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Human mobility and malaria risk in peri-urban and rural communities in the Peruvian Amazon
Joaquin Gomez1, Alessandro Grosso2, Mitchel Guzman-Guzman1
1Laboratorio ICEMR- Enfermedades Emergentes, Laboratorios de Investigación y Desarrollo, Facultad de Ciencias e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Perú.
Background:
While the global burden of malaria cases has decreased over the last two decades, the disease remains a major international threat, even on the rise in many regions. More than 85% of Peruvian malaria cases are in the Amazonian region of Loreto. Internal mobility primarily related to occupation is thought to be primarily responsible for maintaining endemicity and introducing and reintroducing malaria parasites into areas of anophelism, a challenge for malaria eradication. This study focuses on identifying the sources of malaria transmission and patterns of human mobility in order to understand the movement and transmission of the parasite.
Methods:
The assessment of connectivity produced by human mobility was evaluated in three districts of Loreto, through 10 cross-sectional population screening from 2018 to 2020. We used social network analysis (SNA) to obtain weighted and unweighted degrees of connectivity and explore its variability by socio-demographic characteristics. In addition, we integrated travel history and malaria incidence data to estimate parasite connectivity due to internal human mobility between locations. Finally, we used logistic multivariate regressions to explore the factors associated with Plasmodium spp. infection in mobile individuals.
Results:
We found that internal human mobility results in high connectivity between communities from the Mazan, Iquitos, and San Juan Bautista districts. We identified nearby destinations that may act as sinks or sources for malaria transmission, including densely populated towns and rural campsites. In addition, we found that being a male, traveling to rural campsites, and working outdoors are associated with Plasmodium spp. infection in travelers from the Mazan district.
Conclusions:
We provide compelling evidence about how human mobility connects rural communities in the Peruvian Amazon. Using SNA, we uncovered district-specific patterns and destinations, providing further evidence of human mobility heterogeneity in the region. To address the challenge of human mobility and malaria in this setting, geographic heterogeneity of malaria transmission must be considered.
Insights
Human mobility fuels malaria transmission in Peru's Amazon. Understanding these connections is key to controlling the spread of Plasmodium parasites, especially in Loreto.
Area of Science:
- Epidemiology
- Public Health
- Parasitology
Background:
- Malaria remains a significant global health threat, with rising cases in many regions.
- Loreto, Peru, accounts for over 85% of the country's malaria cases.
- Internal human mobility is a primary driver of malaria transmission and persistence in endemic areas.
Purpose of the Study:
- To identify the sources of malaria transmission within the Peruvian Amazon.
- To analyze patterns of human mobility and their impact on parasite movement.
- To understand the connectivity between communities and potential malaria hotspots.
Main Methods:
- Conducted cross-sectional population screenings in three districts of Loreto from 2018-2020.
- Utilized social network analysis (SNA) to map human mobility and connectivity.
- Integrated travel history and malaria incidence data, employing logistic regressions to identify infection risk factors.
Main Results:
- High connectivity was observed between communities in Mazan, Iquitos, and San Juan Bautista districts due to internal mobility.
- Identified rural campsites and towns as potential malaria transmission sources or sinks.
- Male gender, travel to rural campsites, and outdoor work were associated with Plasmodium infection among mobile individuals in Mazan.
Conclusions:
- Human mobility significantly connects rural communities in the Peruvian Amazon, facilitating malaria transmission.
- Social network analysis revealed district-specific mobility patterns and destinations, highlighting regional heterogeneity.
- Addressing malaria control requires considering the geographic variability of transmission driven by human movement.
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