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Article

Malaria Elimination in Costa Rica: Changes in Treatment and Mass Drug Administration

1
Vigilancia de la Salud, Ministerio de Salud, San José, San José 10123-1000, Apartado Postal, Costa Rica
2
Department of Biological Sciences, University of Notre Dame, Notre Dame, IN 46556, USA
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Programa Nacional de Manejo de Vectores, Región Huétar Norte, Ministerio de Salud, Muelle de San Carlos, Alajuela 21006, Código Postal, Costa Rica
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Departamento de Patología, Escuela de Medicina Veterinaria, Universidad Nacional, Heredia, Heredia 304-3000, Apartado Postal, Costa Rica
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Unidad de Investigación en Plasmodium, Centro de Investigación en Enfermedades Tropicales (CIET), Facultad de Microbiología, Universidad de Costa Rica, San Pedro, San José 11501-2060, Apartado Postal, Costa Rica
*
Author to whom correspondence should be addressed.
Microorganisms 2020, 8(7), 984; https://doi.org/10.3390/microorganisms8070984
Received: 17 April 2020 / Revised: 4 May 2020 / Accepted: 11 May 2020 / Published: 30 June 2020
(This article belongs to the Special Issue Epidemiology of Vector-Borne Diseases)
Costa Rica is a candidate to eliminate malaria by 2020. The remaining malaria transmission hotspots are located within the Huétar Norte Region (HNR), where 90% of the country’s 147 malaria cases have occurred since 2016, following a 33-month period without transmission. Here, we examine changes in transmission with the implementation of a supervised seven-day chloroquine and primaquine treatment (7DCPT). We also evaluate the impact of a focal mass drug administration (MDA) in January 2019 at Boca Arenal, the town in HNR reporting the greatest local transmission. We found that the change to a seven-day treatment protocol, from the prior five-day program, was associated with a 98% reduction in malaria transmission. The MDA helped to reduce transmission, keeping the basic reproduction number, RT, significantly below 1, for at least four months. However, following new imported cases from Nicaragua, autochthonous transmission resumed. Our results highlight the importance of appropriate treatment delivery to reduce malaria transmission, and the challenge that highly mobile populations, if their malaria is not treated, pose to regional elimination efforts in Mesoamerica and México. View Full-Text
Keywords: malaria; Plasmodium vivax; Anopheles albimanus; illegal mining; migration; Costa Rica malaria; Plasmodium vivax; Anopheles albimanus; illegal mining; migration; Costa Rica
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MDPI and ACS Style

Chaves, L.F.; Huber, J.H.; Rojas Salas, O.; Ramírez Rojas, M.; Romero, L.M.; Gutiérrez Alvarado, J.M.; Perkins, T.A.; Prado, M.; Rodríguez, R.M. Malaria Elimination in Costa Rica: Changes in Treatment and Mass Drug Administration. Microorganisms 2020, 8, 984. https://doi.org/10.3390/microorganisms8070984

AMA Style

Chaves LF, Huber JH, Rojas Salas O, Ramírez Rojas M, Romero LM, Gutiérrez Alvarado JM, Perkins TA, Prado M, Rodríguez RM. Malaria Elimination in Costa Rica: Changes in Treatment and Mass Drug Administration. Microorganisms. 2020; 8(7):984. https://doi.org/10.3390/microorganisms8070984

Chicago/Turabian Style

Chaves, Luis F., John H. Huber, Obdulio Rojas Salas, Melissa Ramírez Rojas, Luis M. Romero, José M. Gutiérrez Alvarado, T. A. Perkins, Monica Prado, and Rodrigo M. Rodríguez 2020. "Malaria Elimination in Costa Rica: Changes in Treatment and Mass Drug Administration" Microorganisms 8, no. 7: 984. https://doi.org/10.3390/microorganisms8070984

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