Venezuela, Bolivarian Republic Of
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Figure 1. Malaria by Annual Parasite Index (API) at VENEZUELA, BOLIVARIAN municipality level (ADM2), Venezuela 2014 REPUBLIC OF Venezuela is one of the few countries in the Americas that has had an increase of cases since 2000 and ranks as the country with the highest increase at 205% of cases. There were 90,708 cases reported in 2014, which is more than the country has reported in over 50 years (Figures 1 and 2). In the 1950s, Venezuela actually served as a model for elimination efforts and was certified by WHO to have eliminated malaria in its northern part. Despite the current alarming morbidity, Venezuela the death rates have not mirrored the morbidity trends Guyana and there has been a 79% decrease since 2000. API Malaria mostly occurs in the southern states of per 1,000 people Amazonas and Bolivar. Sifontes, a municipality in Bolivar No casesColombia state that shares a border with Guyana, has reported ≤ 0.1 0.11 - 1 1.01 - 5 5.01 - 10 ®Brazil 0 40 80 160 240 Figure 2. Number of cases and deaths due to 10.01 - 50 Kilometers Longitude/Latitude >50 Datum WGS84 malaria in Venezuela, 2000-2014 Source: PAHO/CHA/VT 100,000 50 80,000 40 10058%,000 of all cases in the country (Figure 3).50 The areas s most affected are those where gold mining occurs. The e 80,000 40 s a 60,000 30 s large population in mining areas, poor living conditions, f c s h t o e s and lack of development have all led to the increase of ea a 60,000 30 D s f c h 40,000 20 t o malaria in this area. umber ea N 40,000 20 D 20,000 10 umber In 2014, P. vivax caused 69.3% of malaria infections N in the country, while P. falciparum caused 23.2% of 0 0 20,cases.000 There were also 15 reported cases 1of0P. malariae 2 5 7 9 2 4 0 1 3 4 6 0 3 8 1 in 2014. Anopheles darlingi is the predominant vector in 200 200 200 200 201 201 200 200 200 200 200 201 201 200 201 0 0 2 5 7 9 2 4 0 1 3 4 6 0 3 the country. 8 1 Con■firmed Cases P. ■falciparum & Mixed ■ Deaths P. falciparum & mixed Confirmed cases Deaths 200 200 200 200 201 201 200 200 200 200 200 201 201 200 201 Confirmed Cases P. falciparum & Mixed Deaths Age groups Municipality State Figure 3. Municipalities with the highest number of malaria cases in Venezuela, 2012-2014 80+ Sifontes Bolivar 31,396 46,610 52,509 Female Age groups Municipality70-79St ayearte s Male 80+ Atures Amazonas 2,269 4,377 5,897 Sifontes 60-69Bo liyearvars 31,396 46,610 52,509 Female 70-79 years 3,604 5,057 5,289 50-59 years Male Cedeno Bolivar Atures Amazonas 2,269 4,377 5,897 60-69 years 45-49 years 2,985 5,195 5,224 50-59 years Gran Sabana Bolivar Cedeno 40-44Bo liyearvars 3,604 5,057 5,289 45-49 years Raul Leoni Bolivar 1,363 2,844 5,130 35-39 years 2,985 5,195 5,224 Gran Sabana Bolivar 40-44 years 30-34 years Sucre Bolivar 1,916 2,691 3,490 Raul Leoni Bolivar 1,363 2,844 5,130 35-39 years 25-29 years 30-34 years Piar Bolivar 2,272 2,642 2,089 Sucre 20-24Bo liyearvars 1,916 2,691 3,490 25-29 years Manapiare Amazonas 378 818 1,776 15-19 years Piar Bolivar 2,272 2,642 2,089 20-24 years 10-14 years Antonio Diaz Delta Amacuro 807 395 1,403 378 818 1,776 15-19 years Manapiare 5-9Am yearazonass 757 829 1,263 10-14 years Atabapo Amazonas Antonio Diaz DUndeltaer A 5macuro 807 395 1,403 5-9 years 10,000 5,000 0 5,000 10,000 0 80,000 0 80,000 0 Atabapo80,000 Amazonas 757 829 1,263 Under 5 Decrease Increase 2012 2013 2014 Confirmed cases 0 80,000 0 80,000 0 80,000 10,000 5,000 0 5,000 10,000 Decrease Increase 2012 2013 2014 Confirmed cases 97 97 - 98 - 100,000 50 80,000 40 s e s a 60,000 30 1,000 s Female f c h t o le 856 p 800 Male ea D peo 40,000 20 0 umber 600 00 N , 0 568 10 20,000 10 r 400 pe s 241 e s 161 318 185 a 200 0 0 C 2 5 7 9 2 4 0 1 3 4 6 0 3 8 1 147 0 73 200 200 200 200 201 201 200 200 200 200 200 201 201 200 201 Under 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50+ Confirmed Cases P. falciparum & Mixed Deaths 5 yrs yrs yrs yrs yrs yrs yrs yrs yrs yrs Figure 4. Malaria cases by age and sex in Figure 6. Blood slides examined and SPR in Venezuela, 2014 Venezuela, 2000-2014 Age groups Municipality State 600,000 30% 80+ Sifontes Bolivar 31,396 46,610 52,509 Female 70-79 years SPR) d Male ( e 2,269 4,377 5,897 400,000 20% e n Atures Amazonas 60-69 years t i a m a 3,604 5,057 5,289 50-59 years x Cedeno Bolivar e e 45-49 years l p sitivity R 2,985 5,195 5,224 o Gran Sabana Bolivar 1eo ,20000,000 10% P 40-44 years P Female e d 1,363 2,844 5,130 35-39 years le 856 Sli Raul Leoni Bolivar p 800 Male 30-34 years peo Sucre Bolivar 1,916 2,691 3,490 0 0 0% 600 00 0 1 2 3 4 5 6 7 8 9 0 1 2 25-29 years 3 4 , 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 Piar Bolivar 2,272 2,642 2,089 0 568 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20-24 years 10 r 400 378 818 1,776 15-19 years pe Blood Slides Examined SPR (%) Manapiare Amazonas s 241 e s 161 318 185 10-14 years a 200 Antonio Diaz Delta Amacuro 807 395 1,403 C 5-9 years 147 0 73 Atabapo Amazonas 757 829 1,263 Under 5 DiagnosisUnder and5-9 Treatment10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50+ 0 80,000 0 80,000 0 80,000 10,000 5,000 0 5,000 10,000 5 yrs yrs yrs yrs yrs yrs yrs yrs yrs yrs Microscopy125,000 is used to diagnose malaria, though the Decrease Increase 2012 2013 2014 Confirmed cases Global Fund via PAMAFROFirst-line trea tdonatedments RDTs in 2007 for a s 100,000 e Confirmed Cases pilots study conducted in the Amazon forest area (Figure a f c 75,000 6).o In 2014, the SPR was 17.36% which, has risen in the 600,000 30% Generally, young men between the ages of 20-24 r 97 years were the most affected (Figure 4). The malaria past5 0few,000 years along with the incidence rate. Medication umbe incidence in women (14.5 cases per 100,000) was less is N free in the public health system, but stock-outs have SPR) d 25,000 ( e been400, 00reported.0 A 14-day treatment of cholorquine20% e n t than half of that in men (36.5 cases per 100,000 men) i 0 a m anda primaquine is the first-line treatment forP. vivax in 2014 (Figure 5). Occupation is a risk factor for men. x 1 1 2 2 0 0 9 8 7 3 3 6 5 4 4 e 1 0 1 0 1 0 0 0 0 0 1 0 0 1 0 infections,e while the combination drug of artesunate- l 20 The incidence in pregnant women was 69 malaria cases 20 20 20 20 20 20 20 20 20 20 20 20 20 20 p sitivity R mefloqiune-primaquine is used for P. falciparum. Drug o per 100,000 pregnant women in 2014, which was eo 200,000 10% P *DP ata for first-line treatment unavailable for 2011-2013. e significantly lower than that in non-pregnant women of efficacy studies have not been reported in the past d child-bearing age (267 cases per 100,000 women for 10 years even as the probability of development of Sli that year). This is perhaps because malaria transmission resistance0 to artemisinin remains high in the Guiana0% 8 0 2 4 0 1 3 5 7 $15M 2 4 6 9 1 3 s) 6M 60,000 0 1 1 1 0 0 0 0 0 Shield area. 0 0 0 0 1 1 largely happensn outdoors. o 20 20 20 20 20 20 20 20 20 20 20 20 20 20 20 illi m s) n Blood Slides Examined SPR (%) i n ( $10M Priority Groups y ITNs Figureo 7. Number of malaria cases and those 4M 40,000 b illi Gold miners are the principal population of concern d m e treated with first-line treatment in Venezuela, y IRS ct n i b e ( t as well as those who live in populated areas near gold d o 2000-2014$ e pr ct $5M mines.