage systems, and slander and eliminate breeding sites from mosquito).

He stated that they were conducting research which they hoped to form part of a basis to propose the establishment of a molecular epidemiological surveillance system of imported or revived parasites in Panama and Mesoamerica. [desde la península de Yucatán en México, Centroamérica y Panamá].

Researchers point out that this proposal intends to determine genetic diversity and population structure, to understand epidemiology or disease dynamics, and transmission biology, which are key elements for the successful implementation of elimination programs. .

De Obaldía III confirmed that the initial results of this study were titled Genetic diversity and population structure of human malaria parasites in Panama they showed that during 2007-2012 the Plasmodium vivax parasite circulating in Panama was in a "clonal" phase (highly genetically or cross-linked), which showed low diversity, resulting in low transmission. These results provide evidence of progress towards elimination.

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