Malaria elimination in Haiti by the year 2020: an achievable goal?

Abstract

Haiti and the Dominican Republic, which share the island of Hispaniola, are the last locations in the Caribbean where malaria still persists. Malaria is an important public health concern in Haiti with 17,094 reported cases in 2014. Further, on January 12, 2010, a record earthquake devastated densely populated areas in Haiti including many healthcare and laboratory facilities. Weakened infrastructure provided fertile reservoirs for uncontrolled transmission of infectious pathogens. This situation results in unique challenges for malaria epidemiology and elimination efforts. To help Haiti achieve its malaria elimination goals by year 2020, the Laboratoire National de Santé Publique and Henry Ford Health System, in close collaboration with the Direction d’Épidémiologie, de Laboratoire et de Recherches and the Programme National de Contrôle de la Malaria, hosted a scientific meeting on “Elimination Strategies for Malaria in Haiti” on January 29-30, 2015 at the National Laboratory in Port-au-Prince, Haiti. The meeting brought together laboratory personnel, researchers, clinicians, academics, public health professionals, and other stakeholders to discuss main stakes and perspectives on malaria elimination. Several themes and recommendations emerged during discussions at this meeting. First, more information and research on malaria transmission in Haiti are needed including information from active surveillance of cases and vectors. Second, many healthcare personnel need additional training and critical resources on how to properly identify malaria cases so as to improve accurate and timely case reporting. Third, it is necessary to continue studies genotyping strains of Plasmodium falciparum in different sites with active transmission to evaluate for drug resistance and impacts on health. Fourth, elimination strategies outlined in this report will continue to incorporate use of primaquine in addition to chloroquine and active surveillance of cases. Elimination of malaria in Haiti will require collaborative multidisciplinary approaches, sound strategic planning, and strong ownership of strategies by the Haiti Ministère de la Santé Publique et de la Population.

Malaria Surveillance — United States, 2015

“…Seven samples from patients with infections acquired in the Dominican Republic in 2015 were tested for molecular resistance markers, and none contained a genotype associated with chloroquine resistance. Haiti and the Dominican Republic intend to eliminate malaria transmission on the island of Hispaniola by 2020 ( 81 , 82 ); therefore, the number of cases from both countries is expected to decrease. However, as indicated by the increase in cases in 2015, transmission on the island remains heterogeneous, and malaria cases could begin to increase if efforts to contain transmission are weakened.…”

Haití, la nueva comunidad inmigrante en Chile

“…Casi el 80% de toda la población tiene acceso a las prácticas de una medicina complementaria ampliamente extendida, en tanto que la medicina moderna con frecuencia es el último recurso frente a una enfermedad, especialmente para quienes viven en sectores rurales, dependiendo de su educación y de sus convicciones religiosas 10,11 . La malaria es endémica y Haití concentra el mayor número de casos en ALC (17.696 casos el año 2014), que ha sido difícil de erradicar por las propias condiciones de salud y geografía 13,14 . La prevalencia de tuberculosis (TBC) no es fácil de estimar ya que organizaciones externas financian los programas de tratamiento.…”

Towards the implementation of malaria elimination policy in South Africa: the stakeholders’ perspectives

“…In Ethiopia, shortage of staff, capacity and motivation were identified as key issues likely to threaten the country’s goal of eliminating malaria by 2020 [18]. In Haiti, the meeting of stakeholders comprising laboratory personnel, researchers, clinicians, academics and public health professionals concluded that additional healthcare worker training and the deployment of critical resources were key to achieving the goal of eliminating malaria by 2020 [19]. Sri Lanka, which is now eligible to apply for the WHO (World Health Organization) elimination certification, had its elimination plans in the 1960s frustrated by stakeholders’ complacency, whereby patients with fever were not tested for malaria as a result of physicians’ inertia [5,20].…”