Transmission characteristics
Of a total population of 49.1 million, 10.9 million persons are at risk of malaria in Colombia. There were 72,697 reported malaria cases in 2022. About 61% of cases (44,216/72,697) were caused by P. vivax.1
Unlike other South American countries, the most malaria endemic regions are not in the Amazonian forest but lie in the northwest of the country in the Pacific coastal forests, populated by Afro-Colombian and indigenous communities. The main foci of malaria transmission in the country are located in the Departments of Chocó, Cauca, Nariño and the District of Buenaventura (50 to 60%), followed by Antioquia and Córdoba (20 to 30%), Amazonia (5 to 10%), and Orinoquia (5%).1
Transmission is unstable in some areas with variable and focal transmission in different eco-epidemiological regions. Malaria transmission is characterised by the presence of epidemic cycles that occur every 2 to 7 years, related to the occurrence of the Niño-Southern Oscillation phenomenon. Malaria control is particularly challenging in provinces where illegal mining, logging and the growing of illicit crops are conducted.1
Surveillance
Colombia aims to investigate all confirmed malaria cases. Reported cases were 71.5% of estimated cases in 2022.1 Epidemiological data is reported weekly for non-complicated malaria and immediately for severe cases through the epidemiological surveillance system (SIVIGILA). Strengthening of surveillance in the border area to the north with Panama has been undertaken.1
Colombia is part of the Amazon Network for Surveillance of Antimalarial Resistance (RAVREDA) and was supported by the United States Agency for International Development (USAID) through the Amazon Initiative against Malaria (AMI) project.1
2020 milestones/ malaria elimination
By 2017 Colombia had met its targets for at least a 40% reduction in malaria mortality and case incidence and it is projected to at least retain these gains by 2020.1
Objectives set by the Colombian Government include:1
- A reduction in malaria mortality of 80% in all territories in the period 2012–2021;
- Elimination of malaria in the province of Chocó, prioritizing 14 of the municipalities most affected by the disease by 2022;
- Elimination of malaria in all priority areas by 2022.
Treatment policy for P. vivax
Chloroquine followed by directly observed primaquine 0.25 mg/kg for 14 days for radical cure of P. vivax.2
Diagnosis and treatment is free of charge in the public sector.1
G6PD testing policy
There is no policy for G6PD testing before primaquine radical cure.
G6PD deficiency prevalence
The most frequent G6PD-deficient variant in Africa, known as G6PD*A−, seems to be also the most predominant in South America, and is thought to have been carried to South America in West African slaves. G6PD deficiency prevalence in Colombia is generally high (>5%) and predominantly G6PD*A−, probably reflecting the genetic heritage of African slaves.