SESAI intensifies the fight against malaria in villages of the Yanomami Indigenous Land
The reduction of malaria cases is one of the targets agreed upon in the Yanomami District Indigenous Health Plan (PDSI) and a matter taken very seriously by the Special Secretariat of Indigenous Health (SESAI) of the Ministry of Health. Strategic actions to combat the mosquito that transmits malaria are being intensified in the Special Indigenous Sanitary District (DSEI) Yanomami. The District has drawn up an Emergency Malaria Control Action Plan which is being carried out in ten Base Poles where epidemiological research has indicated the places with the highest incidence of the disease.
"This Plan is for the 10 priority Base Poles according to epidemiological stratification, but it encompasses the entire District. We have been articulating with all sectors to expand and cover the goals agreed upon in the PDSI," says the head of the Indigenous Health Care Division (DIASI) of the Yanomami DSEI, Pedro Galdino.
The Plan provides strategies to combat the mosquito that transmits the disease and prevention actions in the communities of the Yanomami Indigenous Land. The Yanomami DSEI has been testing the population to identify where there are transmission focuses. Since 2019 mass testing is being carried out and more than 100,000 slides of blood samples have been collected for epidemiological investigation of malaria and early diagnosis. In addition to the active search for positive cases, the teams have been taking orientation on prevention and educational actions with the support of indigenous interpreters.
In addition, mosquito nets impregnated with long-lasting insecticides (MILD) from the Ministry of Health are being distributed. Approximately 1,500 impregnated mosquito nets have been installed in villages this year alone. This equipment protects against various insects that also transmit other diseases such as dengue and yellow fever.
The agents to combat endemic diseases are spraying the xaponas (straw houses), fumigation with spatial nebulization in the external area of the villages and draining puddles of stagnant water that can become breeding grounds for the mosquito vector. The DSEI has also hired, this year, six more agents and a pharmacist to reinforce a team of 48 professionals who work in the control of tropical diseases.
Through the laboratory examination of the thick drop using a microscope, it is possible to identify which of the four types of malaria has infected the patient. Treatment with antimalarial drugs is started immediately by the Multidisciplinary Indigenous Health Teams (EMSI) with supervised medication from the Unified Health System (SUS).
Malaria is a tropical disease caused by the plasmodium protozoan parasite that infects the Anopheles mosquito. The disease is transmitted to humans through the bite of the female mosquito. The best form of prevention is to protect yourself from the insect, at dusk and dawn, and to control the vectors of transmission. It is not a contagious disease, being transmitted only by blood, and there are four types of malaria, falciparum being the most serious case.
The Yanomami DSEI serves more than 28 thousand indigenous people in the middle of the Amazon forest between the borders of Roraima and Amazonas and the border with Venezuela. It has more than 700 health professionals working in home visits and in 78 Basic Indigenous Health Units (UBSI), 37 Base Poles, and a Yanomami Indigenous Health Support House (CASAI).
In 2020, during the pandemic, the District received from the Special Secretariat of Indigenous Health (SESAI), of the Ministry of Health, more than R$ 113 million in investments for basic health care, sanitation, hiring professionals, and the acquisition of medical supplies and materials.
In parallel to the actions to combat malaria, the DSEI has intensified the vaccination coverage in 19 Yanomami villages against immuno-preventable diseases through the Indigenous Peoples´ Vaccination Month Campaign (MVPI), held from April 29 to May 14. The DSEI seeks to achieve immunization of 87.5% of the target audience, the goal set by the Immunization Program (PNI), of the Ministry of Health, for the year of 2021.
The MVPI is a strategy used to intensify vaccination in indigenous areas in order to improve vaccination coverage, especially in areas of difficult access and with low vaccination coverage for diseases such as rubella, measles, among others. The balance of this year´s campaign should be out by the end of June. In 2020, the goal was 86% and the DSEI Yanomami reached 92.6% of the target audience.
Despite the difficulty of access to the villages in the middle of the forests, to date, the DSEI has immunized 79% of the indigenous people aged 18 years or older, enrolled in the Indigenous Health Care Subsystem (SASISUS) and specificities of ADPF 709, and 58% with the second dose. The teams spend 15 to 30 days in the area and, only when they return to the DSEI headquarters, the data are entered into the Information System of the National Immunization Program (SI-PNI).