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Malaria in Mexico, 1998–2004 1
Pan AmericanHealthOrganization
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MALARIA IN MEXICO:
Time Series Epidemiological Data from 1998 to 2004
MALARIA IN MEXICO:
Time Series Epidemiological Data from 1998 to 2004
Malaria in Mexico, 1998–2004 2
Pan AmericanHealthOrganization
Malaria in MexicoMalaria in Mexico
I. The Malaria Burden– Risk of Transmission– Malaria Morbidity– Malaria Mortality– Malariometric Indices (API, AFI, AVI,
AMI)II Trends in Case Detection and Diagnosis
– Case Detection: Passive vs. Active Method
– Annual Blood Examination Rate (ABER)– Slide Positivity Rate SPR)
III. TreatmentIV. Resources and Financing
I. The Malaria Burden– Risk of Transmission– Malaria Morbidity– Malaria Mortality– Malariometric Indices (API, AFI, AVI,
AMI)II Trends in Case Detection and Diagnosis
– Case Detection: Passive vs. Active Method
– Annual Blood Examination Rate (ABER)– Slide Positivity Rate SPR)
III. TreatmentIV. Resources and Financing
Malaria in Mexico, 1998–2004 3
Pan AmericanHealthOrganization
The Risk of
Transmission
The Risk of
Transmission
Malaria in Mexico, 1998–2004 4
Pan AmericanHealthOrganization
MEXICO: Population at Risk of Malaria Transmission, 1998–2004 (in thousands)
MEXICO: Population at Risk of Malaria Transmission, 1998–2004 (in thousands)
0
20,000
40,000
60,000
80,000
100,000
120,000
Population at Risk 49,571 50,338 50,338 54,649 54,648 54,649 2,820
Total Population 96,254 97,744 99,198 100,997 102,055 102,055 105,031
1998 1999 2000 2001 2002 2003 20040
20,000
40,000
60,000
80,000
100,000
120,000
Population at Risk 49,571 50,338 50,338 54,649 54,648 54,649 2,820
Total Population 96,254 97,744 99,198 100,997 102,055 102,055 105,031
1998 1999 2000 2001 2002 2003 2004
Malaria in Mexico, 1998–2004 5
Pan AmericanHealthOrganization
MEXICO: Population at Ecological Risk of Malaria Transmission According to Level of
Transmission Risk , 1998–2004 (in thousands)
MEXICO: Population at Ecological Risk of Malaria Transmission According to Level of
Transmission Risk , 1998–2004 (in thousands)
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
20,000
Low Risk 14,921 15,150 15,150 16,941 16,941 16,941 484
Moderate Risk 16,557 16,812 16,812 18,034 18,034 18,034 531
High Risk 18,093 18,376 18,376 19,673 19,673 19,673 1,805
1998 1999 2000 2001 2002 2003 20040
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
20,000
Low Risk 14,921 15,150 15,150 16,941 16,941 16,941 484
Moderate Risk 16,557 16,812 16,812 18,034 18,034 18,034 531
High Risk 18,093 18,376 18,376 19,673 19,673 19,673 1,805
1998 1999 2000 2001 2002 2003 2004
Malaria in Mexico, 1998–2004 6
Pan AmericanHealthOrganization
Malaria MorbidityMalaria Morbidity
Malaria in Mexico, 1998–2004 7
Pan AmericanHealthOrganization
MEXICO: Malaria Morbidity, 1998–2004 (number of positive blood slides)
MEXICO: Malaria Morbidity, 1998–2004 (number of positive blood slides)
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
No. of Cases 15,121 6,402 7,390 4,831 4,289 3,586 3,406
1998 1999 2000 2001 2002 2003 20040
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
No. of Cases 15,121 6,402 7,390 4,831 4,289 3,586 3,406
1998 1999 2000 2001 2002 2003 2004
Malaria in Mexico, 1998–2004 8
Pan AmericanHealthOrganization
MEXICO: Malaria Morbidity According to Level of Transmission Risk, 1998–2004
(number of positive blood slides)
MEXICO: Malaria Morbidity According to Level of Transmission Risk, 1998–2004
(number of positive blood slides)
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
Low Risk 8 40 58 34 28 15 200
Moderate Risk 454 380 1,260 768 682 489 864
High Risk 14,659 5,982 6,072 4,029 3,579 3,082 2,342
Originally Non-Malarious 0 0 0 0 0 0 0
1998 1999 2000 2001 2002 2003 20040
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
Low Risk 8 40 58 34 28 15 200
Moderate Risk 454 380 1,260 768 682 489 864
High Risk 14,659 5,982 6,072 4,029 3,579 3,082 2,342
Originally Non-Malarious 0 0 0 0 0 0 0
1998 1999 2000 2001 2002 2003 2004
Malaria in Mexico, 1998–2004 9
Pan AmericanHealthOrganization
MEXICO: Malaria Morbidity According to Parasite Species (in All Risk Areas), 1998–2004
MEXICO: Malaria Morbidity According to Parasite Species (in All Risk Areas), 1998–2004
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
P. falciparum & mixed 21 16 131 70 17 0 49
P. vivax 15,100 6,386 7,259 4,761 4,272 3,586 3,357
P. malariae 0 0 0 0 0 0 0
1998 1999 2000 2001 2002 2003 20040
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
P. falciparum & mixed 21 16 131 70 17 0 49
P. vivax 15,100 6,386 7,259 4,761 4,272 3,586 3,357
P. malariae 0 0 0 0 0 0 0
1998 1999 2000 2001 2002 2003 2004
Malaria in Mexico, 1998–2004 10
Pan AmericanHealthOrganization
MEXICO: Malaria Morbidity According to Parasite Species (In Moderate and High Areas), 1998–2004
MEXICO: Malaria Morbidity According to Parasite Species (In Moderate and High Areas), 1998–2004
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
P. falciparum & mixed 20 16 131 70 17 0 49
P. vivax 15,112 6,346 7,201 4,722 4,244 3,571 3,357
P. malariae 0 0 0 0 0 0 0
1998 1999 2000 2001 2002 2003 20040
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
P. falciparum & mixed 20 16 131 70 17 0 49
P. vivax 15,112 6,346 7,201 4,722 4,244 3,571 3,357
P. malariae 0 0 0 0 0 0 0
1998 1999 2000 2001 2002 2003 2004
Malaria in Mexico, 1998–2004 11
Pan AmericanHealthOrganization
Malaria MortalityMalaria Mortality
Malaria in Mexico, 1998–2004 12
Pan AmericanHealthOrganization
MEXICO: Malaria Mortality, 1998–2004 (number of deaths)
MEXICO: Malaria Mortality, 1998–2004 (number of deaths)
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
No. of Deaths 0 0 0 0 0 0 0
1998 1999 2000 2001 2002 2003 20040
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
No. of Deaths 0 0 0 0 0 0 0
1998 1999 2000 2001 2002 2003 2004
Malaria in Mexico, 1998–2004 13
Pan AmericanHealthOrganization
Malariometric Indices
(API, AFI, AVI, AMI)
Malariometric Indices
(API, AFI, AVI, AMI)
Malaria in Mexico, 1998–2004 14
Pan AmericanHealthOrganization
MEXICO: Malariometric Indices (API, AFI, AVI, AMI) in all Risk Areas, 1998–2004
MEXICO: Malariometric Indices (API, AFI, AVI, AMI) in all Risk Areas, 1998–2004
0
0.05
0.1
0.15
0.2
0.25
0.3
API 0.3 0.13 0.15 0.05 0.08 0.07 0.07
AFI 0.0004 0.0003 0.002 0 0.0003 0 0.001
AVI 0.3 0.13 0.14 0.05 0.08 0.07 0.07
AMI 0 0 0 0 0 0 0
1998 1999 2000 2001 2002 2003 20040
0.05
0.1
0.15
0.2
0.25
0.3
API 0.3 0.13 0.15 0.05 0.08 0.07 0.07
AFI 0.0004 0.0003 0.002 0 0.0003 0 0.001
AVI 0.3 0.13 0.14 0.05 0.08 0.07 0.07
AMI 0 0 0 0 0 0 0
1998 1999 2000 2001 2002 2003 2004
Malaria in Mexico, 1998–2004 15
Pan AmericanHealthOrganization
MEXICO: Malariometric Indices (API, AFI, AVI, AMI) in Moderate and High Risk Areas, 1998–2004
MEXICO: Malariometric Indices (API, AFI, AVI, AMI) in Moderate and High Risk Areas, 1998–2004
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
0.45
API 0.44 0.14 0.17 0.11 0.09 0.08 0.07
AFI 0.0006 0.0003 0.003 0.003 0.0004 0 0.001
AVI 0.44 0.14 0.17 0.11 0.09 0.08 0.07
AMI 0 0 0 0 0 0 0
1998 1999 2000 2001 2002 2003 20040
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
0.45
API 0.44 0.14 0.17 0.11 0.09 0.08 0.07
AFI 0.0006 0.0003 0.003 0.003 0.0004 0 0.001
AVI 0.44 0.14 0.17 0.11 0.09 0.08 0.07
AMI 0 0 0 0 0 0 0
1998 1999 2000 2001 2002 2003 2004
Malaria in Mexico, 1998–2004 16
Pan AmericanHealthOrganization
MEXICO: Annual Parasitic Index (API), 1998–2004MEXICO: Annual Parasitic Index (API), 1998–2004
0.00
0.05
0.10
0.15
0.20
0.25
0.30
In All Risk Areas 0.3 0.13 0.15 0.05 0.08 0.07 0.07
Moderate and High Risk Only 0.3 0.14 0.17 0.11 0.09 0.08 0.07
1998 1999 2000 2001 2002 2003 20040.00
0.05
0.10
0.15
0.20
0.25
0.30
In All Risk Areas 0.3 0.13 0.15 0.05 0.08 0.07 0.07
Moderate and High Risk Only 0.3 0.14 0.17 0.11 0.09 0.08 0.07
1998 1999 2000 2001 2002 2003 2004
Malaria in Mexico, 1998–2004 17
Pan AmericanHealthOrganization
MEXICO: Annual Index of P. falciparum (AFI), 1998–2004
MEXICO: Annual Index of P. falciparum (AFI), 1998–2004
0
0.0005
0.001
0.0015
0.002
0.0025
0.003
0.0035
0.004
In All Risk Areas 0.0004 0.0003 0.002 0.0008 0.0003 0 0.001
Moderate and High Risk Only 0.0005 0.0004 0.003 0.003 0.004 0 0.003
1998 1999 2000 2001 2002 2003 20040
0.0005
0.001
0.0015
0.002
0.0025
0.003
0.0035
0.004
In All Risk Areas 0.0004 0.0003 0.002 0.0008 0.0003 0 0.001
Moderate and High Risk Only 0.0005 0.0004 0.003 0.003 0.004 0 0.003
1998 1999 2000 2001 2002 2003 2004
Malaria in Mexico, 1998–2004 18
Pan AmericanHealthOrganization
MEXICO: Annual Index of P. vivax (AVI), 1998–2004
MEXICO: Annual Index of P. vivax (AVI), 1998–2004
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
0.45
In All Risk Areas 0.3 0.13 0.14 0.05 0.08 0.07 0.07
Moderate and High Risk Only 0.42 0.18 0.17 0.1 0.11 0.1 0.21
1998 1999 2000 2001 2002 2003 20040
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
0.45
In All Risk Areas 0.3 0.13 0.14 0.05 0.08 0.07 0.07
Moderate and High Risk Only 0.42 0.18 0.17 0.1 0.11 0.1 0.21
1998 1999 2000 2001 2002 2003 2004
Malaria in Mexico, 1998–2004 19
Pan AmericanHealthOrganization
MEXICO: Annual Index of P. malariae (AMI), 1998–2004
MEXICO: Annual Index of P. malariae (AMI), 1998–2004
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
In All Risk Areas 0 0 0 0 0 0 0
Moderate and High Risk Only 0 0 0 0 0 0 0
1998 1999 2000 2001 2002 2003 20040
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
In All Risk Areas 0 0 0 0 0 0 0
Moderate and High Risk Only 0 0 0 0 0 0 0
1998 1999 2000 2001 2002 2003 2004
Malaria in Mexico, 1998–2004 20
Pan AmericanHealthOrganization
Trends in
Case Detection and
Diagnosis
Trends in
Case Detection and
Diagnosis
Malaria in Mexico, 1998–2004 21
Pan AmericanHealthOrganization
MEXICO: Passive vs. Active Case Detection, 1998–2004 (% of Blood Slides Examined)
MEXICO: Passive vs. Active Case Detection, 1998–2004 (% of Blood Slides Examined)
48.81
47.79
67.28
70.63
78.78
78.78
58.83
51.19
52.21
32.72
29.37
21.22
21.22
41.17
0 20 40 60 80 100 120
1998
1999
2000
2001
2002
2003
2004
Passive Active
48.81
47.79
67.28
70.63
78.78
78.78
58.83
51.19
52.21
32.72
29.37
21.22
21.22
41.17
0 20 40 60 80 100 120
1998
1999
2000
2001
2002
2003
2004
Passive Active
Malaria in Mexico, 1998–2004 22
Pan AmericanHealthOrganization
MEXICO: Annual Blood Examination Rate (ABER) in Malarious Areas, 1998–2004
MEXICO: Annual Blood Examination Rate (ABER) in Malarious Areas, 1998–2004
49,571,000
50,338,000
50,338,000
54,648,000
54,649,000
54,648,000
2,820,000
1,759,266
2,013,745
2,003,569
1,816,271
1,577,647
1,500,292
1,454,575
1998
1999
2000
2001
2002
2003
2004
Examined
Population atRisk / InMalarious Areas
49,571,000
50,338,000
50,338,000
54,648,000
54,649,000
54,648,000
2,820,000
1,759,266
2,013,745
2,003,569
1,816,271
1,577,647
1,500,292
1,454,575
1998
1999
2000
2001
2002
2003
2004
Examined
Population atRisk / InMalarious Areas
Malaria in Mexico, 1998–2004 23
Pan AmericanHealthOrganization
MEXICO: Slide Positivity Rate (SPR), 1998–2004MEXICO: Slide Positivity Rate (SPR), 1998–2004
1,759,226
2,013,745
2,003,569
1,816,271
1,577,647
1,500,292
1,454,575
15,121
6,402
7,390
4,831
4,289
3,586
3,406
1998
1999
2000
2001
2002
2003
2004Examined
Positive
1,759,226
2,013,745
2,003,569
1,816,271
1,577,647
1,500,292
1,454,575
15,121
6,402
7,390
4,831
4,289
3,586
3,406
1998
1999
2000
2001
2002
2003
2004Examined
Positive
Malaria in Mexico, 1998–2004 24
Pan AmericanHealthOrganization
TreatmentTreatment
Malaria in Mexico, 1998–2004 25
Pan AmericanHealthOrganization
MEXICO: Antimalarial Drugs Used, 1998–2004MEXICO: Antimalarial Drugs Used, 1998–2004
0
1,000,000
2,000,000
3,000,000
4,000,000
5,000,000
6,000,000
7,000,000
8,000,000
9,000,000
10,000,000
Chloroquine &/or Amodiaquine @ 150mg 6,647,051 8,397,332 8,271,408 8,381,510 9,447,260 9,447,260 8,739,459
Primaquine @ 15mg 770,124 1,657,062 1,582,025 1,682,125 1,960,461 1,961,461 1,331,968
Primaquina 5mg 1,121,792 1,043,792 1,284,591 1,384,691 1,176,276 1,176,276 724,725
Sulfa/Pyrimethamine @ 500/25mg … … … … … … …
Mefloquine @250mg … … … … … … …
Artemisinine Derivatives (# of Tx) … … … … … … …
Quinine @ 300mg … … … … … … 150
1998 1999 2000 2001 2002 2003 20040
1,000,000
2,000,000
3,000,000
4,000,000
5,000,000
6,000,000
7,000,000
8,000,000
9,000,000
10,000,000
Chloroquine &/or Amodiaquine @ 150mg 6,647,051 8,397,332 8,271,408 8,381,510 9,447,260 9,447,260 8,739,459
Primaquine @ 15mg 770,124 1,657,062 1,582,025 1,682,125 1,960,461 1,961,461 1,331,968
Primaquina 5mg 1,121,792 1,043,792 1,284,591 1,384,691 1,176,276 1,176,276 724,725
Sulfa/Pyrimethamine @ 500/25mg … … … … … … …
Mefloquine @250mg … … … … … … …
Artemisinine Derivatives (# of Tx) … … … … … … …
Quinine @ 300mg … … … … … … 150
1998 1999 2000 2001 2002 2003 2004
Malaria in Mexico, 1998–2004 26
Pan AmericanHealthOrganization
Resources and
Financing
Resources and
Financing
Malaria in Mexico, 1998–2004 27
Pan AmericanHealthOrganization
MEXICO: National Budget and Non-Budgetary Contributions to Malaria Control Programs,
1998–2004 (in US$)
MEXICO: National Budget and Non-Budgetary Contributions to Malaria Control Programs,
1998–2004 (in US$)
1,000,000
10,000,000
100,000,000
Contributed Funds and Loans
National Malaria Budget
Total Budget
Contributed Funds and Loans … … … … … … …
National Malaria Budget 14,117,650 15,349,724 17,652,182 17,157,485 19,576,235 19,576,235 20,973,045
Total Budget 14,117,650 15,349,724 17,652,582 17,157,485 19,576,235 19,576,235 20,973,045
1998 1999 2000 2001 2002 2003 20041,000,000
10,000,000
100,000,000
Contributed Funds and Loans
National Malaria Budget
Total Budget
Contributed Funds and Loans … … … … … … …
National Malaria Budget 14,117,650 15,349,724 17,652,182 17,157,485 19,576,235 19,576,235 20,973,045
Total Budget 14,117,650 15,349,724 17,652,582 17,157,485 19,576,235 19,576,235 20,973,045
1998 1999 2000 2001 2002 2003 2004
Malaria in Mexico, 1998–2004 28
Pan AmericanHealthOrganization
MEXICO: Annual US$ Funds per Person in Malarious Areas, 1998–2004
MEXICO: Annual US$ Funds per Person in Malarious Areas, 1998–2004
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
0.45
US$ Funds per Person inMalarious Areas
0.28 0.31 0.35 0.31 0.36 0.36 0.45
1998 1999 2000 2001 2002 2003 20040
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
0.45
US$ Funds per Person inMalarious Areas
0.28 0.31 0.35 0.31 0.36 0.36 0.45
1998 1999 2000 2001 2002 2003 2004
