Washington, Sept. 1, 1998--A dramatic increase has been reported in falciparum malaria in northern Honduras by a group of researchers writing in the current issue of the Pan American Journal of Public Health.
"Over the past few years there has been a striking increase in malaria in Honduras," the journal said. Reported cases rose from 52,110 in 1994 to 75,565 in 1996, a 45% increase in three years. The journal is published by the Pan American Health Organization.
Malaria is a significant cause of death and disease worldwide. Each year, malaria parasites infect between 300 and 500 million people and cause more than 2.7 million deaths. Plasmodium vivax is reported to be the infecting strain in some 98% of Honduran malaria cases, the journal said. "However, we recently documented a much higher proportionate increase of falciparum malaria in northern Honduras." This type of malaria is a much more severe form of the disease.
The authors, Carol J. Palmer and colleagues from the University of Miami School of Medicine and John F. Lindo of the University of the West Indies in Jamaica, said they investigated a recent outbreak in the Colón region, and tested residents of that area as well as the city of San Pedro Sula. They collected 202 blood samples and found that 47% were positive for malaria parasites. Plasmodium vivax, the milder form, was present in 79% of the infected rural patients and 100% of the infected city patients.
The more severe form, Plasmodium falciparum, was present in 21% of the rural patients, the journal said. In 1996, this form of malaria accounted for 3.5% of the malaria cases in that area.
Possible explanations include increased transmission by mosquitoes as a result of a long rainy season, an increase in the non-immune population, development of chloroquine resistance by Plasmodium falciparum parasites, and underdiagnosis, the authors said.
"The widespread development of drug resistance by P. falciparum poses a formidable challenge to controlling and containing the disease in infected individuals. Based on our results and the escalation of malaria cases in Honduras, we strongly recommend increased laboratory testing for accurate identification of malaria parasites and enhanced surveillance for chloroquine resistance," concluded the authors.
The Pan American Health Organization, founded in 1902, works with all the countries of the Americas to improve health and raise living standards.
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