Saturday , June 12 2021

Malaria, disease without eradication



Anopheles female mosquitoes with a single bite are able to carry a parasite that causes malaria or malaria. The mosquito knows no border or borders. Their females are looking for blood to feed their offspring and go from body to body, moving disease in a very difficult cycle to eliminate them. But not impossible

In Panama, malaria is a persecutory disease and the largest number of cases have been reported in indigenous populations.

Malaria-carrying parasites are five species, according to the Pan-American Health Organization (PAHO), but the two most dangerous are Plasmodium vivax and Plasmodium falciparum, which can worsen the patient's condition and cause his death

Epidemiological records of the Ministry of Health (Minsa) show that Plasmodium vivax and Plasmodium falciparum are circulating in this country, and that by comparing cases of people who reported the disease by 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 this number increased to 579.

This latest report also indicates that the increase in the number of people affected by malaria is in line with expectations, as there have been outbreaks of Plasmodium vivax in the Tuira communities, in the Darién province, the Guna Yala region (La Miel, Puerto Obaldía and Playón Chico) and in the Ngäbe region Buglé and Colón.

Challenge

In the face of this situation, Minsa and Gorgas Memorial Institute for Health Studies (IECGES) have taken up the challenge of eliminating malaria in 2020. Under the Strategic Plan of Malaysia Elimination, signed in April, health authorities and PAHO representatives, which propose necessary actions to eliminating native cases in this country.

Among the measures to be taken are active search for cases, integral approach, community orientation and intra-community shower.

In fact, data from Epidemiology show that by October last year, 549 autochthonous cases and 30 cases of malaria imports were reported. Throughout 2017, there were 599 indigenous cases and 31 cases imported, i.e. a total of 630 people reported the disease.

In this sense, the Department of Epidemiology in Minsa reported that cases of disease persist in indigenous areas because they were unable to eliminate malicious foci.

In addition, the key problem they have encountered is the linguistic difference between the population of indigenous groups and health officials who come to these regions with prevention and control programs.

Epidemiology officials reported that during the workshops with subjects they showed deficiencies in diagnosis, treatment, research and response, which is why PEEM relied on these aspects.

Deputy Minister of Health, Eric Ulloa, explained that as a country we are not going to advance, not only against the fight against the mosquito, the vector; but in the active search for cases for which we must cooperate with the community, promoters and associations to actively search for cases and treat them quickly in order to reduce transmission.

He added that there are some obstacles, such as the scattering of endemic sites, endemic areas located on international borders, socio-cultural features of the indigenous population, among others.

Suggestions and research

Meanwhile, the scientist Icges Nicanor Obaldía III recommended a multi-sectoral approach involving MINSA, Ministry of Housing, Deputy Minister of Racial Affairs, inter alia, to focus efforts on endemic foci (improving housing and drainage systems, as well as fumigation and the elimination of mosquito breeding sites).

He maintained that they are carrying out research that they hope will form part of the base to propose the creation of a molecular epidemiological surveillance system for imported or advised parasites in Panama and Mesoamerica. [desde la península de Yucatán en México, Centroamérica y Panamá].

The researcher pointed out that the present proposal aims to determine the genetic diversity and population structure in order to understand the epidemiology or dynamics of the disease, as well as the biology of its transmission, which are key elements in the implementation of an effective elimination program,

De Obaldía III confirmed that the preliminary results of the study entitled Genetic diversity and structure of the population of human malaria parasites in Panama they indicate that in the years 2007-2012 Plasmodium vivax parasite circulating in Panama was in the "clonal" phase (highly related genetically or cross-linked), which indicates a small diversity, and consequently low transmission. These results show the progress in elimination.


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