CDC in Central America
A field researcher from Universidad del Valle-Guatemala (UVG) collects a sample from a participant in an antimicrobial resistance (AMR) research project in Quetzaltenango, Guatemala. Photo by Nicholas Tenorio/CDC
The Centers for Disease Control and Prevention (CDC) has collaborated with public health institutions in Central America since the 1960s, initially focusing on parasitic diseases. In 2003, CDC established a Central America Regional (CAR) office in Guatemala which has supported work in Belize, Costa Rica, El Salvador, Honduras, Guatemala, Nicaragua, Panama, and has managed projects in Brazil, Colombia, and the Dominican Republic. CDC recently announced the establishment of a new regional office covering Central America and the Caribbean in Panama. Guatemala will continue to support activities throughout the region. CDC works with the ministries of health (MOH), the Council of Ministers of Health of Central America (COMISCA), the Pan American Health Organization (PAHO), and other regional and international partners to address COVID-19, HIV, tuberculosis, vector-borne disease, and antimicrobial resistance. CDC also strengthens laboratory, surveillance, and workforce capacities to prevent, detect, and respond to infectious diseases across the region.
Global Health Security
Helping countries respond to public health threats quickly and effectively within their borders is critical to preventing the spread of disease regionally and around the world. In 2006, CDC expanded the scope of the Central America Regional office to support disease outbreak response, surveillance, laboratory systems, and workforce development in coordination with local, regional, and global public health organizations. CDC has partnered with Brigham and Women’s Hospital, Baylor College of Medicine, Washington State University, and Universidad del Valle de Guatemala since 2018 to strengthen epidemiological surveillance for acute febrile illnesses (AFI) and antimicrobial resistance (AMR) in the Dominican Republic, Belize, Guatemala, and El Salvador.
CDC’s AFI surveillance network in Central America and the Dominican Republic identifies emerging and re-emerging disease threats, strengthens regional collaborations, and increases regional capacity for disease surveillance
CDC collaborates with ministries of agriculture, health, environment, and defense across Central America to conduct One Health Zoonotic Disease Prioritization workshops to increase opportunities for cross-disciplinary surveillance, prevention, and control
Since 2017, CDC has participated in outbreak investigations for measles, rabies, fungal infections (mucormycosis), dengue, foodborne diseases, and COVID-19
Starting in 2022, CDC is collaborating with the Government of El Salvador to pilot the region’s first use of bacteria (Wolbachia) to control mosquito-borne disease transmission
CDC and COMISCA support strengthened surveillance of healthcare-associated bloodstream infections (candidemia) in six hospitals in El Salvador
CDC partners with the Executive Secretariat of COMISCA to strengthen the National Institute of Health in El Salvador
Field Epidemiology Training Program (FETP)
CDC’s FETP strengthens the public health workforce capacity to investigate and respond to disease outbreaks. Three FETPs – Frontline, Intermediate, and Advanced – train epidemiologists to identify and contain outbreaks before they become epidemics. Trainees also develop skills to gather critical data and turn it into evidence-based action. COMISCA and MOHs lead FETP activities across the Central America region. Advanced FETP participants earn a master’s degree through Universidad del Valle-Guatemala (UVG).
As of 2021, more than 3,600 Frontline, 1,000 Intermediate, and 170 Advanced residents have graduated from FETPs in Central America
Since 2012, over 100 FETP Central America residents have presented their work at international scientific conferences
COVID-19
The first case of COVID-19 in Central America was confirmed in Costa Rica on March 6, 2020. Since the pandemic was declared, CDC has engaged in technical collaboration with Central American countries across response activities. Previous collaborations between CDC and MOHs to expand regional laboratory capacities and surveillance were critical to the region’s COVID-19 response. FETP graduates are also instrumental to the response as they lead efforts to increase vaccination rates and provide epidemiological technical support to MOHs.
To support Central American countries’ COVID-19 response, CDC leveraged existing surveillance platforms to test for SARS-CoV-2 (the virus that causes COVID-19)
CDC partnered with PAHO to strengthen the region’s genomic sequencing capacity for SARS-CoV-2. This partnership supports national laboratories in Panama and Costa Rica to analyze samples referred from throughout Central America
CDC and partners implement serological surveys to understand COVID-19 trends in communities and healthcare, agriculture, hospitality, and market worker populations in Belize, Dominican Republic, El Salvador, and Guatemala
CDC supports COVID-19 vaccine rollout in Guatemala, Honduras, El Salvador, and Belize. CDC assists with vaccination program management and operations, vaccine promotion in local languages, vaccine outreach to pregnant women, and vaccination scale-up
To support the COVID-19 response, CDC donated laboratory equipment and supplies, antigen tests, personal protective equipment, and other supplies
CDC also helped strengthen rapid response teams’ skills in community testing, vaccination promotion campaigns, and home-based care, and collaborated to investigate COVID-related fungal infections (mucormycosis)
HIV and Tuberculosis (TB)
Since 2003, CDC has collaborated with MOHs to respond to the HIV epidemic in Central America. CDC supports countries in Central America to achieve UNAIDS 95-95-95 goals by 2030. CDC works with partners to prioritize increased quality of services for people living with HIV and other populations living with higher risk of infection. CDC supports the scale-up of evidence-based programs that close gaps in HIV prevention, case finding, early antiretroviral treatment (ART) initiation, optimized treatment, and viral load suppression. CDC focuses on:
- Enhancing local capacity for laboratory quality assurance and supporting national efforts to improve the quality of rapid HIV testing
- Strengthening laboratory capacity and network for HIV testing and viral load monitoring
- Preventing new infections among populations living with increased risk of HIV infection, including men who have sex with men, transgender women, and sex workers
- Increasing access to HIV testing through close contact testing and provider-initiated testing and counseling
- Supporting clinics to improve HIV-related health outcomes by linking patients to care after diagnosis, reengaging people whose treatment was interrupted, initiating rapid and early treatment, viral load suppression, and managing other illnesses that occur more frequently among people living with HIV
- Increasing workforce capacity to care for people living with HIV by using the Extension for Community Healthcare Outcomes (ECHO) model to mentor healthcare workers across the region
CDC supports 44 HIV clinics in Central America with more than 23,000 people receiving ART as of December 2021
Central America was the first region supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) to integrate data on recent infection into HIV surveillance systems. Data are used to identify potential infection clusters to enhance resource delivery and maximize investment and impact
Laboratory Systems Strengthening
For the past 20 years, CDC has supported laboratory-based disease surveillance and detection of novel strains and pathogens. CDC also supports the Regional Network of National Laboratories (REDLAB) strategic plan. CDC activities include:
- Training more than 2,000 laboratory staff personnel through seminars and workshops
- Strengthening capacities of national laboratories in Belize and El Salvador to diagnose fungal (mycotic) diseases
- Enhancing laboratory surveillance of norovirus and rotavirus (viruses that cause vomiting and diarrhea) in Costa Rica
- Supporting biosafety training for local laboratory staff
CDC supports laboratory biosafety activities across the region, such as hosting regional biosafety and biosecurity workshops and certifying biosafety hoods in national laboratories in Guatemala, El Salvador, Honduras, and Belize
Migration and Border Health
Global migration and border health systems impact the health of migrants and potential cross-border movement of pathogens. CDC engages with national governments, U.S. embassies, COMISCA, and other partners to improve HIV services for Venezuelan migrants, enhance border health processes, and understand health-related reasons for migration. CDC activities include:
- Implementation of a survey and virtual regional workshop to identify regional challenges in border health systems and points of entry
- Assessment visits at points of entry on Guatemala’s land borders to identify strengths and challenges
- Integration of border health topics into FETP-Frontline
- Partnership with the Latin American Faculty of Social Sciences (FLACSO) and COMISCA to conduct traveler mobility and COVID-19 KAP (knowledge, attitudes, and practices) surveys with people crossing borders
- Engagement in technical collaboration to enhance HIV prevention, care, and treatment services for migrants throughout Central America. For example, CDC and local partners support increased access to HIV prevention, testing, treatment, and laboratory services for Venezuelan migrants in Colombia and Peru
- Support of COVID-19 testing and vaccination for migrants returning to Central America from the U.S. and Mexico
CDC Leverages Acute Febrile Illness Surveillance System to Respond to COVID-19
Colombia Increases Surveillance to Protect Pregnant Women Against COVID-19
Strengthening Surveillance for Antimicrobial Resistance in Guatemala
CDC-Trained Disease Detective Mobilizes her Community Against Dengue
Detective de Enfermedades Capacitada por los CDC Moviliza a su Comunidad en contra del Dengue
Photos:
CDC in Central America | Flickr
Videos:
Central America Region Overview
Health Impact in Central America Region
COVID-19 Preparedness in Central America Region
CDC and the Universidad del Valle-Guatemala (UVG)
Value of the Field Epidemiology Training Program (FETP) in Central America
Guatemala Veterinarians FETP
Guatemala FETP
Treating HIV in Honduras
