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[08/05/2005]
 Cape Verde | |
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Dr Francis Louis, IMTSSA, Marseille
– Acknowledgements : Dr Yves Guelfi, CMS, SCAC, CP
82 Praia, République du Cap-Vert
Last updated : 9th January 2001
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General Statistics
Area: 4,030 km²
Population of the Archipelago: 406,675
inhabitants
Capital: Praia (110,989 inhabitants)
Other towns: Santa Catarina (44,702 inhabitants),
Santa Cruz (26,423 inhabitants) and Tarrafal (26,875 inhabitants)
on the island of Santiago ; Sao Filipe on the island of Fogo ;
Mindelo on the island of Sao Vincente ; Ribeira Grande, Porto Novo
and Paul on the island of Santo Antao and Espargos on the island of
Sal (international airport)
Currency: Cape Verde escudo
Official Language: Portuguese
Out of 192 countries, Cape Verde ranks 122nd for life expectancy,
120th for infant mortality, 116th for GNP, 79th for daily calorie
intake, 141st for literacy, 109th for the percentage of children in
full-time education (source: Atlas Encyclopédique Mondial, Nathan
Ed., Paris 1996, pp.118-119).The climate is of the tropical-dry
type, saharo-sahelian. The average monthly temperature varies from
19°C in January-February to 30°C from August to October. It is
during these 3 months that some rain falls but in general they do
not exceed 100mm per month. | Epidemiological Facies
Plasmodium falciparum is the only
identified parasite on Cape Verde. The rare cases of malaria due
to Plasmodium malariae
or Plasmodium ovale are all
imported cases.
Malaria is of the unstable, desert type according to the
classification of J. Mouchet and Coll. (3),This signifies that the
transmission is short and uncertain, with much variation from one
year to another and there is little advance warning for the
populations. There is a major risk of epidemic and the Island of
Santiago is regularly hit.
Island
Island | 1988 | 1989 | 1990 | 1991 | 1992 | 1993 | 1994 | 1995 | 1996 | 1997 | | Santiago | 784 | 153 | 66 | 75 | 35 | 43 | 16 | 126 | 76 | 17 | | Sao Vicente | 0 | 0 | 0 | 5 | 1 | 1 | 3 | 0 | 1 | 2 | | Sal | 0 | 0 | 0 | 0 | 2 | 0 | 0 | 0 | 0 | 1 | | Fogo | 0 | 0 | 2 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | | Sao Nicolau | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | | Santo Antao | 0 | 0 | 0 | 0 | 0 | 0 | 2 | 0 | 0 | 0 | | Maio | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | | Boa Vista | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | | Brava | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | | Total | 784 | 153 | 69 | 80 | 38 | 44 | 21 | 127 | 77 | 20 |
These statistics from the « Programme National de Lutte contre le
Paludisme » (4a)(National Program for the Fight Against Malaria)
show two waves of epidemics, in 1988-1989 and in 1995, but more
importantly that the island of Santiago accounts for 1,391 of the
1,413 notified cases of malaria in 10 years (98.4%). The 22 other
notified cases from the other islands were all introduced
cases.
| Vectors
In 1982, F.J.C. Cambournac et al. identified Anopheles arabiensis
on the islands of Maio, Fogo, Boa Vista, Sao Nicolau and
importantly on Santiago (2a). In Santiago, it is the unique malaria
vector. It is found in all zones on the island inferior to 500m of
altitude. Its reproduction occurs in the shallow wells, in standing
water, irrigation canals, and temporary accumulations of
water.
Jacques Brunhes and Coll.(Les anophèles de la région
afro-tropicale, logiciel ORSTOM Ed., 1998) compiled a list of two
species of anopheles in the archapelago: Anopheles
arabiensis and Anopheles pretoriensis, which is not a malaria
vector.
| Chemoresistances
Chloroquine remains effective in autochthonous cases.
There have been no recorded cases of resistance to quinine,
mefloquine nor to the sulfadoxine-pyrimethamine combination.
| Vector Control
Anti larvae action occurs systematically in the islands that are
prone to disease . This is carried out using Gambusia afinis when
possible, abate for the drinking water and diesel for non drinkable
water (4a).
There is no systematic anti-imago control.
| The National Anti Malaria Program
The National Anti Malaria Program is directed by Dr Joana Baptista
Alves who has an annual budget of 30,000 $US at his disposal. The
team is composed of Dr Alvez and two laboratory technicians at
headquarters and 14 of "concelhos" of polyvalent staff: the fight
against malaria is part of the integrated activities.
The archipelago is divided into layers:
Layer 1: altitude higher than 500 m or absence of malaria
vectors
Layer 2: altitude lower than 500 m, rural zone presence of vectors,
possible immigration of malaria infected people.
Layer 3: altitude lower than 500 m, suburban zone, presence of
vectors, permanent immigration of malaria infected people.
The islands of Santo Antao and Brava are in layer 1, those of Maio,
Boa Vista, Sao Nicolau and Fogo in layer 2. The islands of Sal and
Sao Vicente are in layers 1 and 3. Santiago has zones present in
all three layers.
The 1999 Action Plan set up by the PNLP
includes:
Vector Control
The screening of imported cases
Taking on the care of people diagnosed with the
illness.
An epidemiological inquiry to be held into each case
I.E.C action.
Treating boats and aircraft for insects.
| Research Institutions
There is currently no malaria research being held on the
archipelago.
| Advice to travelers
The « Bulletin épidémiologique Hebdomadaire » n°23/99 states that
the Cape-Verde islands are in chemoresistance group 1, and are thus
characterized as a zone without resistance to chloroquine. A
prophylaxis of chloroquine on its own is therefore suitable.
In fact, this Chemoprophylaxis doesn’t seem necessary outside the
months of August September and October. The circumstances of the
trip must also be taken into account: humid season Vs dry ? Staying
in towns or in the countryside ? Staying at a hotel or in a
traditional dwelling ? More often than not simple measures of
precaution against mosquito bites are largely sufficient.
| Bibliography
(only the first author is mentioned)
1. RIBEIRO H. - Os mosquitos de Cabo Verde (Diptera : Culicidae).
Sistematica, distribuiçao, bioecologia e importância médica. Junta
de Investigaçoes do Ultramar, Lisbon, 1980.
2a. CAMBOURNAC F.J.C. - Anopheles arabiensis in the Cape Verde
archipelago. Parassitologia 1982 ; 24 : 265-267.
2b. CAMBOURNAC F.J.C., SANTA RITA VIEIRA H., COUTINHO M.A. et Coll.
- Note sur l'éradication du paludisme dans l'île de Santiago
(République du Cap-Vert). An. Inst. Hig. Med. Trop. 1984 ; 10 :
23-24.3. MOUCHET J. - Typologie du paludisme en Afrique. Cahiers
Santé 1993 ;
3 : 220-238.
4a. ALVES J. - Relatorio, 1998. Doc. Ministère de la Santé,
Programme National de Lutte contre le paludisme, janvier
1999.
4b. ALVES J. - Plano de acçao, 1999. Doc. Ministère de la Santé,
Programme National de Lutte contre le paludisme, janvier
1999.
4c. AREZ A.P. - A clonal Plasmodium falciparum population in an
isolated outbreak of malaria in the Republic of Cabo Verde.
Parasitology 1999 ; 118 : 347-355.
5. KASSANKOGNO Y. - Aperçu sur le programme de lutte africain pour
la période 1996-1997. Malaria and Infectious Diseases in Africa
1999, n°9bis : 52-61.
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Version française 
