SECOND GLOBAL MALARIA ACTION PLAN http://www.gmap2.org/espanol/el-documento-gmap2/ October 2014

Honduras, Central America: Sharing the evidence to inform standard operational procedures In Honduras, Central America, during the period before the year 2010, the absence of updated standards based on local epidemiological and clinical information became a major barrier for improving the clinical and public health management of malaria, hindering the proper training of professional and technical human resources, the systematic recording of information and its interpretation, early diagnosis and prompt treatment of cases, and the promotion of comprehensive measures of prevention and control with community participation.

All of these, in spite of having support from

different sources as external cooperation, including PAHO, WHO, AID, DFID, and also Global Fund resources since 2003. Since 1934, there are local publications which discuss international findings and local information

on

malaria

(Revista

Medica

Hondureña,

http://www.bvs.hn/RMH/html/revista.html). In the period 1934 to 1953, there are articles that describe complicated cases, treatment, vector biology and ecology, and sanitary measures. In the period from 1954 to 1994, there are not publications. Two articles describing a congenital case and another case with neurological manifestations were published in 1995. From 1998, there is a series of articles including editorials, opinion articles, clinical cases and original papers, addressing malaria from different points of view: epidemiological situation, diagnosis, surveillance, clinical presentation and therapeutic management. In all of these articles it is mentioned the need to review and update the MOH standards of malaria prevention and control, because those standard were dated 1992 and were out-of-date on important strategic issues such as diagnosis, surveillance of resistant parasites, identification of sub-clinical infections, recurrent

infections, and the management of severe and complicated cases. In them it is also mentioned the need to train the technical and professional staff in the correct use of the laboratory and interpretation of the results for a satisfactory clinical management of cases and effective public health approach. Since 1998, a series of recommendations has been provided to the National Malaria Program and to the Nation Malaria Laboratory of the MOH. The fact of having achieved the incorporation of scientific evidence based on local observations in the malaria prevention and control guidelines in Honduras could be categorized as a successful enterprise. The scientific production on the topic of malaria originated in the University Hospital, in Tegucigalpa, Honduras, was constantly placed at the reach of MOH authorities. This was not a straightforward process because during almost two decades it has been necessary to coordinate with professionals and technicians with varying degrees of academic preparation, limited research capacity and different levels of teamwork experience.

The constancy in the scientific production and the extent to

provide this information to the MOH authorities, contributed to its incorporation and it proper use.

LINKS 1. Aguilar CJ, E Bu Figueroa, J Alger. Caracterización clínica y epidemiológica de la malaria en una comunidad endémica de Honduras. Rev Med Hondur 2004; 72: 179-186. Available at http://www.bvs.hn/RMH/pdf/2004/pdf/Vol72-4-2004-2.pdf (Accessed October 2014). 2. Aguilar CJ, E Bu Figueroa y J Alger. Malaria: Infección subclínica entre escolares en la comunidad de Palacios, La Mosquitia. Rev Med Hondur 2002; 70: 111-115. Available at http://www.bvs.hn/RMH/pdf/2002/pdf/Vol70-3-2002-3.pdf (Accessed October 2014). 3. Fernández RD, Y García, J Alger. Malaria y embarazo: Observaciones clínicoepidemiológicas en dos zonas geográficas de Honduras. Rev Med Hondur 2001; 69: 8 – 18. 4. Available at http://www.bvs.hn/RMH/pdf/2001/pdf/Vol69-1-2001-3.pdf (Accessed October 2014). 5. Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal. Manual de Manejo de Enfermedades Parasitarias Prioritarias en Honduras. Editores: J Alger, T Alvarado, E Bu, J Fernández, CA Javier, RG de Kaminsky, D Padgett, EY Palou, M Rivera, R Valenzuela, C Zúniga. Instituto de Enfermedades

Infecciosas y Parasitología Antonio Vidal / OPS/OMS, Tegucigalpa, Honduras, Segunda Ed. 2009. Available at http://www.bvs.hn/Honduras/IAV/Manual%20IAV%202009.pdf (Accessed October 2014). 6. Manual de Procedimientos Operativos Estándar para el Diagnóstico Microscópico de la Malaria.J Alger, ML Matute, RE Mejía. Departamento de Laboratorio Nacional de Vigilancia, Secretaría de Salud, Tegucigalpa, Honduras, 2006. Available at http://www.bvs.hn/Honduras/Relampago/Manual_POE_Malaria_Honduras_2006.pd f (Accessed October 2014).