Imported malaria in Cabo Verde (2010-2024): Risks to post-elimination stability

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Tropical Medicine

Background:

• Cabo Verde achieved official malaria-free certification by the World Health Organization (WHO).
• Sustained public health interventions and strategic malaria elimination efforts were key to certification.
• Imported malaria cases pose a persistent threat to maintaining malaria-free status.

Purpose of the Study:

• To analyze imported malaria cases in Cabo Verde from 2010 to 2024.
• To characterize the locations, origins, epidemiological trends, and spatial distribution of imported cases.
• To provide evidence for decision-making to prevent post-certification disease reintroduction.

Main Methods:

• Ecological time-series approach analyzing confirmed imported malaria cases (2010-2024).
• Data collected in collaboration with the National Malaria Control Program and Integrated Surveillance and Response Service.
• Joinpoint Regression Analysis for time trends, Holt-Winters models for forecasting, and spatial data visualization.

Main Results:

• A total of 383 imported malaria cases were reported between 2010 and 2024.
• A significant increasing trend in cases was observed from 2020 to 2024 (APC: +25.75%).
• Forecasts estimate approximately 80 imported cases annually for 2025-2026; most cases occurred on Santiago Island, originating primarily from Guinea-Bissau, Angola, Senegal, and Nigeria.

Conclusions:

• Malaria reintroduction risks persist in Cabo Verde despite its malaria-free status.
• Continuous surveillance, early diagnosis, prompt treatment, and strategic interventions are essential.
• Sustaining elimination requires robust policies, leadership, and resources to manage imported cases effectively.