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

Autor(es)

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]

Afiliação do(s) autor(es)

^[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

• Tipo de documento: Artigo Científico
• Fonte: American Journal of Tropical Medicine and Hygiene; v. 79, n. 4, p. 624-635, OCT 2008.
• Citações Web of Science: 61

Resumo

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)

• Processo FAPESP: 05/51988-0 - Epidemiologia da malaria: fatores de risco, distribuicao espaco-temporal e resposta ao tratamento em uma coorte rural amazonica.
• Beneficiário: Marcelo Urbano Ferreira
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 03/09719-6 - Aquisicao de imunidade contra plasmodium vivax: estudo longitudinal em uma comunidade rural da amazonia brasileira.
• Beneficiário: Marcelo Urbano Ferreira
• Modalidade de apoio: Auxílio à Pesquisa - Regular