- 學位論文
Evaluation on malaria control in Bolivia, Central South America
Evaluation on malaria control in Bolivia, Central South America
並列摘要
Malaria remains a major global problem. In Latin America and the Caribbean, Malaria transmission occurs in 9 countries of the region that share the Amazon rainforest and in 8 countries in Central America and the Caribbean. In Bolivia 75% of the surface is the endemic area of malaria. Purpose This study is aimed at assessing the 5-year achievements (2001-2005) of the strategic malaria control program in Bolivia. Methodology The study design was composed of a retrospective component using secondary data from 8 Bolivian departments. Time Series analysis of Malaria incidence rates in the country were computed for the year 2000 as the base line or pre intervention data, for 2003 as data for during intervention and for 2005 as data after intervention. Results The results for Bolivia as a whole show a continuous increase in population living in malaric areas; the number of malaria cases due to P. vivax, and the API have decreased. The cases due to P. falciparum after showing an important reduction from 2000 to 2003, increased in 2005. The departments of Potosi, La Paz and Chuquisaca show a sustained decrease in API, and reduction of malaria due to P. falciparzim as well as in the Itenez province and Cochabamba and Santa Cruz Departments although in those places incidence of P. falciparum increased after 2003 In Guayaramerin the API increased significantly during the period 2000-2003 but the cases due to P. falciparuin decreased, after 2003 the API decreased but cases due to P. falciparum increased compared to 2003. Tarija department show a continuous increase on the API since the year 2000 but no cases due to P. falciparum were registered. Conclusion and recommendations In five years, in the country as a whole the program has been successful in the struggle against malaria by Plasm odium alciparum, the lethal type of the disease, as for malaria by Plasmodium vivax, the other type of malaria that prevails in Bolivia, its incidence has also decreased. But we also can see a change in the epidemiological distribution of malaria in Bolivia and a relative reduction regarding the seriousness of the situation. However, there is a regional need to strengthen the health services and expand access to diagnosis and treatment of the disease, particularly in areas with transmission due to P. falciparum. The fact that the behavior of malaria prevalence is largely predictable over time - and a direct consequence of action (or inaction) - could he highlighted for everyone. A strong monitoring and evaluation system could bring the right information to the attention of the proper authorities - particularly the Minister of Health - in time to allocate the resources necessary to keep the problem under control permanently and not wait until there has been a resurgence of the problem.