Mauritius’ Demonstrated Capacity in Controlling Communicable Diseases
Preventing vector-borne and other communicable diseases such as malaria, dengue, chikungunya, whooping cough, diphtheria, leprosy, schistosomiasis and poliomyelitis
A few decades ago, Mauritius was facing several communicable diseases, such as malaria, childhood infectious diseases, and tuberculosis. The country has since embarked on important measures as per World Health Organization (WHO) guidelines to eradicate the diseases or to contain them at their present low level.
Presently, Mauritius has acquired rich and varied expertise in responding to disease outbreaks and other public health threats, through both real cases and simulation exercises. Its success in controlling communicable diseases is attributed mainly to the implementation of an efficient surveillance programme as well as to the National Expanded Immunization Programme.
However, Mauritius’ extensive air and trade links with endemic countries have increased the risk of importation of pathogens and the country’s vulnerability to epidemic-prone diseases. In addition, the country is also subject to climate change and its impact on its vector distribution, with increasing threat from vector-borne diseases, which requires constant and heightened vigilance.
Towards a Solution
To address the above challenge, the Ministry of Health and Wellness (MOHW) in Mauritius developed an operational plan for the prevention and control for communicable diseases. The objective of the plan is to control the spread of diseases, enhance the quality of life of the population and contribute to economic development.
As part of its efforts, the MOHW implemented an efficient surveillance programme through the screening of all passengers incoming at port and airport, and health surveillance of passengers from high-risk countries as per the established protocol. The control of communicable diseases is implemented by the Communicable Disease Control Unit and the Public Health and Food Safety Inspectorate of the MOHW, under the responsibility of the respective Director of Health Services. The MOHW also collaborates with the Mauritius Ports Authority, the Passport and Immigration Office, Airports of Mauritius Ltd., Airport Terminal Operations Ltd. (ATOL), and the Civil Aviation Department for port and airport surveillance. Around 80,000 blood samples from asymptomatic passengers are taken and screened for malaria yearly. All positive cases are isolated in medical centres and treated accordingly. Mauritius has also implemented appropriate public health measures to control vectors and prevent local transmissions, for example fogging, larviciding, peri-domestic and rooftop inspections, indoor residual spraying, fever surveys and health education for the public.
In regards to immunization and vaccination measures, the country implemented a National Expanded Immunization Programme. There are six health regions, including the Island of Rodrigues, and each region has a vaccination coordination centre, manned by trained personnel with the necessary logistic support. At present, there are 159 active centres in Mauritius and 15 on the island of Rodrigues, with the aim to provide immunization services at a walking distance.
Furthermore, new vaccines have recently been introduced in Mauritius, recently namely rotavirus vaccine in 2015, pneumococcal vaccines in 2016, and human papilloma virus (HPV) vaccine in 2016. The hexavalent vaccine was introduced in 2018, which confers immunity against diphtheria, tetanus, pertussis, hepatitis, poliomyelitis (inactivated) and Haemophilus type B influenza. The presence of a good road network, adequate transport facilities and other modern communication tools have also contributed significantly to the success of the immunization programme. Measles, mumps and rubella (MMR) vaccination has been extended to the population in high-risk areas and to the workforce of both public and private sectors, targeting specifically the 15–45 year age group. Over 50,000 persons were vaccinated against measles during the supplementary immunization activities. Due to the measles outbreak in April 2018, the vaccination schedule for MMR has been reviewed, with the first dose at nine months and the second dose at 17 months. Other public health measures taken include contact tracing and supplementary immunization activities.
The Vector Biology Control Division has conducted 516 mosquito surveys across the island. Entomological Surveys were reinforced during the dengue outbreaks in the affected regions.
In addition, in July 2018, a Geographic Information System (GIS) Unit was set up at the MOHW. The aim of this unit is to provide mapping, analysis and data management to support more informed decision-making as well as enabling collaboration across the MOHW. The importance of building GIS capabilities was demonstrated during surveillance and response activities for the measles outbreaks to visualize geographical distribution of cases in high-level situation reports, and the dengue outbreaks to assist in the identification of sites for fogging activities. Furthermore, in March 2019, the Integrated Disease Surveillance and Response (IDSR) was initiated as part of the strategy to strengthen the core capacities of the International Health Regulations (2005). It provides the Communicable Diseases Control Unit at headquarters with information for the 11 priority diseases in real time, from all across the island.
For many years, Mauritius has been successfully using several formal and ad hoc multisectoral mechanisms under the rubric of the broader National Disaster Risk Reduction and Management Act (2016) and the updated Public Health and Quarantine Acts to respond to public health emergencies. A fully operational National Disasters Risk Reduction and Management Centre is in place under the aegis of the Ministry of Social Integration, Social Security and National Solidarity to prepare for and respond to natural disasters and epidemics.
In terms of South-South cooperation, the country has cross-border agreements, protocols and memoranda of understanding (MOUs) on public health emergencies with neighbouring countries. Through the Indian Ocean Commission (IOC) Mauritius is aiming to advance a genuine One Health agenda.
It has also signed a charter for the weekly sharing of data on epidemic-prone diseases occurring within the Indian Ocean islands of the Comoros, Madagascar, Mauritius, Reunion and Seychelles. The country is also required to share data with the Africa Centres for Disease Control and Prevention (Africa CDC) via the Zoom platform.
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ADELANTE Programme Knowledge Bank Creating a public repository of triangular cooperation learning
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An Innovative e-Learning Approach for Health: Pre- and in-service training for medical students and health workers for quality health service coverage Improving coverage and quality of health services in disadvantaged areas of Viet Nam
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