Characterization of a malaria outbreak in Colombia in 2010

Abstract

BackgroundAlthough malaria has presented a significant reduction in morbidity and mortality worldwide during the last decade, it remains a serious global public health problem. In Colombia, during this period, many factors have contributed to sustained disease transmission, with significant fluctuations in an overall downward trend in the number of reported malaria cases. Despite its epidemiological importance, few studies have used surveillance data to describe the malaria situation in Colombia. This study aims to describe the characteristics of malaria cases reported during 2010 to the Public Health Surveillance System (SIVIGILA) of the National Institute of Health (INS) of Colombia.MethodsA descriptive study was conducted using malaria information from SIVIGILA 2010. Cases, frequencies, proportions, ratio and measures of central tendency and data dispersion were calculated. In addition, the annual parasite index (API) and the differences between the variables reported in 2009 and 2010 were estimated.ResultsA total of 117,108 cases were recorded by SIVIGILA in 2010 for a national API of 10.5/1,000 habitants, with a greater number of cases occurring during the first half of the year. More than 90% of cases were reported in seven departments (=states): Antioquia: 46,476 (39.7%); Chocó: 22,493 (19.2%); Cordoba: 20,182 (17.2%); Valle: 6,360 (5.4%); Guaviare: 5,876 (5.0%); Nariño: 4,085 (3.5%); and Bolivar: 3,590 (3.1%). Plasmodium vivax represented ~71% of the cases; Plasmodium falciparum ~28%; and few infrequent cases caused by Plasmodium malariae.ConclusionsOverall, a greater incidence was found in men (65%) than in women (35%). Although about a third of cases occurred in children <15 years, most of these cases occurred in children >5 years of age. The ethnic distribution indicated that about 68% of the cases occurred in mestizos and whites, followed by 23% in Afro-descendants, and the remainder (9%) in indigenous communities. In over half of the cases, consultation occurred early, with 623 complicated and 23 fatal cases. However, the overall incidence increased, corresponding to an epidemic burst and indicating the need to strengthen prevention and control activities as well as surveillance to reduce the risk of outbreaks and the consequent economic and social impact.

Malaria-Related Anemia in Patients from Unstable Transmission Areas in Colombia

“…Data collected by SIVIGILA indicate that most malaria-infected individuals in the country seek diagnosis from healthcare providers within the first 2 days after onset of symptoms. 9 Data presented here indicate that patients attended healthcare facilities for malaria diagnosis within a mean period ranging between 4.0 days in Tierralta and 6.6 days in Quibdó . Nevertheless, because of prompt treatment, there was insufficient opportunity to observe more patients with malarial anemia, regardless of whether mild or severe.…”

“…According to the National Surveillance Service of Colombia (SIVIGILA), the highest incidence of malaria occurs mainly in young adults (16-30 years of age) followed by children (5-15 years of age). 9 Laboratory tests. Capillary blood samples collected by finger prick were used for microscopic malaria diagnosis and parasite density counts.…”

“…In Colombia, the total number of cases decreased from approximately 140,000 in 2000 to approximately 60,000 and 23 malariarelated deaths in 2012, corresponding to approximately 0.3 per 1,000 cases in this period. 9,12 This downward trend reflects the country's efforts toward timely diagnosis and effective treatment, 9 which may consequently modify the clinical profile of the disease.…”

“…2,[4][5][6][7] The human population in this region has a different genetic background, P. vivax is the most prevalent malaria parasite species, malaria transmission intensity is low and unstable, and the young adult population seems to be at higher risk for malarial anemia than children. 8,9 As a consequence of this complexity, malaria and anemia exhibit epidemiological characteristics that seem to be unique to the region and remain poorly understood. In 2012, approximately 469,000 malaria cases (microscopically confirmed) were reported on the South American continent, mainly caused by P. vivax (approximately 74%) and P. falciparum (approximately 26%).…”

Malaria complicada en el Chocó: hallazgos clínicos y comparación de datos con el sistema de vigilancia

“…Otros estudios realizados en Colombia reportan más comúnmente una sola complicación (3,21), las diferencias en el hallazgo pueden estar relacionadas con la clasificación de la severidad de los casos, tipo de estudio, y los cortes de parámetros definidos. En este sentido y teniendo en cuenta que el departamento del Chocó es el que mayor número de casos notifica al país, sería importante realizar estudios prospectivos del evento incluso después de que los pacientes sean egresados, a fin de tener información para las acciones de prevención y prestación de servicios.…”