Role of residual spraying for malaria control in Belize.

We studied the impact of reduced residual spraying in Belize by developing a logistic regression model on relationships between numbers of houses sprayed (mostly with DDT) and numbers of malaria cases. We defined the "minimum effective house spray rate" (MEHSR) as the level of spraying that will prevent increases in malaria rates for a defined population. Under the total coverage approach (all houses sprayed), the MEHSR for Belize was 134.6. The model also showed that the odds for decreasing malaria is 1.086 for each increase of 10 houses sprayed per 1,000 population. In further testing, highly significant and differential changes in malaria rates were documented for paired groups of years with house spray rates that were either above or below the MEHSR. Numbers of malaria cases since 1995 are used to show how stratification methods are used in Belize to spray fewer houses (at levels below the MEHSR of 134.6).

Evaluation of intervention programmes cholera epidemic Belize, 1992-94

Shortly after the cholera epidemic started in Peru late January or early February, 1991 programme managers were summoned to an emergency meeting called by the Minister of Health, Belize. A national committee was formed and its main role was to direct and standardize intervention programs in the wake of a cholera epidemic and to advise the minister accordingly. A national plan for the prevention and control of cholera was developed. Approximately one year later (11th January, 1992) Belize witnessed its first case and within the next five months cholera was established in Belize Country. Six intervention programmes went into full gear. These were epidemiological surveillance, laboratory diagnosis, water and sanitation, food safety, medical services and case management and health education and public information. The cholera epidemic was confined to the western and southern districts bordering Guatemala which at that time was experiencing several cases and deaths due to cholera. Two K.A.P.B. surveys were conducted in the two southern districts and the one in the west. Two localities selecting 50 respondents each was used from these districts. Comparisons of these results showed marked differences in knowledges, attitude, practices and behavior with regard to information on cholera per se. The post survey results are clearly an improvement over the former as these same target populations working in partnership with the authorities were able to gradually decrease the incidence of cholera from 158 in 1992 to 135 in 1993 and 6 cases in 1994 with only 8 deaths during the period.(AU)