In an editorial in the May 2010 issue of the journal The Lancet Infectious Diseases, Tulane University malaria researchers urge action to eliminate malaria from Hispaniola, the last island in the Caribbean where the disease occurs regularly.
On Hispaniola, home to the nations of Haiti and the Dominican Republic, malaria is caused by a single mosquito-borne parasite, Plasmodium falciparum.
The authors say in the editorial that success in eliminating malaria from Hispaniola would demonstrate that it is possible to defeat malaria in other regions of the world where it remains a dire threat. There also is evidence in Haiti that the parasite is becoming resistant to chloroquine, an inexpensive treatment for the disease. Eliminating malaria now would save these impoverished nations from having to resort to more expensive drug therapies.
The authors advise that Haiti and the Dominican Republic should advance from basic mosquito control to more intensive methods.
"Key to the successful elimination of malaria on the island will be the strategic use of combinations of methods," say the authors. "Malaria elimination will require that every suspected case on the island be diagnosed and treated."
The authors recommend developing a system for quickly locating and diagnosing new cases; using control methods including insecticide-treated nets and spraying to prevent the spread of malaria; and educating the community to seek treatment for all fevers and support the elimination effort.
Success will require the "unwavering political will" of both governments on the island, and will "set a precedent for health diplomacy," say the authors, all faculty in the Tulane School of Public Health and Tropical Medicine. They are Joseph Keating, assistant professor of international health and development; Donald Krogstad, professor of tropical medicine; and Thomas Eisele, assistant professor of international health and development.