The Epidemiology of Malaria in Belize, 1989-1999
Uniformed Services University Of The Health Sciences Bethesda United States
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Retrospective analyses were conducted to describe the epidemiology of malaria in Belize over a 10-year period and to determine if environmental factors influenced the incidence of malaria at macro- and micro-scales. The purpose was to contribute to the current body of knowledge regarding malaria transmission in Belize, which may aid in region-specific malaria control efforts. Malaria data were obtained from the National Malaria Control Program National Malaria Database. Malaria rates were calculated using the 1991 population census of Belize Central Statistics Office. Other data were obtained from the National Meteorological Service Belize, National Center for Environmental Prediction NCEP, National Weather Service U.S.A., Global Land One-Kilometer Base Elevation GLOBE, National Geophysical Data Center, Land Information Centre LIC, Belize, village and vector surveys, Ministry of Health MOH, SPOT and Landsat multi-spec images. Most of the data from these sources were collected for purposes other than the specific aims of the studies in this dissertation. Over a 10-year period, malaria incidence rates varied temporally and spatially southern and central areas of Belize had consistently higher rates of malaria than northern areas. Toledo District had the highest Plasmodium vivax incidence whereas, Stann Creek District had the highest P. falciparum incidence. Malaria incidence was highest during 1993 through 1996. Plasmodium falciparum incidence was highest in the transitional months preceding the wet season in Stann Creek. Preliminary results indicated malaria incidence differed geographically byseason, type of vegetation, and proximity of villages to rivers or streams. Examination of associations between weather and malaria incidence indicated that precipitation wasassociated with malaria transmission. Higher total rainfall was associated with a highermalaria risk in villages.