title: Outbreak Investigation ofPlasmodium vivaxMalaria in a Region of Guatemala Targeted for Malaria Elimination.
abstract: AbstractThe Department of Santa Rosa, Guatemala, is targeted for malaria elimination. However, compared with 2011, a 13-fold increase in cases was reported in 2012. To describe the epidemiology of malaria in Santa Rosa in the setting of the apparent outbreak, demographic and microscopic data from 2008 to 2013 were analyzed. In April 2012, a new surveillance strategy, funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, was introduced involving more active case detection, centralized microscopy, increased community engagement, and expanded vector control. Interviews with vector control personnel and site visits were conducted in June 2013. From 2008 to 2013, 337 cases of malaria were reported. The increase in cases occurred largely after the new surveillance strategy was implemented. Most (137/165; 83%) 2012 cases came from one town near a lake.Plasmodium vivaxwas the malaria species detected in all cases. Cases were detected where malaria was not previously reported. Monthly rainfall or/and temperature did not correlate with cases. Interviews with public health personnel suggested that the new funding, staffing, and strategy were responsible for improved quality of malaria detection and control and thus the increase in reported cases. Improvements in surveillance, case detection, and funding appear responsible for the temporary increase in cases, which thus may paradoxically indicate progress toward elimination.
authors.affiliation: U.S. Army Public Health Command, Edgewood, Maryland.
authors.forename: Robert
authors.initials: R
authors.lastname: Cohen
authors.affiliation: Area de Salud, Department of Santa Rosa, Ministerio de Salud, Cuilapa, Guatemala.
authors.forename: Joel Sarceño
authors.initials: JS
authors.lastname: Cardona
authors.affiliation: Area de Salud, Department of Santa Rosa, Ministerio de Salud, Cuilapa, Guatemala.
authors.forename: Eliana Solares
authors.initials: ES
authors.lastname: Navarro
authors.affiliation: Universidad del Valle, Guatemala City, Guatemala.
authors.forename: Norma
authors.initials: N
authors.lastname: Padilla
authors.affiliation: Area de Salud, Department of Santa Rosa, Ministerio de Salud, Cuilapa, Guatemala.
authors.forename: Lisette
authors.initials: L
authors.lastname: Reyes
authors.affiliation: Area de Salud, Department of Santa Rosa, Ministerio de Salud, Cuilapa, Guatemala.
authors.forename: Rodrigo Javier Pinto
authors.initials: RJP
authors.lastname: Villar
authors.affiliation: Henry M. Jackson Foundation, Uniformed Services University of Health Sciences, Bethesda, Maryland.
authors.forename: Penny
authors.initials: P
authors.lastname: Masuoka
authors.affiliation: Universidad del Valle, Guatemala City, Guatemala.
authors.forename: Chris
authors.initials: C
authors.lastname: Bernart
authors.affiliation: Division of Global Health Protection, Center for Disease Control and Prevention, Atlanta, Georgia.|Central American Regional Office, Centers for Disease Control and Prevention, Guatemala City, Guatemala.
authors.forename: Leonard F
authors.initials: LF
authors.lastname: Peruski
authors.affiliation: Division of Global Health Protection, Center for Disease Control and Prevention, Atlanta, Georgia.|Central American Regional Office, Centers for Disease Control and Prevention, Guatemala City, Guatemala.
authors.forename: Joe P
authors.initials: JP
authors.lastname: Bryan
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006166:Guatemala / Q000453:epidemiology; D006801:Humans; D007223:Infant; D016780:Malaria, Vivax / Q000453:epidemiology / Q000469:parasitology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D055815:Young Adult