Malaria In Belize: What You Need To Know

Belize is a country in Central America, sharing borders with Mexico to the north, Guatemala to the south and west, and Honduras to the east. It has a population of approximately 400,000 people and is classified as a developing, upper-middle-income nation. In June 2023, the World Health Organization (WHO) certified Belize as malaria-free, following over 70 years of efforts to eradicate the disease. This success is attributed to strong surveillance, access to diagnosis, effective vector control methods, and cross-border collaboration with neighbouring countries. While this is a significant achievement, it is important to remain vigilant as the risk of malaria re-establishment remains.

Belize was certified malaria-free by the WHO in 2023

Belize was certified as malaria-free by the World Health Organization (WHO) in 2023. This milestone was achieved after over 70 years of efforts to eradicate the disease. Belize is the fourth country in the Americas and the second in Central America to receive this certification in the last five years.

The last reported death due to malaria in Belize was in 2006, and the last indigenous case was reported in December 2018. Since then, the country has continued to invest in preventing the re-establishment of malaria transmission. Belize's success in eliminating malaria is attributed to strong surveillance, access to diagnosis, effective vector control methods, and the crucial role of trained community health workers.

Vector control interventions in selected areas at higher risk of malaria importation, along with multisectoral collaboration, have been vital in the early detection of imported cases among seasonal workers. Additionally, Belize has focused on training health staff to maintain malaria suspicion and educating the public on recognizing the signs and symptoms of malaria to seek timely medical attention.

The country's anti-malaria campaign has been supported by the Pan American Health Organization (PAHO) and the Global Fund to Fight AIDS, Tuberculosis, and Malaria. Belize's collaboration with neighboring countries, such as Mexico and Guatemala, has also been instrumental in its success.

The WHO's malaria-free certification recognizes that a country has shown rigorous, credible evidence that the chain of indigenous malaria transmission by Anopheles mosquitoes has been interrupted nationwide for at least three consecutive years. Belize's achievement is a testament to its effective investments in malaria control and collaboration at the country, regional, and global levels.

The last indigenous malaria case was reported in December 2018

Belize was certified as malaria-free by the World Health Organization (WHO) in 2023. The country had been working towards eliminating the disease for over 70 years. This was achieved through strong surveillance, access to diagnosis, effective vector control methods, and trained community health workers. The last indigenous malaria case was reported in December 2018.

Belize's success in eliminating malaria is a significant achievement and serves as an inspiration for other endemic countries in the Americas. The country's efforts included surveillance to ensure prompt diagnosis, treatment, investigation, and timely response, as well as vector control interventions in selected areas at higher risk of malaria importation. Additionally, Belize invested in multisectoral collaboration towards the early detection of imported cases among seasonal workers and trained health staff to maintain malaria suspicion.

The last death due to malaria in Belize was reported in 2006. Since December 2018, the country has had zero indigenous malaria cases and continues to invest in preventing the re-establishment of malaria transmission. Belize's anti-malaria campaign has been supported by USAID and PAHO, contributing to the Disease Elimination Initiative, which aims to eliminate more than 30 communicable diseases, including malaria, in the Americas by 2030.

The certification of malaria elimination by the WHO is an official recognition that a country has interrupted the chain of indigenous malaria transmission by Anopheles mosquitoes nationwide for at least the past three consecutive years. This certification is granted when a country provides rigorous, credible evidence of its malaria-free status, along with an operational national surveillance system capable of rapidly detecting and responding to any malaria cases.

Vector control interventions are used in areas at higher risk of malaria

Vector control is a highly effective way to reduce malaria transmission and is a vital component of malaria control and elimination strategies. The WHO recommends the deployment of either insecticide-treated nets (ITNs) or indoor residual spraying (IRS) for malaria vector control in most areas at risk. These interventions may be supplemented by additional interventions such as larviciding, depending on the setting and available resources. Since 2000, more than 2 billion ITNs have been delivered to malaria-endemic countries, contributing significantly to the decline in malaria incidence. IRS has also played an important role in malaria control, although its contribution has been more modest compared to ITNs.

However, the gains made in malaria control through vector control interventions are threatened by the spread of resistance to insecticides among Anopheles mosquitoes. Therefore, urgent action is needed to mitigate and manage insecticide resistance and develop new tools, technologies, and approaches for vector control. This includes the need for novel vector control approaches targeting outdoor biting anopheline communities, as indoor chemical control tools may no longer be adequate due to changes in vector behaviour.

There are rare locally transmitted cases of malaria in Belize

Belize was certified as malaria-free by the World Health Organization (WHO) in 2023. This certification was the result of over 70 years of efforts to eradicate the disease. Since December 2018, there have been zero indigenous cases of malaria in Belize. This success is attributed to strong surveillance, access to diagnosis, effective vector control methods, and the crucial role of trained community health workers.

Despite this impressive achievement, it is important to note that there are still rare locally transmitted cases of malaria in the country. The US Centers for Disease Control (CDC) has reported rare locally transmitted cases of malaria in some areas of Belize, specifically in parts of Stan Creek. However, there have been no cases reported in Belize City and the islands frequented by tourists, such as Ambergris Caye.

The species of malaria present in Belize is P. vivax, and the risk of transmission is very limited. The CDC recommends mosquito bite prevention as the primary means of protection in the risk areas. Additionally, there is no drug resistance associated with the malaria species in Belize, and no chemoprophylaxis is recommended for travellers to the country.

While Belize has successfully eliminated indigenous malaria cases, maintaining this status requires continuous investment in prevention and surveillance to prevent the re-establishment of transmission. The country continues to invest in surveillance, vector control, multisectoral collaboration, and health staff training to maintain its malaria-free status.

Mosquito avoidance is recommended for travellers to Belize

Belize has been certified as malaria-free by the World Health Organization (WHO), but mosquitoes can still spread other diseases, such as Zika and dengue fever, so mosquito avoidance is still recommended for travellers to Belize.

• Use a good-quality insect repellent containing one of the following active ingredients: DEET (N,N-Diethyl-m-toluamide), Picaridin (also known as KBR 3023, Bayrepel, and icaridin), Oil of Lemon Eucalyptus (OLE), or Para-Menthane-Diol (PMD).
• Apply insect repellent to all exposed skin not covered by clothing.
• If also using sunscreen, apply the repellent after the sunscreen.
• Reapply repellent regularly, especially if you notice mosquitoes flying close to or landing on your skin.
• Reapply after swimming, washing, or excessive sweating.
• When applying repellent to your face, spray it onto your hands first and then rub it onto your face, avoiding your eyes.
• Keep repellent away from synthetic clothes or plastics, as it may damage them.
• Wear loose-fitting, long-sleeved shirts and long pants. Mosquitoes may bite through tight clothing.
• Treat clothing and gear (such as boots, socks, and tents) with permethrin, an insecticide that repels and kills mosquitoes. Alternatively, buy pre-treated clothing and gear.
• Stay and sleep in air-conditioned or well-screened rooms.
• Use a mosquito net if sleeping outdoors or in an unscreened room. Choose a net that is compact, white, rectangular, with 156 holes per square inch, and long enough to tuck under your mattress. Treat the net with an insecticide for added protection.
• Reduce the number of mosquitoes in and around your accommodation by eliminating standing water, where mosquitoes lay their eggs.

In addition to these measures, it is also important to be aware of the symptoms of mosquito-borne illnesses and to seek medical advice if you experience any of them during or after your trip.

Frequently asked questions