Belize's Malaria Mystery: Unraveling The Country's Unique Health Challenge

Belize was certified as a malaria-free country by the World Health Organization (WHO) in 2023. The country had zero indigenous malaria cases since December 2018 and has since been investing in the prevention of the re-establishment of malaria transmission.

However, there are still some risks of contracting other diseases in Belize, such as the Zika virus, dengue fever, and chikungunya. It is recommended that travellers to Belize take necessary precautions, such as getting vaccinated and practising mosquito bite avoidance.

Malaria prevention measures in Belize

Belize is a high-risk country for malaria, and there are several measures that travellers can take to prevent infection.

The CDC recommends that travellers to Belize take antimalarial medication. It is important to consult a doctor about which medication is most suitable for your itinerary, as different types of malaria parasites are active in different areas. It is also important to start taking the medication before travelling to a malaria-prone area, as parasites can enter the body from a mosquito bite and linger in the body.

In addition to medication, there are other measures that can be taken to prevent mosquito bites and reduce the risk of malaria. These include:

• Wearing long-sleeved shirts, long pants, hats, and other clothing that covers most of the body.
• Using insect repellent containing at least 20% DEET.
• Using permethrin-treated clothing and gear, such as boots, pants, socks, and tents.
• Staying and sleeping in air-conditioned or screened rooms.
• Using a mosquito bed net, preferably insecticide-treated, if sleeping in an area exposed to the outdoors.

It is also important to be aware of the symptoms of malaria, which include fever, chills, and flu-like symptoms. If you experience any of these symptoms, seek medical help immediately.

Belize's malaria-free certification

On 21 June 2023, Belize was certified as malaria-free by the World Health Organization (WHO), marking the culmination of the country's over 70 years of dedicated efforts to eradicate the disease. This certification serves as a testament to Belize's successful malaria control initiatives and collaborative efforts with regional partners.

The achievement of malaria-free status in Belize is a significant milestone, as it is the fourth country in the Americas and the second in Central America to attain this distinction in the last five years. Belize's success in eliminating malaria is attributed to several key factors, including strong surveillance systems, improved access to diagnosis, and effective vector control methods. The country also benefited from the collaboration between its national malaria programme and the Belize Vector Ecology Center, which provided crucial information on the distribution and insecticide resistance of malaria-carrying mosquitoes.

In addition, Belize's strategic focus on enhanced surveillance among high-risk populations, cross-border collaboration with neighbouring countries, and participation in regional initiatives all contributed to its successful elimination of malaria. The country's efforts were further bolstered by technical cooperation from the Pan American Health Organization (PAHO) and financial support from organisations such as the Global Fund to Fight AIDS, Tuberculosis and Malaria.

The WHO's malaria-free certification is a formal acknowledgment of a country's ability to interrupt the chain of indigenous malaria transmission by Anopheles mosquitoes for at least three consecutive years. It also requires the presence of a robust national surveillance system capable of detecting and responding to any potential malaria cases, along with a comprehensive programme to prevent the re-establishment of the disease.

Belize's accomplishment in eradicating malaria is a testament to the country's commitment to public health and the effectiveness of its malaria control strategies. This milestone not only inspires other endemic countries in the region but also brings us one step closer to the dream of a malaria-free future.

Diseases spread by mosquitoes in Belize

Belize is home to a variety of mosquito-borne diseases, which can pose a risk to travellers and locals alike. Here is some detailed information on the mosquito-borne diseases present in Belize:

Malaria

Malaria is a risk in some parts of Belize. It is caused by a parasite transmitted to humans through the bites of infected mosquitoes. The disease can be deadly if not treated promptly. Symptoms of malaria include fever, headache, chills, and sweating. To protect yourself from malaria, it is recommended to use insect repellent containing DEET, wear long-sleeved shirts and long pants, and sleep under a bed net. Antimalarial medication may also be prescribed by a doctor for those travelling to malaria-risk areas.

Dengue Fever

Dengue fever is another mosquito-borne viral illness present in Belize. The symptoms of dengue fever include high fever, severe joint and muscle pain, headache, rash, nausea, and fatigue. There is currently no vaccine available for dengue fever, so prevention focuses on avoiding mosquito bites. This can be done by wearing protective clothing, using insect repellent, and eliminating mosquito breeding sites.

Zika Virus

The Zika virus is transmitted by Aedes mosquitoes, which are common in towns and cities. While the illness is usually mild, it can cause serious birth defects if a pregnant woman is infected. To prevent Zika, it is recommended to use mosquito repellent, wear protective clothing, and eliminate mosquito breeding sites.

Chikungunya Virus

The Chikungunya virus is transmitted by Aedes mosquitoes and is also present in Belize. Symptoms include fever, severe joint pain, headache, muscle pain, and rash. Vaccination and insect repellent are recommended to prevent this disease.

In addition to these mosquito-borne illnesses, Chagas disease, transmitted by the assassin bug, and leishmaniasis, transmitted by sand flies, are also arthropod-borne diseases found in Belize.

Vaccinations for Belize

Belize is a vibrant country with a rich culture and nature, offering a little something for every type of traveller. However, it is important to take certain health precautions before visiting the country.

The CDC and WHO recommend the following vaccinations for Belize:

• Typhoid
• Hepatitis A
• Polio
• Yellow Fever
• Chikungunya
• Rabies
• Hepatitis B
• Influenza
• COVID-19
• Pneumonia
• Meningitis
• Chickenpox
• Shingles
• Tdap (tetanus, diphtheria and pertussis)
• Measles, Mumps and Rubella (MMR)

Some of these vaccinations are mandatory, while others are recommended. Here is some more information about a few key immunisations:

Typhoid

The typhoid vaccination is available as a shot or an oral vaccine. The shot lasts for 2 years, while the oral vaccine lasts for 5 years. The oral option must be kept refrigerated and requires the ability to swallow pills. Typhoid is caused by contaminated food and water in areas with poor sanitation.

Hepatitis A

The Hepatitis A vaccination is recommended for most travellers. It is a contagious liver infection, typically spread through the ingestion of contaminated food or water, or close contact with an infected person. Symptoms include fatigue, stomach pain, and jaundice.

Polio

The polio vaccination is required if arriving from a region with active polio transmission. It is considered a routine vaccination for most travel itineraries, and a single adult booster is recommended.

Yellow Fever

The yellow fever vaccination is required if travelling from a country with a risk of yellow fever transmission.

Chikungunya

Belize is a high-risk region for chikungunya, which is transmitted by Aedes mosquitoes. Vaccination is recommended, especially for travellers aged 65 or older, with underlying medical conditions, or planning to stay in the country for an extended period.

Rabies

Rabies is spread through the saliva of infected animals, especially dogs, cats, bats, and monkeys. Belize is a high-risk country for rabies, and the vaccination is recommended for long-term travellers and those who may come into contact with animals.

Hepatitis B

The Hepatitis B vaccination is recommended for travellers to most regions. It is spread through infected blood, blood products, contaminated needles, medical instruments, and sexual intercourse.

Influenza

The influenza vaccination is recommended for travel to all regions, and the vaccine components change annually.

COVID-19

All eligible travellers should be up to date with their COVID-19 vaccinations.

Malaria

Malaria is a risk in some parts of Belize. If you are travelling to a malaria-risk area, consult a healthcare professional and fill your malaria prescription before departing.

In addition to these vaccinations, it is important to take other health precautions when visiting Belize. This includes practising food and water safety, avoiding insect bites, and preventing and treating animal bites.

Healthcare in Belize

Belize's healthcare system has been subjected to several reforms over the years, with a focus on improving the standard of healthcare in the country. The system comprises both publicly and privately run healthcare facilities, financed through public and local private health insurance schemes. The Ministry of Health (MoH) is the government agency responsible for overseeing the entire health sector and is also the largest provider of public health services in Belize.

Public Healthcare in Belize

The public healthcare system in Belize offers affordable care to the majority of Belizeans, with a strong focus on providing quality healthcare through a range of public programs and institutions. The MoH offers free or very inexpensive healthcare services to Belizeans, with a particular emphasis on accessibility and quality improvement. There are eight major public hospitals and around 60 public clinics in Belize, although these remain underfunded, understaffed, and under-supplied. The highest level of care is offered in Belize City, where most of the country's 24/7 hospitals are located, including the premier public healthcare provider, the Karl Heusner Memorial Hospital (KHMH). Outside of Belize City, there are seven additional hospitals located within the capitals of each of the seven other districts, providing a more limited range of services. Additionally, there is a network of approximately 60 public health clinics that provide primary medical and dental care to rural areas. However, these clinics often suffer from inadequate staffing, lack of financial resources, and a lack of equipment and medicine, resulting in reduced access to quality care.

Private Healthcare in Belize

The private health sector in Belize provides care to a smaller portion of the population but at a relatively low cost, similar to the public sector. There are three main private hospitals in Belize: La Loma Luz Hospital, Belize Medical Associates, and Universal Health Services. In total, there are around 100 private hospital beds in the country. The private sector has grown in recent years, especially in urban areas, and offers a more comprehensive range of secondary and tertiary healthcare facilities. The coverage provided by private healthcare facilities is extensive, but the costs are high. The private sector also accepts medical insurance plans, and some international health insurance policies cover the cost of treatment in these facilities.

Health Conditions in Belize

Belize faces several prevalent health conditions, including malaria, dengue fever, gastroenteritis, cholera, and HIV/AIDS. As a developing country, many of these conditions are related to issues surrounding infrastructure and sanitation, as well as a general lack of education and awareness about how these conditions are acquired and transmitted. There are also concerns about potential future outbreaks of malaria, dengue fever, cholera, and HIV/AIDS due to the country's fragile infrastructure and low population. Additionally, there is a high prevalence of communicable diseases, respiratory diseases, and intestinal illnesses, as well as a high mortality rate from non-communicable diseases such as cardiovascular diseases. There has also been an increase in health problems related to human behavior and lifestyle, such as injuries, road traffic accidents, violence, adolescent pregnancy, abortions, sexually transmitted infections, and suicide. Other areas of concern include anaemia, malnutrition, growth retardation, diabetes, limited equity in access to healthcare, inefficient healthcare delivery, and limited capacity for policy formulation and regulation.

Vaccinations and Preventative Measures

The CDC recommends several vaccinations for travellers to Belize, including typhoid, hepatitis A, polio, yellow fever, chikungunya, rabies, hepatitis B, influenza, COVID-19, pneumonia, meningitis, chickenpox, shingles, Tdap (tetanus, diphtheria, and pertussis), and measles, mumps, and rubella (MMR). Additionally, mosquito-borne diseases such as dengue fever, Zika virus, and malaria are present in some regions, so insect repellent, netting, and protective clothing are recommended. It is also important to prioritise food safety by opting for fully cooked dishes, avoiding raw seafood, and choosing eateries with good hygiene practices.

Frequently asked questions