Email updates

Keep up to date with the latest news and content from Malaria Journal and BioMed Central.

Open Access Highly Accessed Case report

Novel strategies lead to pre-elimination of malaria in previously high-risk areas in Suriname, South America

Hélène Hiwat12*, Loretta S Hardjopawiro1, Willem Takken2 and Leopoldo Villegas13

Author Affiliations

1 Malaria Programme, Ministry of Health Suriname, c/o Bureau of Public Health Suriname, Rode Kruislaan 13, Paramaribo, Suriname

2 Laboratory of Entomology, Wageningen University and Research Centre, PO Box 8031, 6700, EH Wageningen, The Netherlands

3 International Public Health Advisor, Dieterstraat 16, Paramaribo, Suriname

For all author emails, please log on.

Malaria Journal 2012, 11:10  doi:10.1186/1475-2875-11-10

Published: 9 January 2012

Abstract

Background

Suriname was a high malaria risk country before the introduction of a new five-year malaria control program in 2005, the Medical Mission Malaria Programme (MM-MP). Malaria was endemic in the forested interior, where especially the stabile village communities were affected.

Case description

The interventions of the MM-MP included new strategies for prevention, vector control, case management, behavioral change communication (BCC)/information, education and communication (IEC), and strengthening of the health system (surveillance, monitoring and evaluation and epidemic detection system). After a slow first year with non-satisfying scores for the performance indicators, the MM-MP truly engaged in its intervention activities in 2006 and kept its performance up until the end of 2009. A total of 69,994 long-lasting insecticide-treated nets were distributed and more than 15,000 nets re-impregnated. In high-risk areas, this was complemented with residual spraying of insecticides. Over 10,000 people were screened with active case detection in outbreak and high-risk areas. Additional notification points were established and the national health system was strengthened.

Discussion and evaluation

In the current paper, the MM-MP is evaluated both on account of the targets established within the programme and on account of its impact on the malaria situation in Suriname. Malaria vector populations, monitored in sentinel sites, collapsed after 2006 and concurrently the number of national malaria cases decreased from 8,618 in 2005 to 1,509 in 2009. Malaria transmission risk shifted from the stabile village communities to the mobile gold mining communities, especially those along the French Guiana border.

Conclusions

The novel strategies for malaria control introduced in Suriname within the MM-MP have led to a significant decrease in the national malaria burden. The challenge is to further reduce malaria using the available strategies as appropriate in the affected areas and populations. Elimination of malaria in the country will require a thorough understanding of transmission dynamics and a dedicated investment in key effective interventions.

Keywords:
Malaria control; Suriname; Insecticide-treated nets; Pre-elimination