Epidemiology and control of malaria in Colombia

Abstract

Malaria is currently one of the most serious public health problems in Colombia with an endemic/epidemic transmission pattern that has maintained endemic levels and an average of 105,000 annual clinical cases being reported over the last five years. Plasmodium vivax accounts for approximately 70% of reported cases with the remainder attributed almost exclusively to Plasmodium falciparum. A limited number of severe and complicated cases have resulted in mortality, which is a downward trend that has been maintained over the last few years. More than 90% of the malaria cases in Colombia are confined to 70 municipalities (about 7% of the total municipalities of Colombia), with high predominance (85%) in rural areas. The purpose of this paper is to review the progress of malaria-eradication activities and control measures over the past century within the eco-epidemiologic context of malaria transmission together with official consolidated morbidity and mortality reports. This review may contribute to the formulation of new antimalarial strategies and policies intended to achieve malaria elimination/eradication in Colombia and in the region.

Fig. 1

malaria transmission foci in Colombia: evolution of the distribution of malaria cases in Colombia in 2002 and 2008 by Plasmodium species.

Fig. 2

number of malaria cases and incidence evolution, Colombia 1937–2008. API: annual parasitic incidence.

Fig. 3

distribution of malaria parasite species in Colombia, 1960–2008.

Fig. 4

distribution of municipalities in Colombia by malaria risk, 2002 and 2008: note that the group of municipalities with 1–10 cases increased from 45–59% between 2002–2008, as did the total number of municipalities. Regarding the percentage of total country cases, the groups of > 1,000 cases accounted for 87% in 2002 and 62.8% in 2008, showing a wider distribution of malaria burden throughout different groups of municipalities.

Fig. 5

evolution of malaria cases according to the malaria control/ eradication strategy between 1937–2008.

Fig. 6

malaria slide positivity rate in Colombia between 1962–2008.

Fig. 7

number of malaria cases in the Pacific coast, Colombia 2000–2008: malaria trend related to Plasmodium species and introduction of artemisinin derivates combination therapy (ACT).