Health policy impacts on malaria transmission in Costa Rica.

Abstract:

:Costa Rica is near malaria elimination. This achievement has followed shifts in malaria health policy. Here, we evaluate the impacts that different health policies have had on malaria transmission in Costa Rica from 1913 to 2018. We identified regime shifts and used regression models to measure the impact of different health policies on malaria transmission in Costa Rica using annual case records. We found that vector control and prophylactic treatments were associated with a 50% malaria case reduction in 1929-1931 compared with 1913-1928. DDT introduction in 1946 was associated with an increase in annual malaria case reduction from 7.6% (1942-1946) to 26.4% (1947-1952). The 2006 introduction of 7-day supervised chloroquine and primaquine treatments was the most effective health policy between 1957 and 2018, reducing annual malaria cases by 98% (2009-2018) when compared with 1957-1968. We also found that effective malaria reduction policies have been sensitive to natural catastrophes and extreme climatic events, both of which have increased malaria transmission in Costa Rica. Currently, outbreaks follow malaria importation into vulnerable areas of Costa Rica. This highlights the need to timely diagnose and treat malaria, while improving living standards, in the affected areas.

journal_name

Parasitology

journal_title

Parasitology

authors

Chaves LF,Ramírez Rojas M,Prado M,Garcés JL,Salas Peraza D,Marín Rodríguez R

doi

10.1017/S0031182020000621

subject

Has Abstract

pub_date

2020-08-01 00:00:00

pages

999-1007

issue

9

eissn

0031-1820

issn

1469-8161

pii

S0031182020000621

journal_volume

147

pub_type

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