By NewsDesk  @infectiousdiseasenews

Strategic actions to combat the malaria-transmitting mosquito are being intensified in the Yanomami Special Indigenous Sanitary District (DSEI). The district drew up the Action Plan for Emergency Malaria Control, which is already being carried out in ten Base Poles, where epidemiological investigation pointed out as places with the highest incidence of the disease.

Image/CDC

The reduction of malaria cases is one of the goals agreed upon in the Yanomami District Plan for Indigenous Health, formulated by the DSEI, with support from the Ministry of Health, through the Special Secretariat for Indigenous Health (SESAI). “This action is for the ten priority Base Poles according to epidemiological stratification, but it encompasses the entire district. We have been articulating with all sectors to expand and cover the goals agreed upon in the plan”, says Pedro Galdino, head of the Indigenous Health Care Division (DIASI) of the DSEI Yanomami.

The plan includes strategies to fight the transmission of malaria and prevention actions in the communities of the Yanomami Indigenous Territory. The DSEI has been carrying out population testing to identify where there are major sources of transmission. Mass testing has been carried out since 2019 and more than 100,000 slides of blood samples have been collected for epidemiological investigation of malaria and early diagnosis. In addition to the active search for positive cases, the teams have provided guidance on prevention and educational actions with the support of indigenous interpreters.

In addition, mosquito nets with long-lasting insecticides from the Ministry of Health are being distributed. Approximately 1,500 mosquito nets were installed in villages this year alone. These devices protect against various insects that also transmit other diseases such as dengue and yellow fever.

The agents to combat endemic diseases are spraying the xaponas (straw houses), misting with mist in the area outside the villages and draining still water puddles that can become breeding grounds for the transmitting mosquito. This year, the DSEI also hired another six agents and a pharmacist to reinforce a team of 48 professionals working in the control of tropical diseases.


PREVENTION AND TREATMENT

Through laboratory examination of thick drop, with the aid of a microscope, it is possible to identify, among the four types of malaria, which infected the patient. Treatment with antimalarials is started immediately by the Indigenous Health Multidisciplinary Teams with supervised medication from the Unified Health System (SUS).

Malaria is a tropical disease caused by the protozoan plasmodium that infects the Anopheles mosquito. The disease is transmitted to humans by the bite of a female mosquito. The best form of prevention is to protect yourself from the insect, at dusk and dawn, and to control the circulation of transmission vectors. It is not a contagious disease, being transmitted solely by blood. There are four types of malaria, with falciparum being the most serious case.

The DSEI Yanomami serves more than 28,000 indigenous people in the middle of the Amazon rainforest, between the border between Roraima and Amazonas, on the border with Venezuela. The district has more than 700 health professionals working in home visits and in 78 Basic Indigenous Health Units (UBSI) of 37 Base Centers and a Yanomami Indigenous Health Support House (CASAI).

In 2020, to fight the pandemic, the Ministry of Health transferred more than R$ 113 million to the Yanomami district to reinforce basic health care, sanitation, hiring professionals and purchasing supplies and medical-hospital materials.

INDIGENOUS VACCINATION

In parallel with the actions to combat malaria, the DSEI Yanomami intensified vaccination coverage in 19 villages against vaccine-preventable diseases through the Indigenous Peoples Vaccination Month Campaign, held between April and May. The district seeks to achieve immunization of 87.5% of the target audience, a goal stipulated by the National Immunization Program (PNI) for 2021.

The campaign is a strategy used to intensify vaccination in indigenous areas with a view to expanding immunization, especially in areas with difficult access and low vaccination coverage for diseases such as rubella, measles, among others. In 2020, the goal was 86% and DSEI Yanomami reached 92.6% of the target audience.

Despite the difficulty of accessing villages amidst the forests, the DSEI has already immunized against Covid-19, so far, 79% of indigenous people over 18 years old, enrolled in the Subsystem for Indigenous Health Care (SASISUS) and specificities of ADPF 709, and about 58% with the second dose. The teams spend 15 to 30 days in the area and, only when they return to the DSEI headquarters, with internet access, are the data entered into the Information System of the National Immunization Program (SI-PNI).