Achievement of malaria pre-elimination in Cape Verde according to the data collected from 2010 to 2016

Abstract

BackgroundMalaria, despite being preventable and treatable, continues to be a major public health problem worldwide. The archipelago nation of Cape Verde is in a malaria pre-elimination phase with the highest potential to achieve the target goal of elimination in 2020.MethodsNationwide malaria epidemiological data were obtained from the Cape Verde health information system that includes the individual malaria case notification system from all of the country’s health structures. Each case is reported to the surveillance service then to the National Malaria Control Programme, which allowed for compilation in the national malaria case database. The database was analysed to assess the origin of the malaria cases, and incidence was calculated from 2010 to 2016 by sex and age. The health centre, health district and month of diagnosis were evaluated, as well as the sex and the age of the patients, allowing a direct descriptive analysis of national data to provide an up-to-date malaria epidemiological profile of the country. Malaria cases were classified as imported or indigenous, and then, geographical analyses were performed using a unique Geographical National Code with Quantum Geographic Information System 2.16.2 software to map the cases by municipalities. The overall temporal evolution of cases was analysed to assess their monthly and yearly variations from 2010 to 2016.ResultsMalaria is unstable in Cape Verde, with inter-annual variation and the majority of infections occurring in adult males (> 20 years). The indigenous cases are restricted to Santiago (96%) and Boavista (4%), while imported cases were recorded in all the nine inhabited islands, originating from neighbouring countries with ongoing malaria transmission; from Lusophone countries (25% from Angola, 25% from Guinea-Bissau), followed by the Republic of Senegal (12%) and Equatorial Guinea (10%). In 2010–2012, more imported (93 cases) than indigenous cases (26 cases) were observed; conversely, in 2013 and 2014, more indigenous cases (49) than imported cases (42) were reported. In 2015 there were 20 imported cases and only 7 indigenous cases. Finally, in 2016, there were 47 indigenous cases and 28 imported cases. The mapping of cases by municipality and country of origin was possible with GIS analyses.ConclusionWhile Cape Verde remains on track to achieve malaria elimination by 2020 owing to the reduction of the annual incidence to below 0.1%, the country still records cases of indigenous and imported malaria. However, the indigenous cases are exclusively confined to the Santiago and Boavista islands, while the imported cases recorded nationwide originate only from the African continent, mainly from adult men from the Lusophone countries. Cape Verde needs to target interventions to remove residual foci on Santiago and Boavista islands to reduce malaria lethality to zero and prevent its reintroduction from African countries via transmission across the archipelago. Cape Verde is a good example of local authority’s commitment to tackle malaria and work towar...

Updates on malaria epidemiology and profile in Cabo Verde from 2010 to 2019: The goal of Elimination

“…To ensure elimination can be sustained and to support the prevention to reintroduction phase, the malaria case data collected as part of routine surveillance from the decade before interruption can be valuable for characterizing the malaria epidemiology and identify risk factors for improved surveillance activities. Therefore, this research extends previous research about malaria cases in the country [13,14] and characterizes both individual and spatial risk factors for endemic and introduced malaria infections.…”

Transition from endemic behavior to eradication of malaria due to combined drug therapies: An agent-model approach

“…Differently from the transition by gametocytemia variation, here the phase transition is only visible for high gametocytemia levels, typically w h = 0.6 or larger. A possible explanation for this is 6 There is no precise knowledge concerning the probability for the mosquito to die due to ITN, IRS or LLIN barriers. We assumed a value of 0.5, which together with a coverage of ITN of 25%, results in a global mortality due to ITN barriers of 0.25 × 0.5 = 0.125.…”

“…For example, in a potential outbreak human fatality rate may rise out of proportion due to the weaker immunity of local populations from reduced exposure to the parasite [5]. Or, in regions under anti-malaria massive drug administration, drug-resistant parasite strains can develop and consequently, through human migratory phenomena, they may be imported into areas of near eradication, locally strengthening malaria transmission [2,3,6].…”

The prevalence of glucose-6-phosphate dehydrogenase deficiency in the Cape Verdean population in the context of malaria elimination

“…island, Praia came at second position with 2.16%. Noteworthy, Santiago was the only study island of Cabo Verde where indigenous malaria cases were reported during the last three years [4,5], stressing the interest of such study in the different municipalities of the island. The prevalence of G6PDd in the Cape Verdean population was higher in males (5.7%) than females (1.6%) ( Table 2).…”

“…Historically, malaria has been the first vector-borne disease in Cabo Verde since the 16 th century during the settlement of the islands, and with some efforts, the disease has been eliminated twice from the archipelago. In the last years, the malaria epidemiological situation has become unstable with the sporadic seasonal transmission, and local transmission exclusively occurring in Santiago and Boavista islands [4,5].…”