Micro-Stratification for Malaria Transmission Risk in a High Burden Area of Honduras

Abstract

Background As Malaria cases are continuously reported across the globe, epidemiological and integral approaches should be considered for an optimal stratification on endemic areas for elimination goal. In Central America, a 75% reduction in malaria incidence has been reported between 2000 and 2015, similarly, in Honduras, more than 75% of total cases in 2016 were concentrated in 7 municipalities, mainly in Gracias Dios department. Achieve malaria elimination in Honduras demands the implementation of strategies to identify main hotspots. Methods Based on WHO guidelines, local malaria epidemiological data from case-based surveillance system of the Ministry of Health between January and December 2016 were analysed. Furthermore, on field evaluations were carried out in Puerto Lempira municipality, Gracias a Dios department to an analysis validation. Finally, a set of epidemiological components were generated and proposed together with risk-factor description and proposed actions for health system improvement. Results On 2016, Gracias a Dios reported 61% of total malaria cases in Honduras; based on our analysis, 12 micro-areas were identified, including epidemiological, entomological, and socio-demographic information from local technicians. Conclusions Malaria elimination in endemic areas urges implementation of different strategies, here we show the on-field micro-stratification process of 12 “micro-areas” carried out in one endemic department of Honduras. This information provides a more targeted strategy for diagnosis, treatment, and vector control interventions for malaria elimination goal in Honduras.