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Warming Guyana coast risks malaria resurgence

Source: Thomson Reuters Foundation - Wed, 7 Sep 2011 10:12 GMT
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GEORGETOWN, Guyana (AlertNet) - Guyana is battling to prevent the spread of malaria as climate change brings higher temperatures and more rainfall, threatening to push the disease back into densely populated coastal regions.

In the tiny South American nation, 90 percent of malaria cases are found in the northwest, which experiences the heaviest rainfall, including the northernmost coastline. But recently, the mosquito-borne disease has also been found in an adjoining coastal region, as well as further inland to the east and south.

Since the early 1990s, Guyana - a member of the Caribbean Community (CARICOM) - has succeeded in reducing malaria from 92,000 cases a year to around 10,000, thanks to the use of treated bed nets, education on malaria drugs and training of health personnel, according to officials.

Prior to that, a DDT (dichlorodiphenyltrichloroethane) insecticide campaign in the 1950s and 1960s had eliminated the mosquito-borne disease from the country’s densely populated coastal areas - mainly in the northeast, around and below Georgetown.

Health Minister Leslie Ramsammy is now concerned that climate change could bring it back to those regions.

“My greatest fear for Guyana is that, if we don’t take control of malaria right now, because of climate change, the vector for malaria is going to spread on the coast,” he told AlertNet.

A vector is an organism that carries a pathogen, such as the mosquito that hosts the malaria parasite.

Recent research confirms that climate shifts are causing an increase in malaria cases in Guyana. According to a report released in June by the U.N. Economic Commission for Latin America and the Caribbean (UNECLAC), from 2006 to 2010, every millimetre increase in rainfall and one-degree rise in temperature led to an additional 11 cases of malaria.

That effect is likely to be amplified in the future, as temperatures and rainfall are predicted to head higher, bringing about changes in vector patterns.

While there are still gaps in scientific knowledge about the links between climate change and malaria, many researchers expect the disease to increase in areas where it is already prevalent as the world warms, shortening incubation periods, and to spread to new regions – particularly higher altitudes.

“Climate change does two things: it amplifies disease species, and then it brings diseases closer to human beings,” Ramsammy said.

“While the climate change impacts on flood and the diseases that come with floods are well known, we have not focused on the ecological changes it brings,” he said, pointing to the environmental shifts that will influence the spread of vector-borne diseases like malaria and dengue.

In Guyana, the mosquito that most often carries the malaria parasite - the Anopheles mosquito - is mainly found in hinterland areas. “But as climate change causes differences in the special distribution of species, there will be a creeping effect,” Ramsammy said.

“What frightens me is that the vector that used to be away from the population on the shorelines of the country is now spreading more widely into the [highly populated] areas,” he said.

MINERS FALLING SICK

In Guyana, it is not just climate change that threatens to put malaria back on an upward trend. The ECLAC report also notes non-climatic drivers, including population growth, urbanisation and economic development.

According to minister Ramsammy, a proliferation of mining camps in the interior, which offer short-term work opportunities, is also complicating efforts to curb the disease. In those impoverished parts of the country, there is a lack of health workers to carry out malaria prevention work and treat those who become infected.

Brian O’Conner, a Rastafarian in his fifties who worked for a few weeks at Omai, a gold-mining area in the western region of Cuyuni-Mazaruni, told AlertNet he had decided to go to a clinic for a malaria test after experiencing most of the symptoms of the parasitic disease.

Omai had been flooded due to heavy rains, providing an ideal breeding ground for mosquitoes.

“I came out about a month ago with these symptoms. I don’t feel bad during the day but when evening approaches, I get pains, headaches and my skin hurts,” he said, while awaiting his test results.

Patients are given a blood test, and receive the results an hour or so later. The test confirms not only whether someone has contracted malaria, but which strain of the parasite they are infected with.

Depending on their condition, they are either given drugs and sent home, or admitted to hospital for more intensive treatment and monitoring.

Another attendee at the clinic, an 18-year-old man called Terrence Simon, said he had spent just over a month in the interior mining district of Aranka before becoming infected with malaria.

Although he took pills, his symptoms got worse. “I was exposed to a lot of mosquitoes,” he said, complaining of fever, sweating and cramps.

Simon and O’Conner are both first-time malaria patients, although the places where they worked are located in common malaria regions.

Minister Ramsammy said Guyana’s health sector cannot keep malaria in check alone, and needs cooperation from pharmaceutical importers, non-governmental organisations and donors, including the World Health Organisation (WHO) and the U.S. government.

The health ministry has launched a programme to help different parts of the country limit the spread of malaria-carrying mosquitoes. And with the support of the Pan American Health Organization (PAHO), the WHO and the U.S. Agency for International Development (USAID), it has surveyed pharmacies to check whether they are stocking the right malaria medicines.

Johann Earle is a Georgetown-based freelance writer with an interest in climate change issues.

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