O-68 A pilot elimination strategy for Plasmodium falciparum malaria in mining-associated endemic settings: a case study from South Rupununi, Region 9, Guyana
Author(s):
RA Niles-Robin, O Valz , K James, H Cox, A Parra-Salazar, W Rodrigues, I Spencer, PM De Salazar
Type Of Study:
- Experimental or Intervention Study
Year of Presentation:
2026
Objective: Malaria elimination in the Amazon region faces
significant challenges from mobile mining populations and
cross-border transmission. In late 2022, Aishalton (population ~1,000) in South Rupununi, Region 9, Guyana, experienced a malaria surge linked to gold mining in neighboring
Marudi Mountain, exacerbated by Brazilian miners displaced from Yanomami territories. This case study evaluates
a pilot elimination strategy targeting Plasmodium falciparum malaria in this mining-associated setting.
Methods: A two-phase strategy was implemented. During elimination phase (September 2023–September 2024): (1) mobile health teams were deployed to mining sites for onsite testing and treatment (September 2023, strengthened February 2024); and (2) real-time digital surveillance with geocoded case classification replaced paper-based reporting (January 2024). Following achievement of zero local transmission, a maintenance phase began with (3) reactive case detection protocol implementation (September 2025) involving household screening within 100-meter radii of future local cases, with two waves at 24-hours and 7 days post-detection.
Results: Between January 2023 and September 2025, 183 Plasmodium falciparum and mixed infection cases were reported (113 imported, 70 local), peaking in September– October 2023. Following intervention implementation, cases declined gradually from October 2023, with accelerated reduction after February 2024 team strengthening. Zero local transmission was achieved in October 2024 and sustained through September 2025 (12 months). Imported cases decreased to 6 total cases in the first 9 months of 2025, representing a 96% reduction from peak levels.
Conclusion: This integrated strategy successfully interrupted P. falciparum transmission in a mining-associated high-risk setting within 13 months through strategic positioning of health services at source populations and realtime surveillance enabling continuous monitoring. Sustained zero local transmission over 12 months demonstrates elimination feasibility in mobile, high-risk populations. Implementation of reactive case detection in September 2025 provides a surveillance maintenance framework for sustaining gains. This model offers a scalable approach for similar mining-affected regions across Guyana and the broader Amazon basin.