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Health policy impacts on malaria transmission in Costa Rica

Published online by Cambridge University Press:  28 April 2020

Luis Fernando Chaves Open the ORCID record for Luis Fernando Chaves [Opens in a new window] ,
Melissa Ramírez Rojas ,
Monica Prado ,
José Luis Garcés ,
Daniel Salas Peraza  and
Rodrigo Marín Rodríguez
Luis Fernando Chaves*
Affiliation:
Vigilancia de la Salud, Ministerio de Salud, San José, Costa Rica
Melissa Ramírez Rojas
Affiliation:
Vigilancia de la Salud, Ministerio de Salud, San José, Costa Rica
Monica Prado
Affiliation:
Centro de Investigación en Enfermedades Tropicales (CIET), Universidad de Costa Rica, San Pedro, Costa Rica
José Luis Garcés
Affiliation:
Vigilancia de la Salud, Ministerio de Salud, San José, Costa Rica
Daniel Salas Peraza
Affiliation:
Ministro de Salud, Despacho del Ministro, Ministerio de Salud, San José, Costa Rica
Rodrigo Marín Rodríguez
Affiliation:
Vigilancia de la Salud, Ministerio de Salud, San José, Costa Rica
*
Author for correspondence: Luis Fernando Chaves, E-mail: lfchavs@gmail.com
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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.

Keywords

BreakpointsEl Niño Southern Oscillationmass drug administrationmalaria eliminationregime shifts
Type
Research Article
Information
Parasitology , Volume 147 , Issue 9 , August 2020 , pp. 999 - 1007
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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References

Adams, DP (1996) Malaria, labor, and population distribution in Costa Rica: a biohistorical perspective. The Journal of Interdisciplinary History 27, 75–85.10.2307/206474CrossRefGoogle Scholar
Aliano, D (2006) Curing the ills of Central America: the united fruit company´s medical department and corporate America´s mission to civilize (1900–1940). Estudios Interdisciplinarios de America Latina y el Caribe 17, 35–60.Google Scholar
Ávila-Agüero, ML (2008) Epidemiología de la malaria en Costa Rica. Acta Médica Costarricense 50, 72–74.Google Scholar
Bennett, A and Smith, JL (2018) Malaria elimination: lessons from El Salvador. The American Journal of Tropical Medicine and Hygiene 99, 1–2.CrossRefGoogle ScholarPubMed
Bergonzoli, G and Rivers Cuadra, JC (2000) Eficacia terapéutica de diferentes regímenes antimaláricos en la región fronteriza de Costa Rica y Nicaragua. Revista Panamericana de Salud Pública 7, 366–370.CrossRefGoogle Scholar
Bouma, MJ and Dye, C (1997) Cycles of malaria associated with El Niño in Venezuela. Journal of the American Medical Association 278, 1772–1774.CrossRefGoogle ScholarPubMed
Bouma, MJ and Van Der Kaay, HJ (1996) The El Niño Southern Oscillation and the historic malaria epidemics on the Indian subcontinent and Sri Lanka: an early warning system for future epidemics? Tropical Medicine and International Health 1, 86–96.CrossRefGoogle ScholarPubMed
Bouma, MJ, Poveda, G, Rojas, W, Chavasse, D, Quiñones, M, Cox, J and Patz, J (1997) Predicting high-risk years for malaria in Colombia using parameters of El Niño Southern Oscillation. Tropical Medicine and International Health 2, 1122–1127.CrossRefGoogle ScholarPubMed
Brady, OJ, Slater, HC, Pemberton-Ross, P, Wenger, E, Maude, RJ, Ghani, AC, Penny, MA, Gerardin, J, White, LJ, Chitnis, N, Aguas, R, Hay, SI, Smith, DL, Stuckey, EM, Okiro, EA, Smith, TA and Okell, LC (2017) Role of mass drug administration in elimination of Plasmodium falciparum malaria: a consensus modelling study. The Lancet Global Health 5, e680–e687.CrossRefGoogle ScholarPubMed
Burton, RA, Chévez, JER, Sauerbrey, M, Guinovart, C, Hartley, A, Kirkwood, G, Boslego, M, Gavidia, ME, Alemán Escobar, JE, Turkel, R, Steketee, RW, Slutsker, L, Schneider, K and Campbell, CC (2018) Factors associated with the rapid and durable decline in malaria incidence in El Salvador, 1980–2017. The American Journal of Tropical Medicine and Hygiene 99, 33–42.CrossRefGoogle ScholarPubMed
Carter, KH, Singh, P, Mujica, OJ, Escalada, RP, Ade, MP, Castellanos, LG and Espinal, MA (2015) Malaria in the Americas: trends from 1959 to 2011. The American Journal of Tropical Medicine and Hygiene 92, 302–316.CrossRefGoogle ScholarPubMed
Castro-Sancho, JI, Munguía-Ramírez, MdR and Ávila-Agüero, ML (2002) Malaria: una actualización. Acta Médica Costarricense 44, 107–112.Google Scholar
Castro, MC, Baeza, A, Codeço, CT, Cucunubá, ZM, Dal'Asta, AP, De Leo, GA, Dobson, AP, Carrasco-Escobar, G, Lana, RM, Lowe, R, Monteiro, AMV, Pascual, M and Santos-Vega, M (2019) Development, environmental degradation, and disease spread in the Brazilian Amazon. PLOS Biology 17, e3000526.CrossRefGoogle ScholarPubMed
Chaves, LF (2017) Climate change and the biology of insect vectors of human pathogens. In Johnson, S and Jones, H (eds), Invertebrates and Global Climate Change, pp. 126–147. Chichester, UK: Wiley.Google Scholar
Chaves, LF, Kaneko, A, Taleo, G, Pascual, M and Wilson, ML (2008) Malaria transmission pattern resilience to climatic variability is mediated by insecticide-treated nets. Malaria Journal 7, 100.CrossRefGoogle ScholarPubMed
Chaves, LF, Hashizume, M, Satake, A and Minakawa, N (2012) Regime shifts and heterogeneous trends in malaria time series from Western Kenya highlands. Parasitology 139, 14–25.CrossRefGoogle ScholarPubMed
Clarck, HC (1928) The field parasite rate for malaria in the banana divisions. United Fruit Company Medical Department Annual Report 17, 72–76.Google Scholar
Faraway, JJ (2004) Linear Models with R. Boca Raton: CRC Press.CrossRefGoogle Scholar
Faraway, JJ (2006) Extending the Linear Model with R: Generalized Linear, Mixed Effects and Nonparametric Regression Models. Boca Raton: CRC Press.Google Scholar
Frantzius, AV (1868) Über die Verbreitung der Malariafieber in Costa Rica. Virchows Archiv 43, 315–329.CrossRefGoogle Scholar
Greenwood, B (2009) Can malaria be eliminated? Transactions of The Royal Society of Tropical Medicine and Hygiene 103, S2–S5.CrossRefGoogle ScholarPubMed
Grupo Técnico Nacional de Enfermedades Vectoriales (2015). Plan de Eliminación de la Malaria en Costa Rica, 2015–2020. San José, Costa Rica: Ministerio de Salud de Costa Rica.Google Scholar
Grupo Técnico Nacional de Enfermedades Vectoriales (2016) Norma de Malaria. San José, Costa Rica: Ministerio de Salud de Costa Rica.Google Scholar
Guzman, AA (1940) Malaria in Costa Rica. Nature 146, 330.Google Scholar
Hastings, A, Abbott, KC, Cuddington, K, Francis, T, Gellner, G, Lai, Y-C, Morozov, A, Petrovskii, S, Scranton, K and Zeeman, ML (2018) Transient phenomena in ecology. Science (New York, N.Y.) 361, eaat6412.CrossRefGoogle ScholarPubMed
Herrera, S, Ochoa-Orozco, SA, González, IJ, Peinado, L, Quiñones, ML and Arévalo-Herrera, M (2015) Prospects for malaria elimination in Mesoamerica and Hispaniola. PLoS Neglected Tropical Diseases 9, e0003700.10.1371/journal.pntd.0003700CrossRefGoogle ScholarPubMed
Hotez, PJ, Woc-Colburn, L and Bottazzi, ME (2014) Neglected tropical diseases in Central America and Panama: review of their prevalence, populations at risk and impact on regional development. International Journal for Parasitology 44, 597–603.CrossRefGoogle ScholarPubMed
Hurtado, LA, Cáceres, L, Chaves, LF and Calzada, JE (2014) When climate change couples social neglect: malaria dynamics in Panamá. Emerging Microbes & Infections 3, e27.CrossRefGoogle ScholarPubMed
Hurtado, LA, Calzada, JE, Rigg, CA, Castillo, M and Chaves, LF (2018) Climatic fluctuations and malaria transmission dynamics, prior to elimination, in Guna Yala, República de Panamá. Malaria Journal 17, 85.CrossRefGoogle ScholarPubMed
International Cooperation Administration Expert Panel on Malaria (1961) Report and recommendations on malaria: a summary. The American Journal of Tropical Medicine and Hygiene 10, 451–502.10.4269/ajtmh.1961.10.451CrossRefGoogle Scholar
John, GK, Douglas, NM, von Seidlein, L, Nosten, F, Baird, JK, White, NJ and Price, RN (2012) Primaquine radical cure of Plasmodium vivax: a critical review of the literature. Malaria Journal 11, 280.CrossRefGoogle ScholarPubMed
Kaneko, A (2010) A community-directed strategy for sustainable malaria elimination on islands: short-term MDA integrated with ITNs and robust surveillance. Acta Tropica 114, 177–183.CrossRefGoogle ScholarPubMed
Kaneko, A, Taleo, G, Kalkoa, M, Yamar, S, Kobayakawa, T and Björkman, A (2000) Malaria eradication on islands. The Lancet 356, 1560–1564.CrossRefGoogle ScholarPubMed
Knaul, FM, Bhadelia, A, Ornelas, HA, de Lima, L and del Rocio Sáenz Madrigal, M (2015) Closing the pain divide: the quest for effective universal health coverage. The Lancet Global Health 3, S35.10.1016/S2214-109X(15)70154-3CrossRefGoogle Scholar
Kroeger, A (2001) ¿Propicia la resistencia medicamentosa y las recaídas el tratamiento breve con antimaláricos? Revista Panamericana de Salud Pública 9, 202–203.CrossRefGoogle Scholar
Kruk, ME, Gage, AD, Joseph, NT, Danaei, G, García-Saisó, S and Salomon, JA (2018) Mortality due to low-quality health systems in the universal health coverage era: a systematic analysis of amenable deaths in 137 countries. The Lancet 392, 2203–2212.CrossRefGoogle ScholarPubMed
Kumm, H. W. and Ruiz, S. H. (1939). A malaria survey of the Republic of Costa Rica, Central America. The American Journal of Tropical Medicine and Hygiene s1–19, 425–445.CrossRefGoogle Scholar
Lieske, H (1950) Malaria in Costa Rica. Zeitschrift für Tropenmedizin und Parasitologie 5, 270–272.Google Scholar
Lynn, WJ (1913) Annual report 1913 Costa Rica division. United Fruit Company Medical Department Annual Report 2, 28–31.Google Scholar
Lynn, WJ (1914) Annual report, 1914, Costa Rica division. United Fruit Company Medical Department Annual Report 3, 26.Google Scholar
Lynn, WJ (1915) Annual report, 1915, Costa Rica division. United Fruit Company Medical Department Annual Report 4, 26.Google Scholar
Marín Rodríguez, R and Chaves, LF (2019) Parasite removal for malaria elimination in Costa Rica. Trends in parasitology 35, 585–588.10.1016/j.pt.2019.04.007CrossRefGoogle ScholarPubMed
Ministerio de Planificación Nacional y Política Económica (2018) Índice de Desarrollo Social 2017. San José, CR: Mideplan.Google Scholar
NOAA (2019). ENSO Cold & Warm Episodes by Season. Available at www.cpc.ncep.noaa.gov/products/analysis_monitoring/ensostuff/ensoyears.shtml (Accessed 23 December 2019).Google Scholar
Núñez, S (1926) The occurrence and Non-occurrence of certain diseases in Costa Rica. The American Journal of Tropical Medicine and Hygiene s1–6, 347–356.CrossRefGoogle Scholar
PAHO (2019) Interactive Malaria Statistics. Available at http://www.paho.org/hq/index.php?option=com_content&view=article&id=2632:2010-interactive-malaria-statistics&Itemid=2130&lang=en (Accessed 23 December 2019).Google Scholar
Palmer, S. (2003) From Popular Medicine to Medical Populism: Doctors, Healers, and Public Power in Costa Rica, 1800–1940. Durham, NC: Duke University Press Books.CrossRefGoogle Scholar
Parker, DM, Tun, STT, White, LJ, Kajeechiwa, L, Thwin, MM, Landier, J, Chaumeau, V, Corbel, V, Dondorp, AM, von Seidlein, L, White, NJ, Maude, RJ and Nosten, F (2019) Potential herd protection against Plasmodium falciparum infections conferred by mass antimalarial drug administrations. eLife 8, e41023.CrossRefGoogle ScholarPubMed
Patz, JA and Olson, SH (2006) Malaria risk and temperature: influences from global climate change and local land use practices. Proceedings of the National Academy of Sciences of the United States of America 103, 5635–5636.CrossRefGoogle ScholarPubMed
Peña Chavarría, A and Guerrero Arguedas, J (1953 a) Influencia de la lucha antipaludica, especialmente la dedetización eb la Hospitalización por Malaria en el Hopsital San Juan de Dios de San José de Costa Rica, en el periodo 1942–1952. Revista Médica Costarricense 20, 54–60.Google Scholar
Peña Chavarría, A and Guerrero Arguedas, J (1953 b) La influencia del DDT en la incidencia del paludismo en Costa Rica. Boletin de la Oficina Sanitaria Panamericana 35, 487–493.Google Scholar
Rigg, CA, Hurtado, LA, Calzada, JE and Chaves, LF (2019) Malaria infection rates in Anopheles albimanus (Diptera: Culicidae) at ipetí-guna, a village within a region targeted for malaria elimination in panamá. Infection, Genetics and Evolution 69, 216–223.CrossRefGoogle ScholarPubMed
Rivera Funes, OF (2005) Las migraciones internacionales y sus efectos económicos en El Salvador. Población y Salud en Mesoamérica 2, 5.Google Scholar
Rosero-Bixby, L and Dow, WH (2016) Exploring why Costa Rica outperforms the United States in life expectancy: a tale of two inequality gradients. Proceedings of the National Academy of Sciences 113, 1130.CrossRefGoogle ScholarPubMed
Ruebush, I, Trenton, K, Marquiño, W, Cabezas, C and Neyra, D (2001) Régimen antimalárico de un día: riesgo de resistencia frente a utilidad. Revista Panamericana de Salud Pública 10, 217–219.CrossRefGoogle Scholar
Ruktanonchai, NW, Bhavnani, D, Sorichetta, A, Bengtsson, L, Carter, KH, Córdoba, RC, Le Menach, A, Lu, X, Wetter, E, zu Erbach-Schoenberg, E and Tatem, AJ (2016 a) Census-derived migration data as a tool for informing malaria elimination policy. Malaria Journal 15, 273.CrossRefGoogle ScholarPubMed
Ruktanonchai, NW, DeLeenheer, P, Tatem, AJ, Alegana, VA, Caughlin, TT, zu Erbach-Schoenberg, E, Lourenço, C, Ruktanonchai, CW and Smith, DL (2016 b) Identifying malaria transmission foci for elimination using human mobility data. PLOS Computational Biology 12, e1004846.CrossRefGoogle ScholarPubMed
Sáenz, R, Bissell, RA and Paniagua, F (2012) Post-Disaster malaria in Costa Rica. Prehospital and Disaster Medicine 10, 154–160.10.1017/S1049023X00041935CrossRefGoogle Scholar
Salisbury, EI (1929) Control of malaria in Costa Rica. United Fruit Company Medical Department Annual Report 18, 88–97.Google Scholar
Salisbury, EI (1930) The malaria index in the Costa Rican division as affected by control measures. United Fruit Company Medical Department Annual Report 19, 33–39.Google Scholar
Scheffer, M (2009) Critical Transitions in Nature and Society. Princeton: Princeton University Press.Google Scholar
Smith, DL, Perkins, TA, Reiner, JRC, Barker, CM, Niu, T, Chaves, LF, Ellis, AM, George, DB, Le Menach, A, Pulliam, JRC, Bisanzio, D, Buckee, C, Chiyaka, C, Cummings, DAT, Garcia, AJ, Gatton, ML, Gething, PW, Hartley, DM, Johnston, G, Klein, EY, Michael, E, Lloyd, AL, Pigott, DM, Reisen, WK, Ruktanonchai, N, Singh, BK, Stoller, J, Tatem, AJ, Kitron, U, Godfray, HCJ, Cohen, JM, Hay, SI and Scott, TW (2014) Recasting the theory of mosquito-borne pathogen transmission dynamics and control. Transactions of The Royal Society of Tropical Medicine and Hygiene 108, 185–197.CrossRefGoogle ScholarPubMed
Sokal, RR and Rohlf, FJ (1994) Biometry: The Principles and Practices of Statistics in Biological Research, 3rd Edn, New York, NY: W. H. Freeman.Google Scholar
The Economist Intelligence Unit (2018). Costa Rica Country Report. Available at http://country.eiu.com/costa-rica (Accessed 2 January 2019).Google Scholar
Vargas, M (2001) Diagnóstico Situacional de la Malaria Y el uso del DDT en Costa Rica. San José, Costa Rica: Organización Panamericana de la Salud.Google Scholar
Venables, WN and Ripley, BD (2002) Modern Applied Statistics with S. New York: Springer.CrossRefGoogle Scholar
Vigilancia de la Salud (2019) Boletín Epidemiológico No. 20. San José: Ministerio de Salud de Costa Rica.Google Scholar
Wallace, R, Chaves, LF, Bergmann, L, Ayres Lopes, CfJ, Hogerwerf, L, Kock, R and Wallace, RG (2018) Clear-Cutting Disease Control: Capital-Led Deforestation, Public Health Austerity, and Vector-Borne Infection. New York: Springer.CrossRefGoogle Scholar
Warren, M, Collins, WE, Jeffery, GM and Skinner, JC (1975) The seroepidemiology of malaria in Middle America II. Studies on the pacific coast of Costa Rica. The American Journal of Tropical Medicine and Hygiene 24, 749–754.CrossRefGoogle ScholarPubMed
Weinstock, H, Garcés, JL, S, JB and Rodríguez, J (1979) Immunodiagnosis of malaria infections by the national malaria eradication service (SNEM) of Costa Rica. Bulletin of Pan American Health Organization 13, 257–263.Google Scholar
WHO (2018) Update on the E-2020 Initiative of 21 Malaria-Eliminating Countries. Geneva: World Health Organization.Google Scholar
Wolter, K and Timlin, MS (2011) El Niño/Southern Oscillation behaviour since 1871 as diagnosed in an extended multivariate ENSO index (MEI.ext). International Journal of Climatology 31, 1074–1087.CrossRefGoogle Scholar