Venezuela, Haiti and the Dominican Republic are the only three countries in the Americas that have not achieved significant reductions in malaria cases (estimated over 30-50% in all the rest endemic countries, including Brazil) during the last decade. I would like to read opinions regarding the current performance of the malaria control program in Venezuela. During the last years over 50,000 cases per year have been reported in the country, according to the WHO, based on national official data.
According Ministry of Health of Venezuela in the 20th week of last year was 1473 cases reported and this year in the 20th week are 1468 cases. The accumulative frecuency tendency is slow down, however, I think that three aspects are important to consider: cases of malaria are in difficult-to-reach-area; human resources for health are insufficient; and, medical treatment is inadequate because be not mix with the traditional treatment of indigenous communities.
In: http://www.mpps.gob.ve/index.php?option=com_phocadownload&view=category&id=43:ano2014&Itemid=915
If you see the number of reported cases between 1998 and 2012, there is a most than clear trend to keep increasing. If we assume for 2013 that at least 1000 cases were reported per week, this means still is increasing with over 50,000 cases during that year. Malaria in the World and Latin America occur in rural areas and in countries with insufficient health care workers. Treatment should be provided and directly observed by the malaria program. So, that is not enough to explain it. For example in Ecuador the work made by the malaria program control in the last decade has significantly decreased its incidence, even in Brazil, the country with the highest number of cases, have decreased disease. See the figure of the trend in Venezuela.
And the changes in incidence in other countries in the Americas region. Sorry, but this is regretable and sad for those directly affected by malaria in states such as Bolivar, Amazonas, Sucre.
Thanks for the new link in your edited post. Quoting the Epidemiological Bulletin #52 of 2013, available at http://www.mpps.gob.ve/index.php?option=com_phocadownload&view=category&id=35:ano2013&Itemid=915, situation in 2013 was worse than in 2012. For that week there was a cummulative number of cases of 76,621. With an increase of 50.1% compared to 2012. "Hasta la fecha existe un acumulativo de 76.621 casos, lo que representa aumento de 50,1% con respecto al período homólogo del año anterior". According to endemic channels of 2013, malaria was most of the year in epidemics. Finally until week 20 of year 2014, there is a cummulative of 29,931 cases, which is more than the whole year number of cases reported up to 2002 (29,491) and before. Although this is an interesting discussion, solutions are beyond the health systems, and involve other sectors in the goverment that should look at the importance of the increasing burden of disease in those neglected populations of the southern area of the country.
Drug resistance in malaria pathogen against all different combinations of quinens, second resistance developed by mosquito vectors, rise in population of secondary hosts, availability of reservoir hosts, Both environmental changes/factiors, drug resistance, blood, transfusion, gene mutations, less efficacy of pharamceuticals and low quality clinical care.
Thanks Ravi, however in Venezuela over 80% of malaria is caused by P. vivax, which has been tested in the country against common antimalarial drugs and still fully sensible to chloroquine.But the drugs are not available by neglect of the health authorities. The same issue for the Anopheles spp, are susceptible to insecticide, but there are no applications made in vector present areas. Climate change affects areas with unstable or highly variable areas, but there is a constant rise as you can see. Besides that, the rest of the countries in South America have been sucessful in control disease during the same period.
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