Friday, December 16, 2011

Communicable disease trends in the Maldives

Maldives is a small, developing country that highly depends on tourism and fisheries as major economic resources. Maldives, being located in the tropics is subjected to tropical diseases such as malaria, filaria, dengue, leprosy, tuberculosis etc. There was a high prevalence of such communicable diseases in the Maldives, two decades back. With the remarkable achievements in the prevention and control of communicable diseases, Maldives is now experiencing a shift in health trends towards non-communicable diseases.

The incidence of communicable diseases in the Maldives has notably declined as a result of effective disease control programs. Since 1984, Maldives has remained malaria free. Leprosy and Filaria has been brought under control. The introduction of multidrug therapy in the 1983 has controlled the spread of leprosy. Both leprosy and filaria has reached the stage of zero transmission. The department of public health (DPH) is responsible for the control of vector borne disease in the Maldives. DPH conducts programs to control and eliminate locally endemic diseases including malaria, filaria, tuberculosis (TB) and leprosy.

Mosquito control
TB had been found to be one of the most fatal respiratory infections. However, the incidence of TB has reduced considerably through the past years and since 1996, the case-fatality has been zero. The main goal of the TB control program (to reduce the prevalence from 0.66 to 0.26 per 1000 population) has now been reached. The incidence of TB in children is negligible due to high coverage of BCG vaccination.

Scrub typhus was first reported in the Maldives, in the 1940's during World War II. The British soldiers in the military base in Addu atoll were victims of scrub typhus. The disease has re-emerged in the Maldives in 2002, after a period of 58 years since its last outbreak. The Maldivian government has taken measures to increase awareness about the disease. Due to better case management, the fatality rate has decreased.

Viral fevers account for a significant cause of morbidity in the Maldives. Dengue continues to be an epidemic in the Maldives. There have been a number of reported cases of dengue fever and dengue hemorrhagic fever in the past few years. In 2006, an outbreak of chikungunya was also reported. Mosquito borne diseases are much commonly found in the islands. The department of public health is conducting vector control programs to control and prevent communicable diseases in the capital and other islands of Maldives.
Dengue awareness
The establishment of Male' Water Supply and Sewerage project is sustaining the provision of safe drinking water and sewerage management in capital and other islands. Food and water borne diseases such as diarrheal diseases along with intestinal parasitic diseases are common in the Maldives. Diarrhea is a major health issue in the Maldives and the morbidity from the disease is high.

MWSC: supplies safe drinking water

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