FROM the 19th century to the first half of the 20th century, Guyana was the most malaria-infected territory in the Caribbean. The Caribbean islands, since they were all above sea-level and enjoyed natural drainage were comparatively free of malaria as compared with Guyana. Until the 1950s, all surviving Guyanese would have been infected with malaria at some stage of their lives.
In those years, malaria sent up the death rate and in areas of poor sanitation such as the sugar estates, malaria decimated the population. Death by malaria was one of the main reasons indentured immigration had to be continuous to replace the workforce.
Then Dr George Giglioli, an Italian doctor who had made Guyana his home devised a malaria campaign in 1946 for the sugar estates and next year for the whole country. Two of the main elements of Dr Giglioli’s campaigns were to eliminate all stagnant water near to populated areas, since the malaria mosquito bred in stagnant water and to spray every habitation with DDT. His campaigns were highly successful and malaria was eradicated. For years, malaria cases were rare in Guyana.
In the last several years however, in the Interior, especially in the mining districts malaria has shown a resurgence with a new and more dangerous parasite – the plasmodium falciparum. This strain of malaria could kill an infected person in a short time, unlike the former strains which allowed a fairly long period of debilitation. All malaria parasites are transmitted to human beings by the bite of the female Anopheles mosquito. The modern treatment, unlike in Dr Giglioli’s day when it was largely quinine, is now Coartem and Primaquine.
When President Granger attended the Commonwealth Heads Of Government Meeting recently, he also attended the Malaria Summit which was linked to the conference. Like Prince Charles, President Granger addressed the summit which showed the Commonwealth at its best. The nations attending the summit evinced fraternal concern for those countries affected by malaria and especially the six most affected: Nigeria, Mozambique, Ghana, Uganda, Tanzania and India. One of the major commitments emerging from the summit was to halve the number of malaria cases over the next five years.
President Granger pointed out that in Guyana, malaria was one of the leading causes of death from communicable diseases. In 2015 there were approximately 8,400 cases of malaria and it seemed that the country was moving towards its eradication, since between 2010 and 2015 there was a 60% decline in new cases. But there was a resurgence of the disease, especially in the mining areas of the interior and in 2016, a 5 per cent increase in new cases was recorded and in 2017 a 5 per cent increase was also recorded. Most of these new cases were in the mining areas and the type of parasite was the plasmodium falciparum which was rarely, if ever, found on the coast. The newness of the strain and the fact that its highest incidence is in the interior where health facilities are fewer, makes the challenge greater. Though the Ministry of Public Health has been assiduously working for the lessening and eradication of the disease, President Granger felt that there was still room for external assistance.
In reducing the number of new cases in Guyana and moving towards eradication, he suggested a number of ideas. The first was disseminating relevant information how to eliminate vectors which are responsible for spreading malaria. This is to be combined with the Public Health Ministry ensuring that stagnant water near human habitations is drained off, since the mosquito breeds in stagnant water.
The next step in the President’s words “involves providing improved tools for identifying and diagnosing active cases of malaria regardless of species”. The modern methods of identifying and diagnosing the disease are much quicker and more accurate than the older methods.
The effective modern treatment, the final step in confronting the disease, the President advises: “Procuring high-quality combination malaria treatment to ensure cure of infected persons including drug-resistant malaria.” These modern drugs have been successfully used against falciparum. Despite the fact Guyana has been trying to keep up with modern methods and has been making good progress over the years in eliminating the disease, there is still room for advice and assistance from the more advanced countries.
Guyana recently commemorated World Malaria Day which is annually promoted by the World Health Organization. The motto for this year’s commemoration is “Ready to Beat Malaria” and the Ministry of Public Health has adopted it as its guiding slogan. The ministry is committed to decreasing the number of new cases by 40 per cent by 2020 and in this drive it will train more health personnel and volunteers, educate the public as to main drug used to treat the disease and to make available such drugs free of charge to all patients who need them. The ministry in its education programe, has recommended Coartem and Primaquine to treat plasmodium falciparum and has also warned against Artecom and Artefan. The ministry’s efforts would be largely concentrated in Regions One and Eight, where most of the affected populations live.