Molecular diagnosis for asymptomatic infections due to Plasmodium in the North Coast of São Paulo State

• Grant number: 16/23200-3
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: February 01, 2017
• End date: December 31, 2017
• Field of knowledge: Health Sciences - Collective Health - Public Health
• Principal Investigator: Silvia Maria Fátima Di Santi
• Grantee: Maria de Lourdes Rego Neves Farinas
• Host Institution: Superintendência de Controle de Endemias (SUCEN). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

In Brazil, in 2015, 142,562 cases of malaria were notified. P. vivax was responsible for 89.2% of cases, followed by P. falciparum and mixed infections, with 10.8%. P. malariae is a species with rare notification, which does not represent the epidemiological reality, since it can be diagnosed as P. vivax. The Extra-Amazon Region is not considered endemic for malaria, but is susceptible to occurrence of outbreaks, that can lead to the reintroduction of the disease. In 2013 it was reported 691 cases, with 159 in Sao Paulo State. In the same year were detected 88 autochthonous cases, most occurring in Espírito Santo with 37 cases, Sao Paulo with 16, Piaui with 14 and Rio de Janeiro with 10 notifications, according to the Ministry of Health. The autochthonous malaria in Sao Paulo State is limited to two distinct geographical regions. Currently, the most important is the Serra do Mar area, ecosystem covered by Atlantic Forest, where the main vector, Anopheles (Kerteszia) cruzii, can be found in high density. Most autochthonous cases presents mild or asymptomatic clinical aspects and were classified as P. vivax or P. malariae. The seroepidemiological profile of the local population showed evidence of exposure of these individuals to different variants of P. vivax or P. malariae. The importance of case detection and determination of circulating Plasmodium species in areas of autochthonous lies mainly in the fact that asymptomatic individuals with low parasitaemia can serve as a source of infection for vectors in different regions of the state, allowing the installation of outbreaks with consequent spread of endemic disease. Moreover, in recent years there were reported transfusional cases in which donors, all asymptomatic, showed displacements to low transmission areas of Sao Paulo State. In addition to the proposal to make the diagnosis more accurately, this study aims to assess the prevalence in these municipalities, of asymptomatic infections that may lead outbreaks and cases of transfusional malaria. (AU)