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. Title of the presentation Author. MALARIA IN BELIZE: Time Series Epidemiological Data from 1998 to 2004. MALARIA IN BELIZE. I.The Malaria Burden Risk of Transmission Malaria Morbidity Malaria Mortality Malariometric Indices (API, AFI, AVI, AMI) - PowerPoint PPT PresentationTRANSCRIPT
Malaria in Belize, 1998–2004 1
Pan AmericanHealthOrganization
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Title of the presentation
Author
Title of the presentation
Author
MALARIA IN BELIZE: Time Series
Epidemiological Data from 1998 to 2004
MALARIA IN BELIZE: Time Series
Epidemiological Data from 1998 to 2004
Malaria in Belize, 1998–2004 2
Pan AmericanHealthOrganization
MALARIA IN BELIZEMALARIA IN BELIZE
I. 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
I. 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 Belize, 1998–2004 3
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The Risk of
Transmission
The Risk of
Transmission
Malaria in Belize, 1998–2004 4
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BELIZE: Population at Risk of Malaria Transmission, 1998–2004 (in thousands)
BELIZE: Population at Risk of Malaria Transmission, 1998–2004 (in thousands)
0
50
100
150
200
250
300
Population at Risk 216 220 … 153 … 153 256
Total Population 230 235 226 250 250 250 265
1998 1999 2000 2001 2002 2003 20040
50
100
150
200
250
300
Population at Risk 216 220 … 153 … 153 256
Total Population 230 235 226 250 250 250 265
1998 1999 2000 2001 2002 2003 2004
Malaria in Belize, 1998–2004 5
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BELIZE: Population at Ecological Risk of Malaria Transmission According to Level of Transmission
Risk , 1998–2004 (in thousands)
BELIZE: Population at Ecological Risk of Malaria Transmission According to Level of Transmission
Risk , 1998–2004 (in thousands)
0
20
40
60
80
100
120
140
160
Low Risk 66 67 … 0 … … 124
Moderate Risk 67 68 … 153 … … 78
High Risk 83 85 … 0 … … 54
1998 1999 2000 2001 2002 2003 20040
20
40
60
80
100
120
140
160
Low Risk 66 67 … 0 … … 124
Moderate Risk 67 68 … 153 … … 78
High Risk 83 85 … 0 … … 54
1998 1999 2000 2001 2002 2003 2004
Malaria in Belize, 1998–2004 6
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Malaria MorbidityMalaria Morbidity
Malaria in Belize, 1998–2004 7
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BELIZE: Malaria Morbidity, 1998–2004 (number of positive blood slides)
BELIZE: Malaria Morbidity, 1998–2004 (number of positive blood slides)
0
500
1,000
1,500
2,000
2,500
3,000
No. of Cases 2614 1850 1486 1097 928 928 1057
1998 1999 2000 2001 2002 2003 20040
500
1,000
1,500
2,000
2,500
3,000
No. of Cases 2614 1850 1486 1097 928 928 1057
1998 1999 2000 2001 2002 2003 2004
Malaria in Belize, 1998–2004 8
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BELIZE: Malaria Morbidity According to Level of Transmission Risk, 1998–2004 (number of positive blood slides)
BELIZE: 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
Low Risk 356 139 … 338 353 353 36
Moderate Risk … 634 … 759 575 575 413
High Risk 2278 1077 … 0 0 0 608
Originally Non-Malarious … … … 0 0 0 0
1998 1999 2000 2001 2002 2003 20040
500
1,000
1,500
2,000
2,500
Low Risk 356 139 … 338 353 353 36
Moderate Risk … 634 … 759 575 575 413
High Risk 2278 1077 … 0 0 0 608
Originally Non-Malarious … … … 0 0 0 0
1998 1999 2000 2001 2002 2003 2004
Malaria in Belize, 1998–2004 9
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BELIZE: Malaria Morbidity According to Parasite Species (In All Risk Areas), 1998–2004
BELIZE: Malaria Morbidity According to Parasite Species (In All Risk Areas), 1998–2004
0
200
400
600
800
1,000
1,200
P. falciparum & mixed … … … 6 0 0 6
P. vivax … … … 1,091 928 928 1,049
P. malariae … … … 0 0 0 2
1998 1999 2000 2001 2002 2003 20040
200
400
600
800
1,000
1,200
P. falciparum & mixed … … … 6 0 0 6
P. vivax … … … 1,091 928 928 1,049
P. malariae … … … 0 0 0 2
1998 1999 2000 2001 2002 2003 2004
Malaria in Belize, 1998–2004 10
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BELIZE: Malaria Morbidity According to Parasite Species (In Moderate and High Areas), 1998–2004
BELIZE: Malaria Morbidity According to Parasite Species (In Moderate and High Areas), 1998–2004
0
200
400
600
800
1,000
1,200
1,400
1,600
1,800
P. falciparum & mixed 151 37 20 2 0 0 6
P. vivax 1,580 1,668 1,466 757 575 575 1,013
P. malariae 0 0 0 0 0 0 2
1998 1999 2000 2001 2002 2003 20040
200
400
600
800
1,000
1,200
1,400
1,600
1,800
P. falciparum & mixed 151 37 20 2 0 0 6
P. vivax 1,580 1,668 1,466 757 575 575 1,013
P. malariae 0 0 0 0 0 0 2
1998 1999 2000 2001 2002 2003 2004
Malaria in Belize, 1998–2004 11
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Malaria MortalityMalaria Mortality
Malaria in Belize, 1998–2004 12
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BELIZE: Malaria Mortality, 1998–2004 (number of deaths)
BELIZE: Malaria Mortality, 1998–2004 (number of deaths)
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
No. of Deaths 0 0 0 0 0 … …
1998 1999 2000 2001 2002 2003 20040
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
No. of Deaths 0 0 0 0 0 … …
1998 1999 2000 2001 2002 2003 2004
Malaria in Belize, 1998–2004 13
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Malariometric Indices
(API, AFI, AVI, AMI)
Malariometric Indices
(API, AFI, AVI, AMI)
Malaria in Belize, 1998–2004 14
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BELIZE: Malariometric Indices (API, AFI, AVI, AMI) In all Risk Areas, 1998–2004
BELIZE: Malariometric Indices (API, AFI, AVI, AMI) In all Risk Areas, 1998–2004
0
1
2
3
4
5
6
7
8
API … … … 7.17 6.07 6.07 4.13
AFI … … … 0.04 0 0 0.02
AVI … … … 7.13 6.07 6.07 4.1
AMI … … … 0 0 0 0.01
1998 1999 2000 2001 2002 2003 20040
1
2
3
4
5
6
7
8
API … … … 7.17 6.07 6.07 4.13
AFI … … … 0.04 0 0 0.02
AVI … … … 7.13 6.07 6.07 4.1
AMI … … … 0 0 0 0.01
1998 1999 2000 2001 2002 2003 2004
Malaria in Belize, 1998–2004 15
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BELIZE: Malariometric Indices (API, AFI, AVI, AMI) in Moderate and High Risk Areas, 1998–2004
BELIZE: Malariometric Indices (API, AFI, AVI, AMI) in Moderate and High Risk Areas, 1998–2004
0
2
4
6
8
10
12
14
16
API 15.19 11.18 9.71 4.96 3.76 3.76 7.73
AFI 1.01 0.24 0.13 0.01 0 0 0.05
AVI 10.53 10.9 9.58 4.95 3.76 3.76 7.67
AMI 0 0 … 0 0 0 0.02
1998 1999 2000 2001 2002 2003 20040
2
4
6
8
10
12
14
16
API 15.19 11.18 9.71 4.96 3.76 3.76 7.73
AFI 1.01 0.24 0.13 0.01 0 0 0.05
AVI 10.53 10.9 9.58 4.95 3.76 3.76 7.67
AMI 0 0 … 0 0 0 0.02
1998 1999 2000 2001 2002 2003 2004
Malaria in Belize, 1998–2004 16
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BELIZE: Annual Parasitic Index (API), 1998–2004BELIZE: Annual Parasitic Index (API), 1998–2004
0
2
4
6
8
10
12
14
16
In All Risk Areas … … … 7.17 6.07 6.07 4.13
Moderate and High Risk Only 15.19 11.18 9.71 4.96 3.76 3.76 7.73
1998 1999 2000 2001 2002 2003 20040
2
4
6
8
10
12
14
16
In All Risk Areas … … … 7.17 6.07 6.07 4.13
Moderate and High Risk Only 15.19 11.18 9.71 4.96 3.76 3.76 7.73
1998 1999 2000 2001 2002 2003 2004
Malaria in Belize, 1998–2004 17
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BELIZE: Annual Index of P. falciparum (AFI), 1998–2004
BELIZE: Annual Index of P. falciparum (AFI), 1998–2004
0
0.2
0.4
0.6
0.8
1
1.2
In All Risk Areas … … … 0.04 0 0 0.02
Moderate and High Risk Only 1.01 0.24 0.13 0.01 0 0 0.05
1998 1999 2000 2001 2002 2003 20040
0.2
0.4
0.6
0.8
1
1.2
In All Risk Areas … … … 0.04 0 0 0.02
Moderate and High Risk Only 1.01 0.24 0.13 0.01 0 0 0.05
1998 1999 2000 2001 2002 2003 2004
Malaria in Belize, 1998–2004 18
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BELIZE: Annual Index of P. vivax (AVI), 1998–2004BELIZE: Annual Index of P. vivax (AVI), 1998–2004
0
2
4
6
8
10
12
In All Risk Areas … … … 7.13 6.07 6.07 4.1
Moderate and High Risk Only 10.53 10.9 9.58 4.95 3.76 3.76 7.67
1998 1999 2000 2001 2002 2003 20040
2
4
6
8
10
12
In All Risk Areas … … … 7.13 6.07 6.07 4.1
Moderate and High Risk Only 10.53 10.9 9.58 4.95 3.76 3.76 7.67
1998 1999 2000 2001 2002 2003 2004
Malaria in Belize, 1998–2004 19
Pan AmericanHealthOrganization
BELIZE: Annual Index of P. malariae (AMI), 1998–2004
BELIZE: Annual Index of P. malariae (AMI), 1998–2004
0
0.002
0.004
0.006
0.008
0.01
0.012
0.014
0.016
0.018
0.02
In All Risk Areas … … … 0 0 0 0.01
Moderate and High Risk Only 0 0 … 0 0 0 0.02
1998 1999 2000 2001 2002 2003 20040
0.002
0.004
0.006
0.008
0.01
0.012
0.014
0.016
0.018
0.02
In All Risk Areas … … … 0 0 0 0.01
Moderate and High Risk Only 0 0 … 0 0 0 0.02
1998 1999 2000 2001 2002 2003 2004
Malaria in Belize, 1998–2004 20
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Trends in Case Detection
and Diagnosis
Trends in Case Detection
and Diagnosis
Malaria in Belize, 1998–2004 21
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BELIZE: Passive vs. Active Case Detection, 1998–2004 (% of Blood Slides Examined)
BELIZE: Passive vs. Active Case Detection, 1998–2004 (% of Blood Slides Examined)
76.13
65.87
72.24
72.24
50.56
23.87
34.13
27.76
27.76
49.44
0 20 40 60 80 100 120
1998
1999
2000
2001
2002
2003
2004
Passive Active
76.13
65.87
72.24
72.24
50.56
23.87
34.13
27.76
27.76
49.44
0 20 40 60 80 100 120
1998
1999
2000
2001
2002
2003
2004
Passive Active
Malaria in Belize, 1998–2004 22
Pan AmericanHealthOrganization
BELIZE: Annual Blood Examination Rate (ABER) in Malarious Areas, 1998–2004
BELIZE: Annual Blood Examination Rate (ABER) in Malarious Areas, 1998–2004
216,000
220,000
15,300
153,000
256,000
27,000
19,375
18,559
18,173
15,480
15,480
25,739
1998
1999
2000
2001
2002
2003
2004
Examined
Population at Risk /In Malarious Areas
216,000
220,000
15,300
153,000
256,000
27,000
19,375
18,559
18,173
15,480
15,480
25,739
1998
1999
2000
2001
2002
2003
2004
Examined
Population at Risk /In Malarious Areas
Malaria in Belize, 1998–2004 23
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BELIZE: Slide Positivity Rate (SPR), 1998–2004BELIZE: Slide Positivity Rate (SPR), 1998–2004
2,614
1,850
1,486
1,097
928
928
1,057
27,000
19,375
18,559
18,173
15,480
15,480
25,739
1998
1999
2000
2001
2002
2003
2004
Examined
Positive
2,614
1,850
1,486
1,097
928
928
1,057
27,000
19,375
18,559
18,173
15,480
15,480
25,739
1998
1999
2000
2001
2002
2003
2004
Examined
Positive
Malaria in Belize, 1998–2004 24
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TreatmentTreatment
Malaria in Belize, 1998–2004 25
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BELIZE: Antimalarial Drugs Used, 1998–2004BELIZE: Antimalarial Drugs Used, 1998–2004
0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
Chloroquine &/or Amodiaquine @ 150mg 154,980 85,990 … 65,420 62,135 62,135 86,627
Primaquine @ 15mg 55,717 127,353 … 15,273 17,483 17,483 20,497
Sulfa/Pyrimethamine @ 500/25mg … … … … … … …
Mefloquine @250mg … … … … … … …
Artemisinine Derivatives (# of Tx) … … … … … … …
Quinine @ 300mg … … … … … … …
1998 1999 2000 2001 2002 2003 20040
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
Chloroquine &/or Amodiaquine @ 150mg 154,980 85,990 … 65,420 62,135 62,135 86,627
Primaquine @ 15mg 55,717 127,353 … 15,273 17,483 17,483 20,497
Sulfa/Pyrimethamine @ 500/25mg … … … … … … …
Mefloquine @250mg … … … … … … …
Artemisinine Derivatives (# of Tx) … … … … … … …
Quinine @ 300mg … … … … … … …
1998 1999 2000 2001 2002 2003 2004
Malaria in Belize, 1998–2004 26
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Resources and
Financing
Resources and
Financing
Malaria in Belize, 1998–2004 27
Pan AmericanHealthOrganization
BELIZE: National Budget and Non-Budgetary Contributions to Malaria Control Programs, 1998–
2004 (in US$)
BELIZE: National Budget and Non-Budgetary Contributions to Malaria Control Programs, 1998–
2004 (in US$)
10,000
100,000
1,000,000
ContributedFunds and Loans
National MalariaBudget
Total Budget
Contributed Fundsand Loans
… … … … … … 238,000
National MalariaBudget
440,174 … … … … … 100,000
Total Budget 440,174 … … … … … 338,000
1998 1999 2000 2001 2002 2003 200410,000
100,000
1,000,000
ContributedFunds and Loans
National MalariaBudget
Total Budget
Contributed Fundsand Loans
… … … … … … 238,000
National MalariaBudget
440,174 … … … … … 100,000
Total Budget 440,174 … … … … … 338,000
1998 1999 2000 2001 2002 2003 2004
Malaria in Belize, 1998–2004 28
Pan AmericanHealthOrganization
BELIZE: Annual US$ Funds per Person in Malarious Areas, 1998–2004
BELIZE: Annual US$ Funds per Person in Malarious Areas, 1998–2004
0
0.5
1
1.5
2
2.5
$US Funds / Person in Malarious Area 2.04 … … … … … 1.32
1998 1999 2000 2001 2002 2003 20040
0.5
1
1.5
2
2.5
$US Funds / Person in Malarious Area 2.04 … … … … … 1.32
1998 1999 2000 2001 2002 2003 2004