MEXICO Figure 1. Malaria by Annual Parasite Index (API) at municipality level (ADM2), Mexico 2014 Mexico has had a 91.0% reduction in malaria cases since 2000, achieving the WHA 58.2 target for the MDG 6C of reducing malaria by 75% in 2010 (Figures 1 and 2). United States Mexico is currently in the pre-elimination phase, though some malaria endemic areas of substantial transmission intensity exist in the country. There were 664 cases reported in 2014, a 33.1% increase from the previous year. No malaria-related deaths have been reported Mexico since 1998. API per 1,000 people No cases Figure 2. Number of cases and deaths due to ≤ 0.1 Table 1. Elimination profile of Mexico, 2012-2014 Figure 2. Number of cases and deaths due to 0.11 - 1 malaria in Mexico, 2000-2014 2012 2013 2014 malaria in Mexico, 2000-2014 1.01 - 5 ® 8,000 4 5.01 - 10 0 125 250 500 750 842 499 664 Km Total Cases 10.01 - 50 Longitude / Latitude >50 Datum WGS84 Cases Investigated 842 499 664 Source: PAHO/CHA/VT 6,000 3 Autochthonous Cases 833 495 656 s e s a Autochthonous- P. f 0 0 0 s h f c t All cases caused by P. falciparum have reportedly been o 4,000 2 833 495 656 ea Autochthonous- P. v D imported in those returning from endemic countries umber during the 2010 to 2014 period (Table 1). Most of these Imported Cases 9 4 8 N 2,000 1 imported cases have been imported from countries in Imported- P. f 9 4 6 the Americas (50%) followed by those in Africa (41%). Imported- P. v 0 0 2 In 2014, two imported cases of P. vivax were reported 0 0 imported from Belize and Colombia each. The former 0 1 2 3 4 5 6 7 8 9 Active Foci 71 61 56 0 1 2 3 4 reported new active foci of P. vivax malaria along its 200 200 200 200 200 200 200 200 200 200 201 201 201 201 201 Figure 10. Funding for malaria in Honduras, *P. f - Plasmodium falciparum border with Mexico in 2014 with movement of people P. v - Plasmodium vivax Confirmed■ Cases P. fa■lciparum & Mixed ■ Deaths 2000-2014 P. falciparum & mixed Confirmed cases Deaths across the border being the reason for re-establishment of transmission. The primary malaria vectors are An. Figure 3. Municipalities with the highest number of malaria Figure 4. Malaria cases by age and sex in albimanus and An. pseudopunctipennis. cases in Mexico, 2012-2014 Mexico, 2014 Malaria transmission in the country is exclusively due to Municipality State P. vivax infections.Age groups Transmission has been largely limited Men accounted for 56.3% of all cases in 2014 (Figure 60+ Candelaria Campeche 0 0 to southern216 states of Chiapas, Campeche, and QuintanaF emale 4). There were more cases reported among children (5-9 55-59 years Choix Sinaloa 98 61 Roo121 along the border with Guatemala and Belize (FigureMa le years old) and teenagers (10-14 and 15-19 years old) 50-54 years than in any other 5-year age group. Information about Del Nayar Nayarit 48 82 28 3). Two other important areas of transmission exist along the borders of 45-49Sinaloa, year sSonora, and Chihuahua states in number of malaria cases in pregnant women was not Pantelho Chiapas 39 17 25 the north and Nayarit,40-44 year Durango,s and Jalisco states in the available as this is not presently captured by the national Mezquital Durango 96 67 24 center of the country.35-39 years information system. Ocosingo Chiapas 28 18 23 30-34 years Sitala Chiapas 6 5 19 Table 1. Elimination25-29 year profiles of Mexico, 2012-2014 Sabanilla Chiapas 22 18 15 Table 1. Elimination20-24 years profile of Mexico, 2012-2014 Figure 2. Number of cases and deaths due to 15-19 years 2012 2013 2014 malaria in Mexico, 2000-2014 Othon P Blanco Quintana Roo 14 11 14 8,000 4 Total Cases 10-14 years 842 499 664 Yajalon Chiapas 12 9 14 5-9 years Cases Investigated 842 499 664 Decrease 0 100 200 0 100 200 0 100 200 Under 5 6,000 3 Increase 2012 2013 201Au4 tochthonous Cases 833 495 656 s 60 40 20 0 20 40 60 e s a Autochthonous- P. f 0 Confirmed cases0 0 s h f c t o 4,000 2 833 495 656 ea Autochthonous- P. v D umber Imported Cases 9 4 8 N 83 2,000 1 Imported- P. f 9 4 6 Imported- P. v 0 0 2 0 0 1 5 6 0 3 4 8 9 2 7 0 1 3 4 Active Foci 71 61 56 2 200 200 200 201 201 200 200 200 200 200 201 201 200 200 201 *P. f - Pl*P.a fs-Plasmodiummodium falci falciparumparum * P. v - PlP. av.s-Plasmodiummodium viv vivaxax Confirmed Cases P. falciparum & Mixed Deaths Figure 3. Municipalities with the highest number of malaria Figure 4. Malaria cases by age and sex in cases in Mexico, 2012-2014 Mexico, 2014 Municipality State Age groups - 81 - 60+ Candelaria Campeche 0 0 216 Female 55-59 years Choix Sinaloa 98 61 121 Male 50-54 years Del Nayar Nayarit 48 82 28 45-49 years Pantelho Chiapas 39 17 25 40-44 years Mezquital Durango 96 67 24 35-39 years Ocosingo Chiapas 28 18 23 30-34 years Sitala Chiapas 6 5 19 25-29 years Sabanilla Chiapas 22 18 15 20-24 years 15-19 years Othon P Blanco Quintana Roo 14 11 14 10-14 years Yajalon Chiapas 12 9 14 5-9 years Decrease 0 100 200 0 100 200 0 100 200 Under 5 Increase 2012 2013 2014 60 40 20 0 20 40 60 Confirmed cases 83 Table 1. Elimination profile of Mexico, 2012-2014 Figure 2. Number of cases and deaths due to 2012 2013 2014 malaria in Mexico, 2000-2014 8,000 4 Total Cases 842 499 664 Cases Investigated 842 499 664 6,000 3 Autochthonous Cases 833 495 656 s e s a Autochthonous- P. f 0 0 0 s h f c t o 4,000 2 833 495 656 ea Autochthonous- P. v D umber Imported Cases 9 4 8 N 2,000 1 Imported- P. f 9 4 6 Imported- P. v 0 0 2 0 0 1 5 6 0 3 4 8 9 2 7 0 1 3 4 Active Foci 71 61 56 2 200 200 200 201 201 200 200 200 200 200 201 201 200 200 201 *P. f - Plasmodium falciparum P. v - Plasmodium vivax Confirmed Cases P. falciparum & Mixed Deaths Figure 3. Municipalities with the highest number of malaria Figure 4. Malaria cases by age and sex in Figure 3. Municipalitiescases with in the Mexico, highest 2012-2014 number of malaria cases in Mexico, 2012-2014 Mexico, 2014 Municipality State Age groups 60+ Candelaria Campeche 0 0 216 Female 55-59 years Choix Sinaloa 98 61 121 Male 50-54 years Del Nayar Nayarit 48 82 28 45-49 years Pantelho Chiapas 39 17 25 40-44 years Mezquital Durango 96 67 24 35-39 years Ocosingo Chiapas 28 18 23 30-34 years Sitala Chiapas 6 5 19 25-29 years Report on the Situation of Malaria in the Americas, 2000-2014(DRAFT V.3) Sabanilla Chiapas 22 18 15 20-24 years 15-19 years Othon P Blanco Quintana Roo 14 11 14 10-14 years Yajalon Chiapas 12 9 14 5-9 years Decrease 0 100 200 0 100 200 0 100 200 Under 5 Increase 2012 2013 2014 60 40 20 0 20 40 60 Confirmed cases The municipality of Candelaria in Campeche state, near efforts have been implemented in Chiapas along the the Guatemalan border, reported an outbreak of malaria 83 train route and focused on increasing microscopy, in 2014, although it had no cases in previous years. A improving access to treatment, distributing bed nets, Table 1. Elimination profile of Mexico, 2012-2014 Figurechange 2. Number in migratory of cases patternsand deaths has due been to suggested as a and engaging indigenous peoples. The Oaxaca state in possible reason for this outbreak. This area is endemic particular has demonstrated significant achievements malaria in Mexico, 2000-2014 2012 2013 2014 as a result of human trafficking and movement of illegal in eliminating malaria; no malaria case was reported in 8,000 4 Total Cases 842 499 664 migrants along the train routes. Inadequate surveillance 2014, decreasing from 902 cases in 2009. This has Cases Investigated 842 499 664 quality was another reason for the outbreak in Candelaria been achieved by modifying the treatment scheme 6,000 wherein detected cases were reported to 3have been to the PAHO/WHO recommended 14-day treatment Autochthonous Cases 833 495 656 s infected elsewhere upon case investigation thereby with chloroquine and primaquine for P. vivax in 2011, e s a Autochthonous- P. f 0 0 0 delaying the detection of increasing transmission s and supervised treatment, vector control interventions, and h f c t o 4,000 2 833 495 656 consequently the response. ea improving access to prompt diagnosis and treatment. Autochthonous- P. v D umber Imported Cases 9 4 8 N Another vulnerable group affected by malaria is the Diagnosis and Treatment 2,000 1 Imported- P. f 9 4 6 indigenous people who live in rural areas. The states of Microscopy has been the primary method of diagnosis.