Impact of imported malaria on the burden of disease in Northeastern Venezuela

Background. Many countries throughout the world are reporting an increasing number of imported malaria cases. It is now well documented that population movements play an important role in the spread and introduction of malaria infection in nonendemic areas. Methods. We evaluated the contribution of imported malaria to the overall malaria burden of disease in an already endemic malaria region in Venezuela, where malaria is exclusively caused by Plasmodium vivax. To estimate the magnitude of this contribution, we retrospectively analyzed cases of imported malaria in Sucre, Venezuela, during a 10-year period (1987-1998). Results. During this period, 1,755 (3.8% of the total) cases of imported malaria were identified. Most of these cases were imported from the Meridian states into Sucre. In Latin America, a major factor in the reemergence and spread of malaria is human migration. Surveillance of imported cases of malaria in Venezuela would allow us to continue evaluating population migration dynamics and its epidemiologic impact on malaria transmission. Conclusion. Enhanced surveillance, such as the one shown in this study, would help the early identification of nonindigenous Plasmodium species and also of resistant Plasmodium strains with a potential to spread locally. Population mobility and imported malaria cases may add to the magnitude of malaria burden in some regions of Latin America. Furthermore, malaria treatment guidelines at local and national levels need to incorporate imported malaria cases in their treatment algorithms and into chemoprophylactic recommendations for travelers.