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Cross-border malaria in Northern Brazil.
Nicholas J Arisco1, Cassio Peterka2, Marcia C Castro3
1Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Building 1, Room 1002A, Boston, MA, 02115, USA.
Malaria Journal
|March 7, 2021
Summary
Cross-border malaria remains a significant challenge in Northern Brazil, particularly in Roraima. Tailored surveillance and control strategies are crucial, considering the distinct profiles of imported malaria cases linked to migration and mining.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- Cross-border malaria transmission poses a significant obstacle to malaria elimination efforts globally.
- Intense human mobility along the Venezuela-Brazil-Guyana border, driven by humanitarian crises and illegal mining, has led to an increase in cross-border malaria cases in Brazil.
- The Brazilian state of Roraima is disproportionately affected by this cross-border malaria burden.
Purpose of the Study:
- To analyze the epidemiology of cross-border malaria in Northern Brazil between 2007 and 2018.
- To understand the characteristics and patterns of malaria cases originating from Venezuela and Guyana.
- To inform public health strategies for malaria control in border regions.
Main Methods:
- Utilized de-identified malaria case data from Brazil's Malaria Epidemiological Surveillance Information System (2007-2018).
- Employed Pearson's Chi-Square test to compare characteristics of cross-border cases from Venezuela and Guyana.
- Applied a logistic regression model to identify predictors of imported malaria cases.
Main Results:
- Cross-border cases from Venezuela and Guyana constituted the majority of imported cases since 2012, with Roraima as the primary receiving state.
- Significant differences were observed in the profiles of cases originating from Venezuela versus Guyana, including patient nationality and movement patterns.
- Venezuelan and Guyanese nationals, Brazilian miners, males, and working-age individuals showed higher odds of imported malaria; Venezuelan citizens were more likely to seek care in municipalities bordering Venezuela.
Conclusions:
- Cross-border malaria significantly contributes to the overall malaria burden in the Venezuela-Guyana-Brazil border region.
- Distinct importation profiles highlight the need for enhanced border surveillance and targeted interventions.
- Strategies must address specific mobility patterns, including those of refugees and cross-border miners.
