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Pan American Health Organization Malaria in Panama, 1998–20043 The Risk of TransmissionTRANSCRIPT
Malaria in Panama, 1998–2004 1Pan AmericanHealthOrganization
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Title of the presentation
AuthorMALARIA IN PANAMA:
Time Series Epidemiological Data from 1998 to 2004
Malaria in Panama, 1998–2004 2Pan AmericanHealthOrganization
MALARIA IN PANAMAI. The Malaria Burden
– Risk of Transmission– Malaria Morbidity– Malaria Mortality– Malariometric Indices (API, AFI, AVI, AMI)
II Trends in Case Detection and Diagnosis– Case Detection: Passive vs. Active
Method– Annual Blood Examination Rate (ABER)– Slide Positivity Rate SPR)
III. TreatmentIV. Resources and Financing
Malaria in Panama, 1998–2004 3Pan AmericanHealthOrganization
The Risk of
Transmission
Malaria in Panama, 1998–2004 4Pan AmericanHealthOrganization
PANAMA: Population at Risk of Malaria Transmission, 1998–2004 (in thousands)
2,400.00
2,500.00
2,600.00
2,700.00
2,800.00
2,900.00
3,000.00
3,100.00
3,200.00
Population at Risk 2,667 2,712 2,757 2,821 2,863 3,016 3,067
Total Population 2,764 2,809 2,839 2,919 2,963 3,121 3,172
1998 1999 2000 2001 2002 2003 2004
Malaria in Panama, 1998–2004 5Pan AmericanHealthOrganization
PANAMA: Population at Ecological Risk of Malaria Transmission According to Level of Transmission
Risk, 1998–2004 (in thousands)
0
500
1,000
1,500
2,000
2,500
3,000
Low Risk 178 237 0 0 2,428 2,256 2,739Moderate Risk 308 224 2,006 2,430 0 368 221High Risk 0 … 424 391 435 497 107
1998 1999 2000 2001 2002 2003 2004
Malaria in Panama, 1998–2004 6Pan AmericanHealthOrganization
Malaria Morbidity
Malaria in Panama, 1998–2004 7Pan AmericanHealthOrganization
PANAMA: Malaria Morbidity, 1998–2004 (number of positive blood slides)
0
1,000
2,000
3,000
4,000
5,000
6,000
No. of Cases 1,039 936 1,036 928 2,244 4,500 5,095
1998 1999 2000 2001 2002 2003 2004
Malaria in Panama, 1998–2004 8Pan AmericanHealthOrganization
PANAMA: Malaria Morbidity According to Level of Transmission Risk, 1998–2004
(number of positive blood slides)
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
Low Risk 130 65 … 0 0 321 923
Moderate Risk 909 871 75 102 254 675 1,960
High Risk … … 961 826 1,990 3,504 2,212
Originally Non-Malarious … … … … 0 0 0
1998 1999 2000 2001 2002 2003 2004
Malaria in Panama, 1998–2004 9Pan AmericanHealthOrganization
PANAMA: Malaria Morbidity According to Parasite Species (in All Risk Areas), 1998–2004
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
4,500
P. falciparum & mixed 124 40 45 39 337 627 882
P. vivax 914 896 991 889 1,907 3,873 4,213
P. malariae 0 0 0 0 0 0 0
1998 1999 2000 2001 2002 2003 2004
Malaria in Panama, 1998–2004 10Pan AmericanHealthOrganization
PANAMA: Malaria Morbidity According to Parasite Species (In Moderate and High Risk Areas),
1998–2004
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
P. falciparum & mixed 114 29 45 39 337 602 800
P. vivax 795 841 991 889 1,907 3,539 3,372
P. malariae 0 0 … 0 0 0 0
1998 1999 2000 2001 2002 2003 2004
Malaria in Panama, 1998–2004 11Pan AmericanHealthOrganization
Malaria Mortality
Malaria in Panama, 1998–2004 12Pan AmericanHealthOrganization
PANAMA: Malaria Mortality, 1998–2004 (number of deaths)
0
0.5
1
1.5
2
2.5
3
3.5
4
No. of Deaths 0 0 1 1 2 4 3
1998 1999 2000 2001 2002 2003 2004
Malaria in Panama, 1998–2004 13Pan AmericanHealthOrganization
Malariometric Indices
(API, AFI, AVI, AMI)
Malaria in Panama, 1998–2004 14Pan AmericanHealthOrganization
PANAMA: Malariometric Indices (API, AFI, AVI, AMI) in All Risk Areas, 1998–2004
00.20.40.60.8
11.21.41.61.8
API 0.4 0.3 0.4 0.33 0.78 1.44 1.66AFI 0 0 0 0.01 0.12 0.2 0.29AVI 0.32 0.33 0.36 0.32 0.67 1.24 1.37AMI 0 0 0 0 0 0 0
1998 1999 2000 2001 2002 2003 2004
Malaria in Panama, 1998–2004 15Pan AmericanHealthOrganization
PANAMA: Malariometric Indices (API, AFI, AVI, AMI) in Moderate and High Risk Areas, 1998–2004
0
2
4
6
8
10
12
14
API 2.95 3.89 0.43 0.33 5.16 4.79 12.27AFI 0.37 0.13 0.02 0.01 0.77 0.7 2.44AVI 2.58 3.75 0.41 0.32 4.38 4.09 10.28AMI 0 0 0 0 0 0 0
1998 1999 2000 2001 2002 2003 2004
Malaria in Panama, 1998–2004 16Pan AmericanHealthOrganization
PANAMA: Annual Parasitic Index (API), 1998–2004
0
2
4
6
8
10
12
14
In All Risk Areas 0.4 0.3 0.4 0.33 0.78 1.44 1.66Moderate and High Risk Only 2.95 3.89 0.43 0.33 5.16 4.79 12.27
1998 1999 2000 2001 2002 2003 2004
Malaria in Panama, 1998–2004 17Pan AmericanHealthOrganization
PANAMA: Annual Index of P. falciparum (AFI), 1998–2004
0
0.5
1
1.5
2
2.5
In All Risk Areas 0 0 0 0 0.12 0.2 0.29Moderate and High Risk Only 0.37 0.13 0.02 0.01 0.77 0.7 2.44
1998 1999 2000 2001 2002 2003 2004
Malaria in Panama, 1998–2004 18Pan AmericanHealthOrganization
PANAMA: Annual Index of P. vivax (AVI), 1998–2004
0
2
4
6
8
10
12
In All Risk Areas 0.34 0.33 0.36 0.32 0.67 1.24 1.37Moderate and High Risk Only 2.58 3.75 0.41 0.32 4.38 4.09 10.28
1998 1999 2000 2001 2002 2003 2004
Malaria in Panama, 1998–2004 19Pan AmericanHealthOrganization
PANAMA: Annual Index of P. malariae (AMI), 1998–2004
00.10.20.30.40.50.60.70.80.9
1
In All Risk Areas 0 0 0 0 0 0 0Moderate and High Risk Only 0 0 0 0 0 0 0
1998 1999 2000 2001 2002 2003 2004
Malaria in Panama, 1998–2004 20Pan AmericanHealthOrganization
Trends in Case Detection
and Diagnosis
Malaria in Panama, 1998–2004 21Pan AmericanHealthOrganization
PANAMA: Passive vs. Active Case Detection, 1998–2004 (% of Blood Slides Examined)
18
18
18
14
16
16
17
82
82
82
86
84
84
83
0 20 40 60 80 100 120
1998
1999
2000
2001
2002
2003
2004
Passive Active
Malaria in Panama, 1998–2004 22Pan AmericanHealthOrganization
PANAMA: Annual Blood Examination Rate (ABER) in Malarious Areas, 1998–2004
486,000
461,000
2,430,000
2,821,000
2,863,000
3,121,000
3,067,000
187,055
161,219
149,702
156,588
166,031
166,811
171,179
1998
1999
2000
2001
2002
2003
2004
Examined
Population at Risk /In Malarious Areas
Malaria in Panama, 1998–2004 23Pan AmericanHealthOrganization
PANAMA: Slide Positivity Rate (SPR), 1998–2004
187,055
161,219
149,702
156,588
166,031
166,811
171,179
1,039
936
1,036
928
2,244
4,500
5,095
1998
1999
2000
2001
2002
2003
2004
Examined
Positive
Malaria in Panama, 1998–2004 24Pan AmericanHealthOrganization
Treatment
Malaria in Panama, 1998–2004 25Pan AmericanHealthOrganization
PANAMA: Antimalarial Drugs Used, 1998–2004
0100,000200,000300,000400,000500,000600,000700,000800,000900,000
Chloroquine &/or Amodiaquine @ 150mg 196,000 191,000 198,000 195,000 266,000 865,052 712,852
Primaquine @ 15mg 197,500 189,000 194,500 182,500 161,000 771,829 554,942
Sulfa/Pyrimethamine @ 500/25mg 2,100 … … 80 221 5,000 6,000
Mefloquine @250mg … … … … … 5,463 8,500
Artemisinine Derivatives (# of Tx) … … … … … … …
Quinine @ 300mg … … … … … … …
1998 1999 2000 2001 2002 2003 2004
Malaria in Panama, 1998–2004 26Pan AmericanHealthOrganization
Resources and
Financing
Malaria in Panama, 1998–2004 27Pan AmericanHealthOrganization
1
10
100
1,000
10,000
100,000
1,000,000
10,000,000
Contributed Funds and Loans
National Malaria Budget
Total Budget
Contributed Funds and Loans … … … … … … 88,417National Malaria Budget 5,171,984 5,161,509 5,066,318 4,680,289 3,986,849 2,751,541 5,024,766Total Budget 5,171,984 5,161,509 5,066,318 4,680,289 3,986,849 2,751,541 5,113,183
1998 1999 2000 2001 2002 2003 2004
PANAMA: National Budget and Non-Budgetary Contributions to Malaria Control Programs,
1998–2004 (in US$)
Malaria in Panama, 1998–2004 28Pan AmericanHealthOrganization
PANAMA: Annual US$ Funds per Person in Malarious Areas, 1998–2004
0
2
4
6
8
10
12
US$ Funds per Person inMalarious Areas
10.64 11.2 2.09 1.66 1.39 0.91 1.67
1998 1999 2000 2001 2002 2003 2004