Report on the Situation of Malaria in

the Americas – 201712

1
Document prepared by the Regional Malaria Program, Pan American Health Organization with data from Annual
Country Reports- 2017
 Report on the Situation of Malaria in the Americas – 2017
Gener alsit
uat ioni nendemi ccount ri
es Fi
gur
e1.Mal
ari
amorbidit
yandmor t
ali
tyi
n
Thelas tdecades howsanov eral
l downwar dtr
endofmal ariamor bidit
y theAmeri
cas,2007-2017
andmor t
ali
t
yr atesi ntheRegi onoft heAmer i
cas( Fig.1).Ther ewer e
approximately7, 500fewerc onfi
rmedcas esofmal ariabetween2007 0.
8M 400
Conf
i
rmedCases
and2017.Ex cl
udingVenez uela,int hes ameper iod,mal ari
a-relat
ed Deat
hs
deathsalsodecr easedbyal mos thal ffr
om 170i n2007t o88i n2017

ons]
(Fi
g.1).Almos thalfoftheendemi cc ountri
esshowedatl eas t75% P.f
alc
ipar
um &mi
xed
0.
6M 300
reduct
ioninmor bidit
y,whi l
e35% s howedami nimum of35% r eduction

l
l
nmii
(Fi
g.2).In2017,t herewer eappr oximat el
y108mi l
li
onpeopl eatr iskof

i
malari
a.Des pi
tet heov erall
trendingdec l
i
neinthenumberofcas esand

medcases[

hs
Deat
deaths,thelas tthreey earss howedas teadyincreasei nthenumberof 0.
4M 200
malari
ac ases( Fig.1).Ther i
s eisat t
r i
butedtotheinc reaseint he
numberofc asesi nVenez uela,Ni caragua,Brazil
,andGuy ana( Table
1).

r
i
Conf
0.
2M 100
Five-yearsnapshot :2013-2017:Ov er93% ofal lmalariaint he
Amer icaswasconc ent ratedi nsixcount r
ies:Brazil
,Colombi a,Guy ana,
Haiti
,Per uandVenez uela.I nthes ameper i
od,17oft he21endemi c
countriesshowedami nimum ofaone- t
hirdreducti
oninindi genous 0.
0M 0
cases,i ncludinghi
ghbur denc ount
riess uchasHai tiandCol ombia.

2007

2008

2009

2010

2011

2012

2013

2014

2015

2016

2017
Meanwhi l
e,10oft hec ount r
ies(Belize,Cos taRica,ElSalv ador ,
Hondur as,FrenchGui ana,Domi ni
canRepubl i
c,Ecuador ,and
Guat emal a)report
eddec r easesabov e75% i nt heinci
denc eof Between2016and2017:Bet ween2016and2017,t heRegi onofthe
i
ndigenousc asesinthatper i
od.Thiss howst hatthesec ount ri
esare Amer icasobs erveda26% r iseinmal ari
a( f
rom 569, 203t o776, 444).
progres si
ngandar eont rackt oachievingthegoal softheGl obal Sev encount ri
esr eport
edani ncreaseinindigenousmal ar
iac asesfrom
Techni calStrategyforMal ari
aby2020.Howev er,t
hereisat hreatofnot 2016t o2017:Br azil
,FrenchGui ana,Guy ana,Mex ico,Nicaragua,and
achiev i
ngt hegoalsinPer u,Guyana,Ni car
agua,andVenez ueladuet o Venez uela.Thei ncreasei ncasesi nVenezuel aandNi car
aguac onti
nue
tobes ignif
icant(Fig.2).Howev er,t
heover allincreas eincas esinthe
i
nc r
eas esi nmal ar
ia( Fig.2) .
Amer icasi slargelyduet oinc r
easesi nmal ariatrans missi
oni nBrazil
,
ParaguayandAr gent inahav erepor tedz er oindigenousc asesof NicaraguaandVenez uela( Table1.).Despitet her i
singmal ariacases,
malarias i
nce2011and2012,r espec tively.Par aguayhasal s oreport
ed therewasadownwar dtrendi nthemor bidit
yr atesofcount riesthat
noimpor t
edc asesi n2017.Thel ates tmal ari
aout break sinPar aguay gener allytendt ohavehi ghbur denoft hedi sease( Bolivi
a,Col ombia,
occurredi nthedepar tment sofCani ndey u(2007)andAl toPar aná Guat emal a,Hai t
i,Hondur as,andPer u)
.
(2009).The17mal ari
ac asesdet ec t
edi nAr gentinai n2017wer e
i
mpor tedc asesfrom count r
iesint heAmer icasandAf r
ica.In2016, In2017,Venez uel
as awa171% per centincreasei nconfi
rmedcases
ArgentinaandPar aguayof f
icial
lyr eques tedt heWHO t obegi nthe from theprev i
ousyearandacc ountedf orov erhalfofthecasesi
nt he
malariaeliminati
onc er ti
f
icati
onpr oces sint heirterritori
esandt heyare Amer icas.Almostalloft
hes ecaseswer eindigenousandwer ereported
ontrac kforthec er t
if
ication.ForAr gentinat or emai nont rackt orecei
ve i
n16outoft he23states,withBoli
vars tat
eac counti
ngfort
hree-
fourt
hs
theeliminati
onc er ti
fi
c ati
on,itmus tmai ntaini t
sepi demi ologi
cal oftotalcasesi nt
hec ountry.Oft
hos eidentif
ied,P.v i
vaxaccountedfor
surveil
lanceef f
ortsf ort i
melyev entident if
icati
onf ornewc asesfrom t
he two-thir
dsoft hecaseswhi l
etherestoft heinfec t
ionswereduetoP.
Boli
viant err
it
ory.Theendemi cmuni c i
palityofYac uibai nbor dering falci
parum (15%)andmi xedinf
ecti
ons( 5%) .
Boli
viai sofparti
c ulari nter
es tasi thass hownani nc reasef r
om 15i n
2014t o104i n2017. Inpar ti
cular,thecasesi nBol i
v ars t
atewer elimitedtoSi f
ontes
muni cipali
ty,wher eone- thi
rdofal lcasesi nthecount rywere
Inthepas tfi
vey ear s,Venez uelaandNi c ar
aguai nc r
easedbyal most conc entrated.Des pitethet otal populationofSifontesbeing
530% and917% r es pec t
ively,wit
ht hes igni
ficantincreaset aki
ngplace approxi mat el
y50, 000,t heyr epor tedar ound120, 000c ases,whi ch
i
nthel astthreey ear s( 2015-2017;Tabl e2.).Cos taRi careported showst hemagni tudeoft het rans missionwithpeopl egetti
ngmul ti
ple
i
ndigenousc asesf ort hes econdy eari nar ows i
nc e2015— 4i n2016 i
nfectionsi nay ear.Al so,largemi grati
onsofunac countedpeopl etot he
and12i n2017.The2017c as eswer erec ordedint hec antonsofSan areaf ormi ninginc reasedt hepr opor t
ionofmi nerswi t
hmal ari
aby30%
Carlos(6c ases)
,Mat ina(3c as es)
,andSar apiqui(3c ases).The (36,376)f rom thepr evi
ousyear .Themovementoft hepopulationfrom
detecti
onofcas esi nt hesedi str
ict
shighl i
ghtst heriskof others tatesandcount r
iest oSi f
ontesduet othei l
l
egal mini
ngboom has
re-
establi
shmentoft ransmi ssioninar easwher eec ol
ogical condi
ti
ons encour agedt hesepeopl etos ettl
einpl aceswi t
hcondi ti
onsc onducive
persist
. formal ariat r
ans mission.I ntur n,botht heUni t
edNat i
ons(UN)andt he
Wor ldBankagr eet hatVenezuel aisgoi ngthroughacompl exs it
uation
duet osoci al,polit
ical,andec onomi cpr obl
ems .

Sur i
namei swel loni tswayt oeli
minati
ngl ocal tr
ans mis si
onofmal ari
a
Fi
gur
e2.Decr
easeinmalari
amor bi
dit
ybycount
ri
esof by2020t hr
ought hei mplement at
ionofi t
sNat ional Mal ari
aEl i
mi nati
on
theAmer
icas,2007-2017 Strategy .Fort
yi ndigenousmal ariacas eswer er eportedi n2017
100% compar edt o1756i n2010.I n2017,al most70% ofal lcaseswer efound
707%
893%

>75% Decr
ease
amongmal esbet weent heagesof15and59,demons t
ratingthes t
rong
75%
50-
75% Decr
eas
e ass oci
at i
onofmal ariar i
skt oeconomi cac ti
vi
ty.Ass uch,Sur iname’ s
50% <50% Decr
ease suc cessi sther esultofpr oacti
veandi nnov ati
v einterventionst hat
hange

pri
mar il
yf ocus edonar easandc ommuni tiesatr isk,suchaspeopl e
I
ncr
ease
25% engagedi ninfor mal ands mal l
-scal
emi ningoper at
ionsaswel lasthose
agec

thatser vethemi ners .Surinamecanhel pst r

engt henr egional eff
ort
sby
0% strengthenings urveil
lanceandcont rolmeas uresands haringitslessons
ent

-
25% l
ear ntwi t
hnei ghbor i
ngBr azil
,Guy ana,andFr enc hGui ana.
ec
Pr

-
50% Between2014and2017,Per ureducedthenumberofmal ar
iacasesby
morethan15% ( f
rom 65,
252t
o55, 367cases)
.TheMinist
ryofHealthof
-
75% Peruapprovedthe"Malari
aZer
oPl an"i
n2017wi t
htheobjecti
veof
-
100% el
iminat
ingmalari
aintheAmazonr egi
onofPeru,part
i
cularl
yinLoreto
depart
mentwhichhad96% ofallcasesin2017.
.

i
ador

uador

i
Dom.Re.

t
aguay

as
e
a

a
na

ana

a
name
Panama

u
ana
agua
a
Hai
i
emal

ombi

uel
Per
az
z
c

c
i
aRi

v
i
i

Hondur
Bel

i
gent

Bol
Mex
Br
.Gui

Guy

Venez
v

ar
i
Sal

Mostofthecaseswer
elocat
edi
ndi
st
ri
ct
swi
t
hal
argepr
opor
ti
onof
Col
Guat

Sur
Par

Ec
t
Cos
Ar

c
Ni
Fr

et
hni
cit
ies.
El

*
*
*

*Fr
enchGui
ana *
*Domi
ni
canRepubl
i
c
1
 Report on the Situation of Malaria in the Americas – 2017
Tabl
e1.Mal
ari
aincount
ri
esi
ntheRegi
onoft
heAmer
icas,2015-2017
Bl
oodSl i
des P.f
alci
parum &
Count
ry Year Tot
alPopnatRi
sk Conf
ir
medCases SPR API
Examined mi
xedinfect
ions
Bol
ivi
a 2015 4,
549,
215 159,
167 6,
907 96 4.
34 1.
52
2016 4,
549,
215 155,
407 5,
553 9 3.
57 1.
22
2017 4,
549,
215 151,
697 4,
587 4 3.
02 1.
01
Brazil 2015 25,
933,
921 1,573,
538 143,
161 16,
743 9.
00 5.
52
2016 33,
469,
323 1,341,
644 129,
246 15,
297 9.
47 3.
86
2017 37,
954,
004 1,656,
428 194,
370 20,
933 11.
46 5.
12
Colombi a 2015 10,
176,
936 316,
451 55,
866 32,
363 17.
01 5.
49
2016 10,
792,
295 242,
973 83,
227 50,
098 28.
11 7.
71
2017 10,
792,
295 244,
732 54,
102 30,
925 21.
28 5.
01
Domi nican 2015 6,
319,
676 316,
947 661 651 0.
18 0.
10
Republ ic 2016 5,
549,
499 280,
124 755 722 0.
20 0.
14
2017 5,
625,
227 226,
988 398 370 0.
15 0.
07
French 2015 136,
831 11,
558 434 91 3.
75 3.
17
Guiana 2016 136,
388 9,
430 258 80 2.
74 1.
89
2017 107,
020 .
.. 597 84 5.
58
Guatemal a 2015 12,
600,
000 295,
246 5,
540 51 1.
88 0.
44
2016 10,
361,
230 333,
535 4,
854 4 1.
46 0.
47
2017 .
.. 372,
158 3,
744 5 1.
01
Guyana 2015 767,
000 132,
941 9,
984 3,
950 7.
51 13.
02
2016 747,
884 110,
891 11,
108 4,
547 9.
55 14.
85
2017 751,
223 100,
096 13,
936 6,
117 13.
92 18.
55
Haiti 2015 10,
243,
693 69,
659 17,
583 17,
583 5.
81 1.
72
2016 9,
600,
395 61,
210 21,
430 21,
430 7.
09 2.
23
2017 11,
741,
236 62,
539 19,
135 2,
119 6.
48 1.
63
Hondur as 2015 5,
717,
174 150,
854 3,
575 933 2.
32 0.
63
2016 7,
897,
968 167,
836 4,
097 1,
351 2.
24 0.
52
2017 8,
055,
603 148,
160 1,
287 129 0.
78 0.
16
Nicaragua 2015 3,
523,
063 604,
418 2,
307 345 0.
38 0.
65
2016 2,
762,
132 553,
615 6,
284 1,
311 1.
13 2.
28
2017 2,
461,
541 660,
452 10,
949 1,
869 1.
65 4.
45
Panama 2015 717,
489 64,
511 562 6 0.
87 0.
78
2016 725,
253 50,
772 811 38 1.
60 1.
12
2017 673,
330 38,
270 689 6 1.
80 1.
02
Peru 2015 4,
453,
082 865,
980 66,
609 13,
682 7.
69 14.
96
2016 3,
273,
897 566,
230 56,
623 15,
319 10.
00 17.
30
2017 3,
843,
337 388,
699 55,
367 13,
321 13.
75 14.
41
Venez uela 2015 6,
165,
291 625,
174 137,
996 35,
967 22.
07 22.
38
2016 10,
712,
823 852,
556 242,
561 61,
615 26.
01 22.
64
2017 16,
537,
063 1,144,
635 414,
527 96,
101 36.
21 25.
07

Tabl
e2.Mal
ari
aincount
ri
esofE2020i
ntheRegi
onoft
heAmer
icas,2015-2017
Cases
Count
ry Year Tot
alCases
I
nvest
igated
I
mpor
ted I
ndi
genous-
fal
..I
mpor
ted-
fal
ci.
.Impor
ted-
vivax Act
iveFoci
Ar
gent
ina 2015 11 8 1 0 3 4 0
2016 7 7 1 0 3 2 0
2017 17 17 17 0 8 6 0
Beli
z e 2015 13 13 4 0 0 4 11
2016 5 5 1 0 0 1 2
2017 9 9 2 0 1 1 3
CostaRica 2015 8 8 8 4 4 4 0
2016 13 13 9 3 3 6 1
2017 25 25 13 7 7 5 3
Ecuador 2015 686 686 59 184 18 41 20
2016 1,
424 1,424 233 403 91 142 23
2017 1,
380 1,380 105 309 55 48 6
ElSalvador 2015 9 9 7 0 0 7 4
2016 14 14 1 0 0 1 6
2017 4 4 3 0 0 3 0
Mexico 2015 551 551 34 0 6 27 50
2016 596 596 45 0 14 31 43
2017 765 765 29 0 11 15 46
Paraguay 2015 8 0 8 0 2 2 0
2016 10 0 10 0 3 3 0
2017 5 5 5 0 2 3 0
Suriname 2015 376 376 295 17 91 170
2016 327 327 251 6 94 147
2017 551 433 511 1 113 279 19
Bl
ankc
ell
sand"
..
."i
mpl
ynodat
aav
ail
abl
e
2
 Report on the Situation of Malaria in the Americas – 2017
Dist
ri
buti
onofbednet sinPeruhasnott akenplac es i
nce2016,and
alt
houghthenumberofhous ehol
dss prayedincreas edfrom 7, 581i n Fi gur
e3.Mal ariabyagegr
oupandsex,2017
2016to15,865in2017,theopennat ur
eofpeopl e’shomesi nLor et
o- 100, 000
Femal
e Mal
e
especi
all
ythoseinAndoas-mak esitdiff
icul
ttos prayhous es.Thepl an 90, 000
aimstoaddressthelackofaccesstodiagnosisandt r
eat mentaswel las
thecover
ageofpr event
ivemeasuresthatputsthem ont hepat ht o 80, 000
malari
aeli
minati
on. 70, 000

medCases
Hondur asr epor tedlessc as esi n2017,asc ompar edt o2015and2016 60,
000
(Table1) .Thedec li
nei nc as esi spot entiall
yas soc i
atedwi tht
her eported
50,
000
cons oli
dat ionofj ell
yfi
shf i
shi ngf r
om t hec oas talareasofGr aci
asaDi os

r
i
Conf
i
nHondur ast oPuer toCabez asal ongt heNi caraguanCar i
bbeancoast al 40,
000
str
ip.Al thought herewasl i
ttl
edi fferencebet weent heP.v i
vaxcas es,
30,
000
Hondur ass howeda90% dec reas einP.f al
c iparum c as esbetween2016
and2017.Al so,Gr aciasaDi oss howeda75% dec reasei nP.vivax 20,
000
cas es.Fur t
her more,impr ov edac ces stobednet s ,andpr omptdiagnos is
10,
000
andt reat mentandi nv estmenti ns urveil
lanc ei sc ontri
but i
ngtothe
0
reduc t
ionofmal ariacas es.Ther ei sani nc r
eas eint henumberofc ases

<5

14

19

24

29

34

39

44

49

50+
beingi nv es t
igated,aswel lasani mprov ementi nqual ityofthe

5-

10-

15-

20-

25-

30-

35-

40-

45-
i
nv esti
gat ions .
*
Dat
apr
ovi
dedbyHai
t
iisexcl
udedduet
omet
hodsofr
epor
ti
ng
Plasmodi um speci es
Alt
hought herear ef iveparasit
es pecies ,fours peciesofpl asmodiaaf f
ect
people(P.viv ax,P.f alci
parum,P.mal ariaeandP.ov ale).Plasmodi um Figure4.MalariaCasesbyAgegr oupandCount r
y,2017
viv
axandP.f alci
parum hav ethehi ghes tprev alenceint hewor ldand Peru 20% 35% 37% 7%
poset hegreat estthreat.Unli
keP.f alciparum,P.v ivaxmanagest o
Panama 14% 23% 49% 14%
persi
stinlatentst ateformont hsorev eny earsi ntheliverofi nf
ected
peopleandc aus ear elapse.Inthissens e,thet rai
ningofheal thsystems Ecuador 13% 35% 45% 7%
personnel
,res pons i
blefortheidentif
i
c ationoft hepl asmodi um species,
13% 24% 48% 15%
i
saf undament alc omponentf ortheunder standingoft heepi demiologyof Hait
i
thedisease. Beli
ze 11% 11% 44% 33%

Br
azi
l 10% 23% 56% 11%
I
n2017,P.vivax(75%)andP.f al
ciparum (
20%)c ausedthecasesinthe
Amer
icas.P.fal
ci
parum madeupal mos tal
l oftheinf
ect
ionsinthe Mexi
co 9% 30% 49% 12%
Domi
nicanRepublicandHait
i.Despitetheincreaseincasesin
Hondur
as 8% 22% 63% 6%
Ni
car
aguaandVenez uel
a,t
hereisadec r
eas einproport
ionofcasesdue
t
oP.falci
par
um andmi xedi
nfecti
ons. *
Fr.Gui
ana 8% 17% 68% 7%

IntheAmer
icas,P.vi
vaxhasthehi
ghesti
nci
denceandisresponsi
bl
efor Col
ombia 7% 24% 59% 10%
almostt
wo-
thi
rdsoft
heinfect
i
onsregi
st
eredbetween2013and2017. Ni
caragua 6% 24% 61% 9%
Duringthisperi
odofti
me,al
l i
ndi
genousc asesreportedbyBelize,Costa
Guyana 6% 13% 73% 8%
Rica,El Sal
vadorandMexicowerec ausedbyP.v ivax.Fur
thermore,
onlyfourcasesofP.fal
ci
parum caseswerer epor
tedinBoli
v i
acompar ed Bol
i
v i
a 6% 22% 62% 10%
to959i n2013. 25% 62% 8%
Guat
emal
a
Malariacasesbysexandage Venez
uel
a 13% 71% 11%
Between2013and2017,s i
xoutofev er
y10c asesrepor
tedint
he *
*Dom.Rep. 13% 70% 14%
Americasoc cur
redinmen.Dur ingthes ameperiod,t
hemajori
t
yof
casesint heAmericaswerereportedamongt hoseaged15-19and Ar
gent
i
na 6% 81% 13%
20-
24y ears(
Fig.3).In2017,t
hepr opor
tionofcasesi
nmenwast he Cos
taRi
ca 84% 16%
sameas2016ands l
i
ghtl
ylowerthanin2013( Fi
g.3).
Sur
iname 94% 6%
InSur inameandVenez uela,thoseaged15- 49ac countedforoverhal fof
ElSalv
ador 100%
allcasesdemons trat
ingas t
rongas soci
at i
onofmal ariari
skandi l
legal
andi nformalmini
ngin2017( Fig.4).Thef oll
owingninec ountr
ies 0% 20% 40% 60% 80% 100%
account edforasignif
icantporti
onoft het ot
alnumberofc asesreported Conf
i
r medCases
forthos eaged14andbel ow:Bol i
vi
a,Br az i
l
,Colombi a,Guatemala,
Guy ana,Hai ti
,Ni
caragua,Per u,andVenez uela(Fi
g.4) .Thissuggests * Fr
enchGuiana*
*DomincanRepubl
i
c
thatas i
gnif
i
cantf
ractionofthemal ariatransmissi
onofi nthesec ountries AgeGr oup
occur swithi
nthehous ehold. Lessthan5year
s 15to49y
ears
5t
o14year
s 50andabove
Amaz onas
In2017,t he25muni ci
pal i
tieswi tht hehi ghes tmal ariabur deni nthe Sixt
eenofthe25muni ci
pal
iti
eswi t
hthehighestcasesi n2016wer e
Amaz onasr epor tedov erhal foft het otal cas esi ntheAmer icas(Fig.5). al
soamongt het
op25muni cipal
it
iesin2017.Theot herninethatare
Compar edt ot hepr ev i
ousy ear,mal ar i
ai nc r
eas eswer eobs ervedi n24 nolongerinthet
op25muni cipal
it
iesincl
udeQuibdo,SanJ uan
outoft he25muni ci
pal it
iesi n2017.The25muni ci
pal i
ti
esar e Bauti
sta,
Casacoi
ma,Tigre,RodriguesAlves,Napo,At abapo,Boli
var,
repres entedbys i
xs tatesi nt hreec ount ries,wi thVenez uel a(17)havi ng andAltoBaudo.Thefoll
owingninemuni ci
pali
t
ieswer eamongt he25
thehi ghes tnumberofmuni c i
paliti
es ,followedbyBr azil(7)andPer u(1). munici
pali
ti
esin2017,butnot2016:Ber mudez,Caji
gal ,Bar
celos,
Themal ari
ac as esint hese17muni cipaliti
esi nVenez uelac ombi ned SantaIsabel
,Bagre,Aut
ana,Manapi are,Ri
bero,andMar i
no.
acc ount edforhal foft hecas esint heAmer icas ,whi le20% ofal lt
he
cas esoc curredi nSi fontesofBol i
varSt ate.Asar es ultofanout break, Alt
houghGr anSabanai samongt hetop25muni ci
pali
t
iesforboth
thec ombi nedc as esinBer mudez ,Caj i
gal ,Beni tez,Ri ber o,andMar i
no years,itshoweda40% r educti
on,whileQui bdowasnol ongeramong
muni cipali
tiesi nSuc res t
ater epres ent ed10% oft het otal casesamong thetop25muni cipal
iti
esafterr
educingt wo-t
hir
dsofit
scases .Andoas
thes ehi ghbur denmuni cipaliti
es .Mal ar i
ac ontinuest oinc reas ein wasnol ongerconsideredamongt het op10( ofthe25)muni ci
pal
it
i
es
Sifontesandex tendt onei ghbor ingmuni c i
pal i
ti
ess uc hasEl Callaodue between2016and2017duet oanincreas eincasesi
not her
totheper sistenc eofi llegal mi ningandas sociateds ocial confli
cts.These municipali
ti
es.Sifontesisthemunicipali
tywiththemostcas esinboth
andot herper s istentfac torshav ec ompr omi sedt heef fi
cienc yof years,whi l
emal ari
ainAt ur
eshasal soincreasedexponential
lyowing
distri
but i
onofs uppliesaswel last hec ov erageofv ec t
orc ontrolacti
vit
ies tolowc overageofpr eventi
v ei
nter
ventions.
thatai mt or educ emal ar i
a.. .
3
 Report on the Situation of Malaria in the Americas – 2017
Mesoamer ica Fi
gure5.Munici
pali
ti
es(
ADM- 2)wi
thhighmal ar
iaburdeni
n
In2017,t he25muni ci
pali
ti
eswi tht hehighes tbur denof countr
iesoftheAmazonassub-r
egion,2015-2017
diseasei nMes oamer i
carepor t
eda20% i nc r
eas efrom the
prev i
ousy ear( Fig.6).Fift
eenoft he25muni cipali
ti
ess howed Muni cipal
ity State Country
ani ncreasei nmal aria.Muni ci
paliti
esinGr aciasaDi oss t
ate Sifontes Boli
var Venezuel
a 71,
934 102,
543 142,
267
ofHondur ashav eshowns ignif
i
c antdec reas e.The Atur es Amaz onas Venezuel
a 9,
812 12,
856 46,
725
muni cipal
iti
es( PuertoLempi raandSonaguer a)thatac counted El Cal l
ao Boli
var Venezuel
a 4,
462 11,
135 38,
230
forov er50% ofal lcasesinHondur asi
n2016r educedt hei
r Cruz eirodoSul Acre Brazi
l 14,
979 20,
591 21,
322
cas esbyatl eastthree-fourthsin2017.Thef ollowingfour
Car oni Boli
var Venezuel
a 922 9,
004 17,
789
muni cipal
iti
esi nGuat emal a:LaGomer a,Ti quisate,and
Cedeno Boli
var Venezuel
a 6,
898 11,
727 14,
600
Mas aguar eportedatl eastaone- f
ourthreduc ti
onsi nce2016.
Suc re Boli
var Venezuel
a 3,
820 8,
944 13,
628
LaGomer a,whi chex hibi
tedas ignifi
canti ncreas eofcas esin Manaus Amaz onas Brazi
l 9,
748 9,
699 13,
596
2015wasabl etodec reasemal ariacas est hrought he *SaoGabr i
el Amaz onas Brazi
l 5,
071 10,
415 12,
274
reinforcementofepi demiological surveil
lanc eef for
ts .Along Raul Leoni Boli
var Venezuel
a 7,
777 11,
250 11,
338
wi t
hGuat emal a,themal ari
ar educt i
oni nHondur asand
Panamaex hibi
tst heimpac tofther eadjus tmentofac ti
viti
es, Andoas Loreto Peru 7,
898 10,
112 10,
744
suc hasbet terac ces stodiagnos i
sandt reatmentt hrough **Andr esEl oy Suc r
e Venezuel
a 774 5,
047 10,
142
volunt eerc ollabor atorsusingRDTandmas sdi st
ri
but i
onof Piar Boli
var Venezuel
a 2,
115 5,
447 9,
509
bednet s . Manc ioLima Acre Brazi
l 5,
552 7,
885 9,
290
Ber mudez Suc r
e Venezuel
a 57 2,
496 9,
242
Fifteenoft he25muni ci
palit
ieswi ththehi ghes tcasesi n2016
GranSabana Boli
var Venezuel
a 8,
354 15,
662 8,
996
wer eal soamongt hetop25muni cipali
ti
esi n2017.The
n2016,but Caj i
gal Sucre Venezuel
a 46 889 8,
884
foll
owi ng10muni c i
pali
ti
eswer eamongt het op25i
noti n2017:Toc oa,Br usLaguna,Lademoc rac i
a,Vi ll
eda Ba rcelos Amaz onas Brazi
l 4,
207 3,
865 8,
129
Mor al
es ,Ol anc hit
o,Sant aCat al
ina,Puer t
oBar r
ios, ***Sant aIsabel Amaz onas Braz
il 1,
608 3,
348 7,
581
Chi quimul i
lla,Des emboc adur a,andFr ayBar tolomedel as Beni tez Suc r
e Venezuel
a 935 6,
104 7,
517
Cas a. Bagr e Para Brazi
l 129 6,
793
Aut ana Amaz onas Venezuel
a 3,
528 3,
802 6,
139
Althoughmal ari
as eemst ohav ehal vedinEl Pr ogres o,
esof Manapi are Amaz onas Venezuel
a 3,
091 3,
234 6,
126
transmi ssionc ontinuest ooc curi nfarmsandc ommuni ti
muni ci
palit
iesi nt hebor derings tateofCor tes.Thes li
ght Rib ero Suc r
e Venezuel
a 413 1,
997 5,
988
i
nc reas einGunaYal aisrelatedt opas s i
ves urveil
lanc ewi t
h Mar ino Suc r
e Venezuel
a 13 571 5,
871
i
ntroduc ti
onofRDTf orusebyc ommuni t
yhealthwor kers.
Changef rom previousyear 0 100,000 0 200,0000 200,
000
Siunamuni ci
pali
ty,whichwasnotamongt hetop25i n2016,
Dec rease Inc
rease 2015 2016 2017
wasamongt hetopf i
ve( ofthe25)muni ci
pal
iti
eswitht hemost
casesi n2017duet oanout br
eak,whichmaybel i
nk edtothe *SãoGabr i
eldaCachoeir
a* *
AndresEl
oyBlanco,*
**SantaIsabel
doRi oNegr o
expandi ngriskofmalar i
afrom theneighbori
ngmuni cipali
t
yof Dist
ri
ct-
leveldat
a(ADM- 3)usedforPer
u,whi
chwerepar t
iall
yavai
labl
edur i
ng2015-2017.
Ros i
ta.Al t
hough,Roat ans howeddec l
ineofmal ar
iamai nly
duet opr eventi
onac t
ivit
i
esands uper
v i
si
onoft hediagnos i
s
andt reatmentnetwor k,i
tex per
iencedanout breaki
n2017. Figur e6.Muni ci paliti
es( ADM- 2)wi thhi ghmal ar iabur deni n
Hi spani ola count
ri
esoft
heMesoamer
icansub-
regi
on,2015-2017
Themuni ci
pali
ti
eswiththehighestburdenofmalari
aar e Municipali
ty Stat
e Country
represent edbyHai t
i.Sevenmunic i
pali
ti
es(LesIroi
s,Les Puert
oCabez as *RACCN Ni
caragua 673 1,
309 7,
954
Angl ai
s ,Port-
a-Piment,Jer
emie,Ans ed’Hainaul
t
,Dame LaGomer a Escui
ntl
a Guat
emal a 1,
935 1,
655 1,
253
Mar ie,andRos eaux)madeupal mos thal
fofthetot
alcasesin 340 818 1,
151
Rosi
ta *RACCN Ni
caragua
Hai t
i (
Fig.8).Elevenofthe25muni cipal
it
iesshowadec li
ni
ng
Waspan *RACCN Ni
caragua 414 441 710
t
r endi n2017.
Si
una *RACCN Ni
caragua 45 14 362
Eight
eenofthe25muni ci
pal
it
ieswit
hthehighestcasesin Masagua Escui
ntl
a Guat
emal a 807 565 359
2016werealsoamongt hetop25muni ci
pal
it
iesin2017for Ti
quisate Escui
ntl
a Guat
emal a 424 615 317
theisl
andofHispani
ol
a.Themuni ci
pal
it
iesofArnaudNippes, Pri
nzapolka *RACCN Ni
caragua 393 74 315
Carref
our,Leogane,Ganthi
er,Arcahai
e,andGr essi
ewere
PuertoLempir
a Graci
asADi os Honduras 954 1,
854 314
amongt he25muni ci
pal
it
ieswit
ht hehi
ghestburdenin2016,
butnotin2017.Thefoll
owingfi
vemuni ci
pal
it
i
eswer eamong ElEstor I
zabal Guatemal
a 301 235 301
the25muni ci
pal
it
iesi
n2017,butnot2016:Bar aderesNi
ppes, **
Sant aLuci
a Escuint
l
a Guatemal
a 246 211 300
Cav ai
l
lon,AnseaVeau,Tor beck,andPeti
teRivier
ede GunaYal a GunaYal a Panama 200 270 300
Nippes. Panzos Alt
aVer apaz Guat emala 453 172 234

In2017,therewereoutbr eaksinthemunicipali
ti
esofLesIr s Roat
oi an **
*Isl
asDeLa Hondur as 88 150 217
andPor t
-a-Pi
mentthatincreasedmal ar
iacas esby50% and Chepo Panama Panama 136 216 142
98% respecti
vel
y(Fig.8).Cr oi
x-Des-
Bouquet s,Del
mas ,and ElProgreso Yoro Honduras 191 273 136
Port
-au-Pri
ncereducedt heircasesbymor ethanhalfin2017, Bonanza *RACCN Ni
c agua 42
ar 55 126
removingthem f
rom thetop10muni ci
pali
t
ies. Batopil
as Chihuahua Mexi
co 16 26 114
Chisec Al
taVerapaz Guat
emal
a 128 38 105
Asfort
heDominicanRepubl i
c,mal
ari
aiscur
rent
l
yalmost
excl
usi
vel
yli
mit
edt os hant
ytownsset
tl
edonthebor
derof **
**NuevaConce Escui
ntl
a Guat
emal
a 86 84 100
ri
ver
sinSantoDomi ngo **
***Sant
aCata AltaVerapaz Guat
emal
a 59 29 90
Sit
ala Chi
apas Mexi
co 12 52 85
VectorCont rolInterventions
Sonaguer
a Col
on as 167
Hondur 274 82
In2017,justov er726,207homesand1. 6mil
li
onpeopl ewer e
prot
ec t
edthroughi ndoorres i
dual spr
ayi
ng(I
RS) .Meanwhi le, Chi
lon Chi
apas Mexi
co 17 30 80
another4.7mi l
li
onwer epr otectedwi thi
nsect
i
cide-treatedbed Sant
aCat
ali
na Ngobe-
Bugl
e Panama 34 107 77
nets(ITNs).I
nr ecenty ear
s ,cov eragebyIRShasdec reased. 0 2,
000 0 2,
000 0 10,
000
Between2016and2017t henumberofpeopl epr otectedby Changef
rom pr
evi
ousyear
Dec
rease I
ncr
eas
e 2015 2016 2017
IRSwasr educ edby22%,whi let hatbyITNsincreasedby
12%. *RACCN-Nort
hCaribbeanCoastAut
onomousRegi
on,*
*Sant
aLuci
aCot
zumal
guapa,*
**I
sl
as
del
aBahi
a,**
**NuevaConcepci
on,**
***
Sant
aCatal
i
nalaTi
nta
4
 Report on the Situation of Malaria in the Americas – 2017

Fi
gur
e7.Mal
ari
abyAnnualPar
asi
teI
ndex(
API
)att
hesecondadmi
nist
rat
ivel
evel(
ADM-
2)i
ntheAmer
icas-2017

Between2016and2017,Venezuel
a,Brazi
l
,Colombia,Panama,and
theDomini
canRepubl
icwerethecount
ri
esthatrepor
tedthegr
eatest Fi
gure8.Muni
cipal
it
ies(
ADM-2)wi
thhi
ghmal ar
iabur
den
decl
inesi
ncover
agebyIRS. incount
ri
esoftheIsl
andofHi
spani
ola,2015-2017
Amongt hesecount ri
es,Venez uel
as howedt hemos tdrast
icr educt
ions Muni
cipal
it
y St
ate Countr
y
(99%),comparedt o2015and87% c ompar edt o2016.Bol ivia’s2017 LesI
roi
s Gr
and-Ans
e Hai
ti 365 781 1,
500
poli
cyadopti
oninc ludedfreedistr
ibutionofI TNs /
LLINst oall age LesAngl
ai
s Sud Hai
t
i 371 1,
238 1,
493
groupsandthroughmas scampaigns .Further more,I RSis
Por
t-
a-Pi
ment Sud Hai
t
i 71 107 1,
392
recommendedbyt hemal ar
iacontrolprogram.Bol i
via,alongwi th
Cos t
aRica,Nicaragua,andPer uex hibi
tedt hemos timportant Jer
emi
e Gr
and-
Ans
e Hai
t
i 1,
801 2,
029 1,
358
i
nc r
easesinIRSc overage.Inparti
c ul
ar,ther ewasan80% i ncreasein Ansed'
Hai
naul
t Gr
and-
Ans
e Hai
t
i 777 1,
462 1,
320
IRSinNicaragua largelyduetoanor gani
zedr espons etotheout break Dame-
Mar
ie Gr
and-
Ans
e Hai
t
i 1,
332 1,
746 1,
112
i
nPuer t
oCabez as.
Roseaux Gr
and-
Ans
e Hai
t
i 1,
183 1,
981 798
Resistancet oi nsect i
cides Bonbon Gr
and-
Ans
e Hai
t
i 53 222 635
In2017,t hes t
ructur
eoft heAmericasNet workforSurvei
ll
anceand Abr
icot
s Gr
and-
Ans
e Hai
t
i 282 606 588
Insecti
cideRes ist
anc eManagementl edtomor ec ount
ri
esdev el
oping
thei
rs urvei
l
lanceandmanagementpl ansforinsecti
ci
deresistancef or Cor
ail Gr
and-
Ans
e Hai
t
i 433 417 526
Anophel esthanpr eviousyears.Thef ol
lowing13endemi cc ountri
es Cr
oix
-Des
-Bouquet
s Oues
t Hai
t
i 1,
077 1,
468 412
areint hedevelopmentphas eoftheirrespecti
veplans(Braz i
l
,Bolivia, Ver
ret
tes Ar
ti
boni
t
e Hai
t
i 113 299 398
Colombi a,CostaRi ca,Domi ni
canRepubl ic,Ecuador,Guatemal a, 105 104 395
Bar
ader
es Ni
ppes Hai
t
i
Guy ana,Hai t
i
,Hondur as,Mexico,Nicaragua,andPar aguay).
Ti
bur
on Sud Hai
t
i 131 335 366
Meanwhile,Argent
ina,Panama,Per u,andSur inamear eint heini
ti
al Char
donni
eres Sud Hai
t
i 124 280 360
consul
tat
ionstagesoft heirentomol ogi
c alsurveil
lanceandi nsecti
ci
de 42 234 353
Por
t-
Sal
ut Sud Hai
t
i
resi
st
ancemanagementpl ans .Alt
houghPanamaandSur inamehav e
notbeguntheirdevelopmentoft heplans ,theyex pressedtheirdesir
e Del
mas Oues
t Hai
t
i 1,
628 831 334
tocomplywiththepol i
ciesands t
rategicframewor kssurr
oundi ng LesCay
es Sud Hai
t
i 90 316 301
malari
a.I
n2017,Cos taRi ca,Guat emal a,Colombi a,Hondur as,and St
.Loui
sduSud Sud Hai
t
i 10 537 283
FrenchGuianac ar
riedouts ensi
tivi
tytestsonAnophel es.
Por
t-
au-
Pri
nce Oues
t Hai
t
i 659 562 259
Diagnosi sandt reatment Pest
el Gr
and-
Ans
e Hai
t
i 336 499 254
Thedi agnos i
sandt i
melytreatmentar epar
amountformal ari
ac ont
rol
. Cavai
l
lon Sud Hai
t
i 171 63 238
In2017,t heupt akeofrapiddi agnosti
ctest
sformalari
a( RDT) 33 32 210
AnseaVeau Ni
ppes Hai
t
i
perf
or medi nendemi cc ountr
iesc ont
inuedtoexpandbymor ethan
100,000,c ompar edto2012( f
rom 220,529to364,878).This Tor
beck Sud Hai
t
i 13 65 200
demons tratestheadopt ionoft hestr
ategyatt
henat i
onalandr egi
onal *
Pet
i
teRi
vi
erede Ni
ppes Hai
t
i 11 37 142
l
evel aswel lasapos si
bleimpr ovementinaccesstodiagnosis.
Changef r
om previ ousyear 0 2,
000 0 4,
0000 2,
000
Theproport
i
onofc asest
reat
edwit
hint
hefi
rst72hour
saft
ert
heons et Decrease I
ncr
ease 2015 2016 2017
ofsymptomsexceeded70%,asreport
edbyBoli
vi
a,Brazi
l
,Ecuador
,
*Pet
it
eRivier
edeNippes
Per
u,andSur i
name( Fi
g.9). Dataatcommunelevelusedf
orHai
ti

5
 Report on the Situation of Malaria in the Americas – 2017
Nonet heles s,i
tislikel
yduetoconfusi
onont hepar tofthecount
ries
Tabl e3.Fi
rstl
ineoftreat
mentf
ormal
ari
abyspeci est
ypei
n
thatrepor tthetimeel apsedbet
weens ampling(notsincetheonsetof
sy mptoms )ands tar
toftreat
ment.St
rengtheningthec apaci
ti
esof theR egi
ónoft
heAméri
ca s
nationalpr ogramst omax imi
zethesupplyofinputstoc ombatmalari
a Count ry P.vi
vax P.fal
ci
par
um
i
sapr erequi si
teforadequateaccesstodiagnosisandant i
malar
ial Argent
ina CQ+PQ AL+MQ,CL,DO
treatments .
Beli
z e CQ+PQ(14d) CQ+PQ(1d)
Vulner abl epopul ations Boli
v i
a PQ+CQ(7d) AL+PQ
Between2013and2017,peopl ewhoar el
ivi
ngi nconditi Braz
onsof i
l CQ+PQ(7d);
CQ+PQ(
14d) AL+PQ;AS+MQ+PQ
vul
ner abili
tys awas i
gni f
i
c antinc r
eas eincases .Duringt hisper
Col iod,a
ombi a CQ+PQ(14d) AL+PQ(1d)
one-four t
hi ncreasewasobser vedamongpr egnantwomenandCos taRica CQ+PQ(7d);
CQ+PQ(
14d) CQ+PQ(1d)
i
ndigenouspopul ati
ons .Nic araguaandVenez uel apresent edt
Domihe
nicanRepubl
i
c CQ+PQ(14d) CQ+PQ(1d)
hi
ghes tnumberofc as esamongpr egnantwomen.Dur ingt hesame
Ecuador CQ+PQ(7d) AL+PQ
peri
od,ei ghtoft heendemi cc ount ri
ess howedadec reas e.Wi t
h
ElSal vador CQ+PQ(14d) AL
33,103c ases,Venez uelapr es entedt hehighes tnumberofc asesi n
i
ndigenouspeopl eamongt heendemi cc ountr
iesi Fr
n2017,a50%enc hGuiana CQ+PQ AL;
AQ+PG
i
ncreas es i
nce2013.Guat emal a,Hai t
i,Hondur as Guat
,andPanamahaveemala CQ+PQ(14d) CQ+PQ(3d)
i
mpr ovedt hequal i
tyofdat aonpr egnantwomenwhi lePer uneedst
Guy ana o CQ+PQ(14d) AL+PQ(1d)
conti
nuei mpr ov ement .Inmanymal ar
iaendemi ccountr
ies ,poorand
Haiti CQ+PQ(14d) CQ+PQ(1d)
di
sadv antagedpeopl ewi t
hl imitedac cesstoheal t
hfacil
itiesand
Hondur as CQ+PQ(14d) CQ+PQ(1d)
tr
eatment sar edi sproporti
onat el yaf f
ectedbythedi seas e.At uresin
Mex ico CQ+PQ CQ+PQ
Amaz onasSt ate,wher et hei ndi genouspeopl el i
ve,washi thar dby
Ni
c aragua CQ+PQ(7d) CQ+PQ(1d)
casesofmal aria,withf ourfoldinc reasei ncases .
Panama CQ+PQ(7d);
CQ+PQ(
14d) AL+PQ(1d)
One-thirdofthecasesinmi ner
swer ef
oundi nc ount
ri
eswi t
hinthe Paraguay CQ+PQ(14d) AL+PQ
GuianaShi eld(Fi
g.10).Si
nc eminerssearchforgoldinwaterypit
s, Per u CQ+PQ(7d) AS+MQ+PQ( 1d)
whichs erveasbreedinggroundsformos quit
os,tensofthousandsof Suriname CQ+PQ(14d) AL+PQ(1d)
i
ll
egal minerscont
ractthedisease.Theec onomicacti
vit
ythat Venez uela CQ+PQ(14d) AS+PQ(1d)
promotedmigrati
onandtoBolí
v arst
atefrom ot
herst
ateshas
resul
tedi
nther api
dspreadofthediseaseamongt heindi
genous CQ-Chl oroqui
ne PQ-Pr i
maquine MQ-Mefloqui
ne AS-Art
esunate AL-Ar
temet
her&
peoplewhoc omei ncont
actwi
ththemi nersandthoseli
vi
nginother Lumefantri
neAQ-At ovaquone CL-Cli
ndamycinDO-Doxycycl
ine
stat
esasthemi nersr
eturntot
heirhomes . ForP.falci
parum-(3d):15mgofPr i
maquineperdayfor3days(adul
ts)
(
1d)
:45mgofPr
imaqui
nei
nonedoseon1stday(
adul
t
s)
Thepr opor t
ionofcas esamongmi nersi nSur i
namedec r
eas edby ForP.v i
vax-(14):15mgofPr i
maquineperdayfor14days( adul
ts)
80% bet ween2013( 629cas es )and2017( 134) .I
n2017,one- fourt
h (
7):30mgofPr imaqui
neperdayf or3days( adult
s)
ofthet otalcaseswer eamongmi ners.Sur inamei ss howingpr ogress *Artemisi
nin-
basedcombi nat
i
ontherapy(ACT)isusedf ori
mpor t
edcasesofP.
throught heMi nistr
yofHeal thMal ariaPr ogr amme,whi chtargets fal
ci
parum incountri
esusi
ngCQ asf i
rst
-l
inetr
eatmentforthisspeci
es.
vulner ablepopul ationssuchasmobi lemi grantgol dminers.The
progr ammepr ovidesmal ari
as ervicesi nami grantcli
nicin Fi gur e9.Ti met akenf ort reatmentsi ncet heonsetof
Par amar i
bo,oper atesasmal l numberofbor dermal ari
a-screening
sympt oms,2015-2017
pos tsal ongt hebor derwithFr enchGui ana,mai nt
ainsamal aria
serv i
c edeliverer( MSD)net wor kingol d-miningar eas,performsac t
ive Count ry 2015 2016 2017
cas edet ect
i
ons urveysinremot emi ningar eas ,andimplement s Argent i
na
Mal ak i
t-ani nnov ati
vepil
otpr ojectus edf ors el
f-di
agnos i
sand
Belize
self-t
reat ment .
Bol
ivi
a
Casesi mpor t
edf r
om mal ari
ai nendemi ccount ri
es Br
azi
l
I
n2017,8, 411i mport
edc as eswer erepor t
edby14oft heendemi c
Col
ombi
a
countri
esintheAmer icas.One- t
hirdoft hesec as esoccurr
edi n
Venez uel
a(2,941)whi l
eBraz i
lac countedforal mos tt
wo-thir
dsoft he Cost
aRi
ca
i
nfecti
ons.Duringthes ameper iod,almos talloft heimportedc ases *
Dom.
Rep.
(7,
686)intheAmer i
casor i
ginat
edi nfourc ountries(Venez uela,
Ecuador
Guy ana,Col
ombi a,andPer u)
.Braz i
lreportedthel argestnumberof
casesdetectedinitsterr
it
oryimpor tedfrom otherc ountri
es( 4,148 ElSal
vador
cases). *
*Fr
.Gui
ana
Guat
emal
a
Financing
Mos tofthebudgetf ormal ariac ont r
ol t
heAmer icasbet ween2013 Guyana
and2017c amef rom national gov ernmentr esourc es.Dur ingt hi
s Hai
ti
peri
od,t hegov ernmenti nves tedj us tover900mi lli
ondol lars, Hondur
as
repr
es enti
ngappr oximatelytwo- thirdsoft ot
alfi
nanc i
ngi nthe
Amer i
cas( Fig.12) .Between2013and2017,ei ghtc ountries( Boli
vi
a, Mexi
co
Brazil
,Colombi a,Cos t
aRi ca,Domi nicanRepubl ic,El Salvador , Ni
car
agua
Panama,andSur i
name)showedadec l
inei
nmal ariafundi ngf r
om Panama
thenationalgov ernment .Ec uadors howeda71% dec li
nebet ween
Par
aguay
2016( US$20, 000,000)and2017( US$5, 835,
716) .Thisisduet othe
eart
hquak er espons einEc uadori n2016andt heens uingi ncreasein Per
u
vectorcontrolbudget ;budgetf oronl ymal ar
iac ontrolisdifficul
tto Sur
iname
esti
mat einintegratedv ec t
orc ontr ol pr
ogrammes . Venezuel
a
Between2012and2017t hei nvest
mentf rom theUnitedSt atesAid 25% 50% 75% 25% 50% 75% 25% 50% 75%
forInternati
onal Dev elopmentandt heGl obalFundt oFightAI DS, % ofallcases % ofallcases % ofal
lcases
Tuber culosisandMal ari
af ortheAmer icasamount edt o
approx imatelyUS$140mi l
li
on( Fi
g.12).In2017,gov ernment *Domi
ni
canRepubl
i
c* *
FrenchGuiana
fundingr eachedUS$145mi l
li
on,whichwas70% oft hetot albudget Timetaken
forthaty ear,sl
ightlylowert hanin2016.Sev enendemi cc ountri
es Sameday 2-
3day s >3days
(Brazil
,Col ombia,Guat emal a,Guyana,Ni caragua,Paraguay ,and
Peru)i ncreasedt heirgover nmentbudgeti n2017c omparedt o2016. 1 day Less t
han3da y
s

6
 Report on the Situation of Malaria in the Americas – 2017

Fi
gur
e10.Mal
ari
ainVul
ner
abl
ePopul
ati
ons However,t
herewer
eincreasesi
nmal ar
iai
nthr
eeoft
heseseven
count
ri
es:Brazi
l
,Guyana,andNicar
agua.
Mi
ner
s(2017) Pr
egnantWomen
Incontrast,during2017,gover nmentf undingdecl i
nedi nBoliv
ia,
Count
ry Mi
ner
s 2016 2017 CostaRi ca,Domi ni
canRepubl i
c,Mexi co,Panama,andSur i
name
Ar
gent
i
na 0.
00 0.
00 fr
om thepr eviousyear.Des pit
ethest eadydec reasei nfundinginthe
l
astfivey ears(US$787, 966i n2013andUS$451, 993i n2017),
Bel
i
ze 0.
00 Boli
viaex hibi
teda20% dec lineinc onfir
medc as es.Inor derto
Bol
i
via 0.
96 conti
nuei tscommi t
mentt opr ovi
dingfreemal ari
apr event i
ontool
sto
minersandot herhard-
to-r
eac handmobi l
epopul at
ions,Sur i
name
Br
azi
l 1.
63 1.
69 mus ti
nc r
eas eitsgovernmentcont ri
butionforit
sel i
mi nati
ons t
rat
egy
Col
ombi
a 0.
50 0.
79 asfundinghasbeenst eadil
ydec l
i
ningsi nce2013.
Cost
aRi
ca 0.
00 2.
60
Fi
gur
e12.Fi
nanci
ngf
ormal
ari
a,2007-2017
*
Dom.Rep. 0.
37 1.
02
250M
Ec
uador 1.
65 1.
86

El
Sal
vador 2.
45 0.
00
200M
*
*Fr
.Gui
ana
Guat
emal
a 0.
15 0.
86

ons]
Guy
ana 1.
09 1.
23
150M

l
l
nmii
Hai
t
i 0.
58 0.
91

i
Hondur
as 1.
53 0.
91

US$[
Mexi
co 0.
30 0.
21 100M

Ni
car
agua 5.
40 1.
57

Panama 0.
32 0.
87
50M
Par
aguay 0.
00

Per
u 0.
53 0.
42
0M
Sur
iname 0.
48 0.
31 2007

2008

2009

2010

2011

2012

2013

2014

2015

2016

2017
Venez
uel
a 0.
28 0.
71

0% 50% 100% 2.00 4.00 2.

00 4.00
*Dataunavail
abl
eforCost
aRicaandEcuador(2014),FrenchGuiana( 2007-13&
Tot
alCases Relat
i
veRisk Relat
i
veRisk 2017),Guatemal
a(2009&2010),Hai
ti
(2007-11),Honduras(2015),Nicar
agua
(2009),Per
u(2009&2014),Sur
iname(2007,2009-17)andVenez uela(2007-08&
*Domi
ni
canRepubl
i
c**
Frenc
hGui
ana 2017).
Fundi
ngSour ce
Mi
ner
s Ot
her
s
Bi
lat
eral
s USAI
D Wor
ldBank

Fi
gure11.Peopl
eprotect
edbyI
ndoorResi
dualSprayi
ng GFATM UNAgenci
es Gov.budget
(I
RS)andInsect
ici
de-Tr
eat
edNet
s(ITNs)
,2007-2017
10M

8M
l
l
nmions]
i

6M
ot
epr ec i
ed[
t

4M
Peopl

2M

0M
2007

2008

2009

2010

2011

2012

2013

2014

2015

2016

2017

Peopl
epr
otect
edbyI
RS
Peopl
epr
otect
edbyI
TNs

7
 Report on the Situation of Malaria in the Americas – 2017

Mal
ari
ainnon-
endemi
ccount
ri
es
Generalsi
tuationofnon- endemiccountri
es
I
n2017,19oft he32oft henon-endemiccount
ri
esi
ntheAmeri
casr
eport
edatot
alof106casesofmal
ari
aandnoas soci
ateddeat
hswere
r
eport
ed,excludingt
heUni tedStat
esandCanada(Tabl
e4).Cuba(
36)andUr
uguay(23)r
eportedt
hehi
ghestnumberofmalari
acasesamong
t
henon-endemi cnat
ionsoft heAmeri
cas.

Largenumberofimpor
tedcasesfr
om Guy anaandVenezuel
awer ereport
edinCuba.Sevenoft
hecasesr
epor
tedinUruguaywer
eimported
fr
om theAmeri
cas,mainl
yBrazi
l.I
ncreasedimpor
tedcasesf
rom HondurastotheCaymanIsl
andsmaybeduetotheavai
labi
l
it
yofdi
rectf
l
ight
servi
cest
hatconnect
sbothcountr
ies.

Almostal
loftheimpor t
edc asesi
nTrinidadandTobago(11outof12cas es),wer
efrom Venezuel
a.Duetothegeographicalproxi
mity,Tr
ini
dad
andTobagoisac onv enientdest
i
nati
onwher eVenezuel
anmigrantsgotoforvari
ousreasons.Theri
skofhavi
ngre-est
ablishedmal ari
a
tr
ansmissi
oninthi
sc ount r
yremainshighandcal
lsforr
obustsurvei
l
lance.Ofthetot
alcasesi
nnon-endemiccount
ri
esr eportedbetween2015
and2017,almosthalfwer ecausedbyP.f al
ci
par
um andmixedinfecti
ons,andthespeciesi
sunknowninalmost10% ofthecas es.

Fi
gur
e13.Mal
ari
abycount
ryf
rom whi
chcaseswer
eimpor
tedbynon-
endemi
ccount
ri
esi
ntheRegi
onoft
heAmer
icas,2015-2017

Paki
st
an

Mexi
co I
ndi
a

Sudan
Senegal Chad
Ni
car
agua
Gui
nea
Panama Hai
t
i
I
voryCoast
Ni
ger
ia
Sout
hSudan
Col
ombi
a Guyana
Equat
ori
alGui
nea Uganda
Gabon
Congo

Per
u Br
azi
l
Angol
a Mozambi
que

Sout
hAf
ri
ca

*Doesnoti
ncl
udecasesr
epor
tedi
mpor
tedbyCanada&Uni
t
edSt
atesofAmer
ica.
I
mpor
tRegion Numberofcases
Amer
icas 0
As
ia 50
Af
ri
ca 100
134

8
 Report on the Situation of Malaria in the Americas – 2017
Tabl
e4.Numberofmal
ari
acasesi
nnon-
endemi
ccount
ri
esoft
het
heRegi
onoft
heAmer
icas,2007-2017
Year
Count
ry 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Angui l
l
a 0 0 0 0 0
Antigua&Bar buda 1 0 1 1 0 0 0 0 0 0
Aruba 0 0 0
Bahamas 6 14 1 6 2 2 3 0 0 2
Barbados 2 2 10 9 5 2 2
Bermuda 2 2 2 2
Bonai r
e 0
Brit
i
shVi rginIsl
ands 0 0 0 0 0
Canada 397 381 364 514 517 480 490 449 552 612 114
CaymanI s l
ands 1 1 3 0 5 1 1
Chil
e 5 4 3 5 10 6 4 8 8 21
Cuba 35 19 28 32 48 37 29 71 36
Curaçao 0 0 0
Domi nica 0 0 1 1 0 1 0 1 0
Grenada 0 0 1 0 0 1 2 0 1 0 0
Guadel oupe 12 0 8 1 2 2 1 1 2
Jamai ca 199 22 22 12 9 5 6 4 3 8
Mar t
ini
que 14 11 7 13 2 9 5 4 2
Mont eserrat 0 0 0 0 0 0
Puer t
oRi co 3 2 3 5 2 1 1 1 5 4 0
Saba 0 0 0 0
SaintBar thel
emy 0 1
SaintKitt
s&Nev is 0 1 1 1 0 0
SaintLuc ia 0 1 1 2 1 1 1 1 1
SaintMar tin 2 1 7 1 0 0 0 0
*SaintVinc ent&theG 0 1 2 0 0
SintMaar ten 0 0 0 0
Tri
nidad&Tobago 16 22 24 23 10 19 13 12 8 12
UnitedSt atesofAmeri
ca 1,
505 1,
298 1,
484 1,
691 1,
925 1,
687 1,
741 1,
725 1,
517 2,
053 1,
744
Uruguay 12 5 2 7 13 2 7 14 23
USVi r
ginI sl
ands 0 0 0 0 0 0 0 0 0 0 0
GrandTot al 2,
166 1,
798 1,
924 2,
273 2,
540 2,
264 2,
340 2,
244 2,
146 2,
774 1,
964
*
Sai
ntVi
ncent&t
heGr
enadi
nes*
*Bl
ankspac
esi
mpl
ynodat
aavai
l
abl
e**
*Pr
eli
minar
ydat
afr
om Canadaf
or2016&2017andf
rom USAf
or2017

Tabl
e5.I
mpor
tedcasesi
nnon-
endemi
ccount r
iesoft
heAmer
icasbycount
ry/
Regi
onofori
gin,2015-2017
Count
ry/Ter
rit
ory Count
ri
esofAmer
icas
oupe

co

a
que

1 42
ntLuci
bados
Bahamas

dad&
ca
gua&

muda

enada

uguay
buda

oRi
Cayman

ca
Canada

A.
Tobago
ands

ni
Cuba
e

Jamai

ni
l

Guadel

Countr
y/Regi
on
S.
Chi

Domi

ni
t
i
Bar

U.
Ber

sl

Puer
Bar
Ant

Mar

f
rom whichmalar
ia Ot
herRegi
ons
Gr

Ur
Sai

i
I

Tr

wasimported 1 2,
867
Bahamas 1
*U.
S.A.-Uni
t
edSt
atesof
Br
azi
l 3 3 1 11 3 Amer
ica
Col
ombi
a 2 1 5

Domi
ni
canRepubl
i
c 3 1 2 42 1

El
Sal
vador 1

Guat
emal
a 25

Guyana 0 1 16 1 2 19 1

Hai
t
i 2 3 0 0 0 0 33

Hondur
as 4 4 1 15

J
amai
ca 1

Mexi
co 1 3

Ni
car
agua 1 2 1

Panama 1 1

Per
u 6 4 22 1

Venez
uel
a 2 8 1 1 11 3 1

Tr
ini
dad 1

*
Cent
ral
Amer
ica,unsp 10
Af
ri
ca 1 1 1 3 255 4 99 1 1 1 8 3 1 1 52,
867 35
Asi
a 2 25 1 1 4 1 294 2
Oceani
a 7
Unknown 11 1 1 138

*
Cent
ral
Amer
ica,Unspeci
f
ied
9