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On multifactorial drivers for malaria rebound in Brazil: a spatio-temporal analysis
Mario J C Ayala1, Leonardo S Bastos1, Daniel A M Villela2
1Fundação Oswaldo Cruz (Fiocruz), Programa de Computação Científica, Av. Brasil, 4365-Manguinhos, Rio de Janeiro, 21040-900, Brazil.
Malaria Journal
|February 18, 2022
Summary
Malaria cases, particularly Plasmodium vivax, have unexpectedly increased in the Brazilian Amazon since 2015. Factors like deforestation and agricultural activities are linked to this rise, necessitating targeted control programs.
Area of Science:
- Epidemiology
- Public Health
- Environmental Science
Background:
- Malaria incidence in Brazil reversed a decreasing trend, with a significant increase observed in the Brazilian Amazon basin starting in 2015.
- This resurgence, particularly in areas with high transmission of Plasmodium vivax and Plasmodium falciparum, highlighted potential weaknesses in national malaria control efforts.
Purpose of the Study:
- To investigate factors contributing to the recent increase in malaria cases in the Brazilian Amazon.
- To identify specific regions and associated drivers of malaria resurgence.
Main Methods:
- A spatio-temporal Bayesian model was employed to analyze over 5 million malaria case records from 2003 to 2018.
- The analysis focused on identifying municipalities with unexpected increases in malaria cases, correlating them with migration, economic activities, and deforestation.
Main Results:
- Plasmodium vivax incidence surpassed historical trends in Amazonas, Amapá, Acre, Pará, Roraima, and Rondônia between 2015 and 2018.
- Plasmodium falciparum also showed increased incidence in Amazonas, Acre, Amapá, and Roraima.
- Outdoor and agricultural activities, deforestation, and travel were associated with the rebound in malaria cases in Roraima, Amazonas, Pará, and Rondônia, primarily for P. vivax.
Conclusions:
- The Brazilian Amazon experienced an unexpected malaria surge from 2015-2018, predominantly P. vivax, across several states.
- Agricultural activities, outdoor work, travel, and deforestation are implicated in specific regions, demonstrating multifactorial influences.
- The heterogeneity of the Amazon basin underscores the need for malaria control programs tailored to local socio-economic and environmental conditions.
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