HONDURAS Figure 1. Malaria by Annual Parasite Index (API) at municipality level (ADM2), Honduras 2014 Since 2010, malaria in Honduras has continuously declined after having increased in previous years. Honduras successfully accomplished the WHA58.2 target for MCG 6C, and in 2014, achieved a 90% Belize decrease in morbidity compared to 2000 (Figures 1 and 2). A reduction of 37.7% of cases was reported in 2014 from the previous year. About 31 municipalities had more than 1 case per 1,000 inhabitants in one or more years (stratum 3), while 90 municipalities had less than 1 case per 1,000 inhabitants in all 3 years Guatemala during 2012-2014 (stratum 2) (Figure 3). Honduras Figure 2. Number of cases and deaths due to API malaria in Honduras, 2000-2014 per 1,000 people No cases El Salvador 40,000 4 ≤ 0.1 0.11 - 1 Nicaragua 1.01 - 5 30,000 3 ® 5.01 - 10 0 25 50 100 s Kilometers 10.01 - 50 e s Longitude/Latitude a s Datum WGS84 >50 h f c Source: PAHO/CHA/VT t o a 20,000 2 r e e 40,000 4 Stratum 1 177 D mb u 40,000 4 Stratum 2 90 N 10,000 1 Figure 3. Number of municipalities (ADM2) by strata in 30,000 3 Stratum 3 31 Honduras, 2012-2014.30,000 3 s e 0 50 100 150 200 s a s 0 0 s h e f c t s Number of municipalities o a 9 8 7 6 5 4 3 2 1 0 20,000 2 0 1 2 3 4 a r e s 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 e h D 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 f c 177 Stratum 1 t o 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 a *Stratum 1: No autochthonous malaria case in 2012-2014; 20,000 2 mb r e e u Stratum 1 177 D Stratum 2: <1 case per 1000 inhabitants in 2012-2014; N Stratum 2 90 Stratum 3: >1 case per 1000 inhabitants in 2012-2014. ■C onP. fifalciparumrmed Cases & mixed ■ ConfirmedP. falciparum cases & Mix ■ed Deaths Deaths mb u Stratum 2 90 N 10,000 1 Stratum 3 31 The northeastern rainforest area of La Moskitia lies along 10,000 1 Stratum 3 31 0 50 100 150 200 the Atlantic coast and has the highest incidence of malaria 0 0 Municipality Department in the countryAg eas groups well as the Mesoamerican sub-region. Number of municipalities 2 5 4 7 9 1 6 0 50 100 150 200 0 3 8 0 2 1 4 3 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 1 1 1,769 50+ 0 0 0 0 0 0 0 Puerto Lempira Gracias A Dios 870 7Combined,42 the departments of GraciasNumber oaf mDiosunici pandalities Colón 0 0 0 0 0 0 0 0 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 5 4 7 9 1 6 0 3 8 0 2 1 4 45-49 years *Stratum 1: No autochthonous malaria case in 2012-2014; 3 0 0 0 0 1 1 1 Tocoa Colon 513 332 460 Female 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 reported 69.1% of all cases in the country in 2014. The Stratum 2: <1 case per 10000 inhabitants0 0 in 2012-0 2014;0 0 0 0 2 2 2 2 2 2 2 *Stratum 1: No autochthonous40-44 years malaria case in 2012-2014; 2 2 2 2 2 2 2 2 Trujillo Colon 1,376 466 290 municipality of Puerto Lempira in Gracias a Dios hadMa thele Stratum 3: >1 case per 1000 inhabitants in 2012-2014. Confirmed Cases P. falciparum & Mixed Deaths Stratum 2: <1 case35 pe-3r9 1000 years inhabitants in 2012-2014; Villeda Morales Gracias A Dios 274 390 238 highestStratum 3: number >1 case30 pe of-3r4 1000cases years inhab in Hondurasitants in 2012 (Figure-2014. 4). Confirmed Cases P. falciparum & Mixed Deaths Sonaguera Colon 560 442 217 25-29 years Brus Laguna Gracias A Dios 167 234 182 Figure 4. Municipalities20-24 years with the highest number of malaria cases in Honduras, 2012-2014 15-19 years Municipality Department Age groups Saba Colon 244 126 179 10-14 years Puerto Lempira Gracias A Dios 870 1,769 742 50+ 54 181 155 Municipality Department Age groups Danli El Paraiso 5-9 years 45-49 years Puerto Lempira Gracias A Dios 870 1,769 Tocoa 742 Colon 50+ 513 332 460 Female Olanchito Yoro 279 147 86 Under 5 45-49 years 40-44 years Tocoa Colon 513 332 Trujillo460 Colon 1,376 466 Female 290 Male Roatan Bay Islands 149 119 80 150 100 50 0 50 100 150 40-44 years 35-39 years Male Trujillo Colon Confirmed ca1s,3e7s6 466 Vill29e0da Morales Gracias A Dios 274 390 238 30-34 years Decrease Increase 0 500 1000 1500 0 500 1000 1500 0 500 1000 1500 35-39 years 2012 2013 201Vill4 eda Morale*58s % of cGarsaecis awser Ae Di cloassifis ed in 27the4 presented age groups. 390 Son238aguera Colon 30-34 years 560 442 217 25-29 years Sonaguera Colon 560 442 B21ru7s Laguna Gracias25-29 A Dios years 167 234 182 20-24 years 15-19 years Brus Laguna Gracias A Dios 167 234 18Sa2ba Colon 20-24 years 244 126 179 15-19 years 10-14 years 80 Saba Colon 244 126 17Da9nli El Paraiso 54 181 155 10-14 years 5-9 years 54 181 155 279 147 86 Danli El Paraiso Olanchito Yoro 5-9 years Under 5 Olanchito Yoro 279 147 8Ro6 atan Bay IslandsUnder 5 149 119 80 150 100 50 0 50 100 150 Roatan Bay Islands 149 119 80 Confirmed cases Decrease Increase 0 500150100100 0150050 0 05005100001010500150 0 500 1000 1500 2012 Confirmed cases2013 2014 *58% of cases were classified in the presented age groups. Decrease Increase 0 500 1000 1500 0 500 1000 1500 0 500 1000 1500 2012 2013 2014 *58% of cases were classified in the presented age groups. 80 80 - 78 - 40,000 4 30,000 3 s e s a s h f c t o a 20,000 2 r e e Stratum 1 177 D mb u Stratum 2 90 N 10,000 1 Stratum 3 31 0 50 100 150 200 0 0 Number of municipalities 2 5 4 7 9 1 6 0 3 8 0 2 1 4 3 0 0 0 0 1 1 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 2 2 2 2 2 *Stratum 1: No autochthonous malaria case in 2012-2014; 2 2 2 2 2 2 2 2 Stratum 2: <1 case per 1000 inhabitants in 2012-2014; Stratum 3: >1 case per 1000 inhabitants in 2012-2014. Confirmed Cases P. falciparum & Mixed Deaths Figure 5. Malaria cases by age and sex in Honduras, 2014 between 2010 and 2013 the number of malaria cases Municipality Department Age groups in pregnant women increased from 22 to 92 although Puerto Lempira Gracias A Dios 870 1,769 742 50+ the total number of cases decreased, implying that 45-49 years surveillance has improved in recent years. Tocoa Colon 513 332 460 Female 40-44 years Trujillo Colon 1,376 466 290 Male 35-39 years Priority Groups Villeda Morales Gracias A Dios 274 390 238 30-34 years The most affected populations in Honduras are the indigenous peoples, especially those of the Miskito 560 442 217 25-29 years Sonaguera Colon ethnic group who reside in Gracias a Dios. Other affected 20-24 years Brus Laguna Gracias A Dios 167 234 182 ethnic groups are the Tawaka in Wampusirpi and the 15-19 years Saba Colon 244 126 179 Pech in Olancho. Migratory populations, especially along 10-14 years Danli El Paraiso 54 181 155 the Nicaraguan border, report a high number of cases. 5-9 years These are mostly the Miskito people who have families Olanchito Yoro 279 147 86 Under 5 in both countries. Roatan Bay Islands 149 119 80 150 100 50 0 50 100 150 Confirmed cases Decrease Increase 0 500 1000 1500 0 500 1000 1500 0 500 1000 1500 Figure 6. Blood slides examined, RDTs examined, *58% of cases were classified in the presented age groups. 2012 2013 2014 andFig SPRure 6 in. B Honduras,lood slides 2000-2014examined, RDTs examined, and SPR in Honduras, 2000-2014 200,000 24% ) Particularly, the municipality of Wampusirpi in Gracias a Dios R 80 P S d 150,000 18% ( and Jose Santos Guardiola in the Bay Islands have shown e e n t i a m significant decline in malaria: from 702 cases in 2009 to 2 R a x y t i e 100,000 12% cases in 2014 and from 184 cases to 11 cases, respectively. v i e t l i p s o This has been achieved through a massive distribution o e Figure 3. Number of municipalities (ADM2) by strata in P P of LLINs coupled with improved quality of surveillance 50,000 6% e d i Honduras, 2012-2014.