Advanced search
Start date
Betweenand
Related content
(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Malaria on the Amazonian frontier: Transmission dynamics, risk factors, spatial distribution, and prospects for control

Full text
Author(s):
da Silva-Nunes, Monica [1] ; Codeco, Claudia T. [2] ; Malafronte, Rosely S. [2] ; da Silva, Natal S. [2] ; Juncansen, Camila [2] ; Muniz, Pascoal T. [2] ; Ferreira, Marcelo U. [2]
Total Authors: 7
Affiliation:
[1] Univ Sao Paulo, Inst Biomed Sci, Dept Parasitol, BR-05508900 Sao Paulo - Brazil
[2] Univ Fed Acre, Dept Hlth Sci, BR-69915000 Rio Branco, Acre - Brazil
Total Affiliations: 2
Document type: Journal article
Source: American Journal of Tropical Medicine and Hygiene; v. 79, n. 4, p. 624-635, OCT 2008.
Web of Science Citations: 61
Abstract

Little follow-up data on malaria transmission in communities originating from frontier settlements in Amazonia are available. Here we describe a cohort study in a frontier settlement in Acre, Brazil, where 509 subjects contributed 489.7 person-years of follow-up. The association between malaria morbidity during the follow-up and individual, household, and spatial covariates was explored with mixed-effects logistic regression models and spatial analysis. Incidence rates for Plasmodium vivax and Plasmodium falciparum malaria were 30.0/100 and 16.3/100 person-years at risk, respectively. Malaria morbidity was strongly associated with land clearing and farming, and decreased after five years of residence in the area, suggesting that clinical immunity develops among subjects exposed to low malaria endemicity. Significant spatial clustering of malaria was observed in the areas of most recent occupation, indicating that the continuous influx of nonimmune settlers to forest-fringe areas perpetuates the cycle of environmental change and colonization that favors malaria transmission in rural Amazonia. (AU)