Malaria control in the municipality of San Esteban, Honduras.

OBJECTIVES To assess the burden of malaria in San Esteban, Department of Olancho, Honduras, and provide recommendations for control. METHODS Malaria causes appreciable morbidity in San Esteban. In 2006, health workers reported an increase in malaria cases and requested recommendations for control. In 2005, 385 cases (Plasmodium vivax, 316; P. falciparum, 69) were detected from 4 007 blood smears in the San Esteban laboratory (slide positivity rate = 9.6%). During May-July 2006, we assessed the burden of malaria and made recommendations. We reviewed epidemiologic data from slide-confirmed malaria cases in 2005 and 2006 and conducted a knowledge, attitudes, and practices survey in households to assess malaria diagnostic, treatment, and prevention practices. RESULTS During May-July 2006, 143 laboratory-confirmed malaria cases were detected (P. vivax, 134; P. falciparum, 9) in San Esteban, compared with 104 (P. vivax, 79; P. falciparum, 25) in May-July 2005. From January 2005 to July 2006, 538 cases were detected in San Esteban, with increased frequency in May-October and the highest incidence in children 0-14 years old. We administered 112 surveys in 19 communities. Seventy percent of respondents reported a history of malaria in a household member, with the highest frequency reported in mothers (45%) and children under 14 years old (37%). Most households did not have mosquito protection such as bed nets, screens, or indoor residual insecticide. CONCLUSIONS Malaria is ongoing in San Esteban, with increased incidence in children. We recommend increased availability and promotion of insecticide-treated bed nets, improved timing and coverage of indoor residual spraying, and improved community malaria practices through education sessions.