Haiti – will malaria be added to all the problems?

According to the WHO’s Weekly Epidemiological Record (2008), “Hispaniola is the only Caribbean island where malaria persists” in endemic form.  From that base, “Hispaniola has been the source of outbreaks of Plasmodium falciparum malaria in the Bahamas and Jamaica.” Current estimates from WHO are for “eliminating … malaria from
Hispaniola by 2016–2017.”

haiti-damage-un-photo.jpgWhat are the implications for malaria transmission from the horrendous earthquake that has devastated the Port au Prince area?

Randall and Tirrell report that, “SURVIVORS of the Haiti earthquake face deadly outbreaks of diarrhoea, measles and malaria after the country’s already fragile water and health systems were destroyed.” The destruction of general as well as health infrastructure and the loss of life in the health workforce will have long term consequences in the ability of the country to respond to infectious diseases now and for a long time to come.

According to the Global Fund, “The current malaria situation is not well known in the country because of the inexistence, since 1988, of a structured and operational control program at both the central and peripheral levels. Still malaria has long been documented in Haiti as a significant public health problem. Haiti is the only island in the Caribbean region (Hispaniola – Dominican Republic and Haiti) where malaria is endemic.”

In addition, The World Malaria Report 2009, states that, “As of 2008, French Guiana, Guatemala and Haiti were the only countries yet to adopt the policy of using ACT for treatment of P. falciparum malaria.” The WMR also documents that half of Haiti’s population is at high risk from malaria and the remainder at low risk.

Prior to the catastrophe Haiti’s Round 3 Global Fund project was reportedly on track in terms of malaria treatment and bednet distribution, although chloroquine is listed as the treatment drug. Health and Management Information Systems including surveillance activities were still in need of strengthening.

Researchers from the US Centers for Disease Control and Prevention have shown highly “focal and seasonal distribution of malaria in Haiti,” with rural areas and rainy season periods producing more of the disease. Sub-Urban areas are increasingly at risk. For example, “Historically, malaria transmission peaks in November, December, or January in central Haiti.”

We can conclude that those right in the densely populated (and heavily damaged) parts of Port au Prince may not be at immediate risk from malaria, but as people move out from the city center to seek shelter and services, more people will be susceptible.

Haiti has yet to receive its Round 8 Global Fund money and the Round 3 grant is basically finished. We hope that donors trying to provide aid in this emergency will not forget to bring malaria drugs and insecticide-treated nets.

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