Análise do processo de eliminação da transmissão da malária na Amazônia brasileira com abordagem espacial da variação da incidência da doença em 2016*

Braz, Rui Moreira; Barcellos, Christovam

doi:10.5123/s1679-49742018000300010

Cited by 29 publications

(11 citation statements)

References 9 publications

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“…The LA region concentrates over 99% of malaria cases, but these cases are not uniformly distributed. Between 30 and 40 municipalities concentrate about 80% of annual cases and results show that municipalities where malaria is most prevalent have lower ISTs than lower risk settings (3), similar to what was shown by others [2,19]. Malaria concentration in a few municipalities shows an advanced stages in disease control and elimination in the country, but there is much to be done yet.…”

Section: Discussionsupporting

confidence: 80%

Factors in time to malaria treatment in the Brazilian Amazon: a survival analysis

Maia¹,

Beluzo²,

Carlos³

et al. 2021

Preprint

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Background: Malaria continues to be one of the most relevant infectious diseases in Brazil and globally, with over 150.000 cases in 2019 alone. Due to high P. vivax prevalence and P. falciparum elimination goals, the Brazilian Malaria Elimination Program placed a high priority on timely treatment. Cases in the country are concentrated in the Legal Amazon region, with diagnosis and treatment provided for free by the government through its public health system, but many relevant questions about heterogeneity in risk and access to treatment remain.Methods: We use data from the Malaria Epidemiological Surveillance System, maintained by the Ministry of Health, from 2007-2019 to analyze factors that affect time to treatment of malaria in three distinct periods. We use Kaplan-Meier survival functions to estimate the interval between the appearance of first symptoms and beginning of treatment for several administrative, demographic, social and health variables.Results: Despite advances in malaria control over the last two decades, the program has not achieved its timely treatment goals in any of the periods analyzed. Malaria risk was highest among working-age adults, concentrated in a few high risk municipalities, autochthonously transmitted, in agriculture and domestic services, lower education, mid to low levels of parasitaemia, brown, indigenous and black populations and males. The main parasite is P. vivax and the majority of cases is still passively detected. Time-to-treatment was lower when they were detected actively, had lower levels of schooling, were not pregnant or past the 2nd trimester, between 0 and 14 years of age, worked in agriculture, had low parasite counts, were infected with P. falciparum, were indigenous people and lived in high risk municipalities.Conclusions: Differences in access to treatment were small if compared to differences in risk of acquiring malaria in the first place, but active case detection, municipal risk and race showed significant differences and potential avenues for intervention.

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Section: Discussionsupporting

confidence: 80%

Factors in time to malaria treatment in the Brazilian Amazon: a survival analysis

Maia¹,

Beluzo²,

Carlos³

et al. 2021

Preprint

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“…Third, results compared investment per states without discriminate municipalities of unexpected increases to establish investment priorities; this also happened because Health Ministry has done the majority of resource allocation. Elimination indicators can support investment priorities because only few municipalities concentrate the 80% of incidence and a large number of municipalities in Amazon basin has achieved malaria elimination [34].…”

Section: Discussionmentioning

confidence: 99%

On multifactorial drivers for malaria rebound in Brazil: a spatio-temporal analysis

Bastos

Villela

2021

Preprint

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Background: Malaria incidence in Brazil reversed its decreasing trend when cases from recent years, as recent as 2015, exhibited an increase in the Brazilian Amazon basin, the area with highest transmission of Plasmodium vivax and Plasmodium falciparum. In fact, an increase of more than 20% in the years 2016 and 2017 revealed possible vulnerabilities in the national malaria-control program. Methods: We studied factors that are potentially associated with this reversal, including migration, economical activities, and deforestation, and weakening of investment in control programs. We analyze past incidences of malaria cases due to Plasmodium vivax and Plasmodium falciparum with a spatio-temporal Bayesian model using more than 5 million individual records of malaria cases from January of 2003 to December of 2018 in the Brazilian Amazon to establish the municipalities with unexpected increases in cases. Results: We observe an increase in imported cases from border countries in Roraima state and found small effects due to deforestation and change of occupations. Also, an overall funding reduction from 2013 to 2016 happened before an increase in malaria cases in five regions in Amazon basin, markedly for P. vivax incidence and especially, in Pará and Roraima States. Conclusion: Urban developments, discontinued funding for control programs, migration from border areas, deforestation activities, and different economic activities such as mining and agriculture appear linked to the rebound on malaria incidence. These multifactorial drivers show that malaria control programs require permanent attention towards elimination.

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“…However, we can expect such a number to be negligible. In Brazil, the legal Amazon, whose malaria cases are reported in the SIVEP-Malária, accounts for more than 99% of the Brazilian malaria cases [ 25 , 26 ]. In conclusion, the CBMIS reports reliably on the number of cases within the cross-border area.…”

Section: Discussionmentioning

confidence: 99%

Contributing to Elimination of Cross-Border Malaria Through a Standardized Solution for Case Surveillance, Data Sharing, and Data Interpretation: Development of a Cross-Border Monitoring System

Saldanha¹,

Mosnier²,

Barcellos³

et al. 2020

JMIR Public Health Surveill

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Background Cross-border malaria is a significant obstacle to achieving malaria control and elimination worldwide. Objective This study aimed to build a cross-border surveillance system that can make comparable and qualified data available to all parties involved in malaria control between French Guiana and Brazil. Methods Data reconciliation rules based on expert knowledge were defined and applied to the heterogeneous data provided by the existing malaria surveillance systems of both countries. Visualization dashboards were designed to facilitate progressive data exploration, analysis, and interpretation. Dedicated advanced open source and robust software solutions were chosen to facilitate solution sharing and reuse. Results A database gathering the harmonized data on cross-border malaria epidemiology is updated monthly with new individual malaria cases from both countries. Online dashboards permit a progressive and user-friendly visualization of raw data and epidemiological indicators, in the form of time series, maps, and data quality indexes. The monitoring system was shown to be able to identify changes in time series that are related to control actions, as well as differentiated changes according to space and to population subgroups. Conclusions This cross-border monitoring tool could help produce new scientific evidence on cross-border malaria dynamics, implementing cross-border cooperation for malaria control and elimination, and can be quickly adapted to other cross-border contexts.

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Análise do processo de eliminação da transmissão da malária na Amazônia brasileira com abordagem espacial da variação da incidência da doença em 2016*

Cited by 29 publications

References 9 publications

Factors in time to malaria treatment in the Brazilian Amazon: a survival analysis

Factors in time to malaria treatment in the Brazilian Amazon: a survival analysis

On multifactorial drivers for malaria rebound in Brazil: a spatio-temporal analysis

Contributing to Elimination of Cross-Border Malaria Through a Standardized Solution for Case Surveillance, Data Sharing, and Data Interpretation: Development of a Cross-Border Monitoring System

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