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Mapeo de la endemicidad global y la carga clínica de Plasmodium vivax, 2000-17: un estudio de modelado espacial y
Katherine E Battle1, Tim C D Lucas1, Michele Nguyen1
1Malaria Atlas Project, Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK.
Lancet (London, England)
|June 24, 2019
Resumen
Los casos globales de malaria por Plasmodium vivax se redujeron un 41,6% entre 2000 y 2017, pero el progreso se ha estancado en los últimos años. Esto pone de relieve los desafíos para los esfuerzos de eliminación de la malaria, especialmente en las regiones inestables.
Área de la Ciencia:
- Salud global
- Enfermedades infecciosas
- Epidemiología
Sus antecedentes:
- Plasmodium vivax representa una carga significativa para la salud mundial, sin embargo, su distribución y tendencias están mal cuantificadas.
- Las evaluaciones precisas de la endemicidad de P. vivax son cruciales para los programas nacionales de paludismo, especialmente los que tienen como objetivo la eliminación.
- Este estudio proporciona los primeros mapas globales que detallan la carga clínica de P. vivax desde 2000 hasta 2017.
Objetivo del estudio:
- Trazar un mapa de la carga clínica global y las tendencias temporales de la malaria por Plasmodium vivax.
- Proporcionar evaluaciones actualizadas de la endemicidad de P. vivax y el impacto de la enfermedad para las estrategias de eliminación de la malaria.
Principales métodos:
- Utilizó un enfoque de modelado espacial y temporal, ajustando los datos de vigilancia malariométrica de rutina para obtener sesgos.
- Se utilizaron indicadores socioeconómicos para generar series temporales de la carga clínica de P. vivax.
- Modelos geoespaciales bayesianos integrados y datos combinados de P. falciparum en África subsahariana para crear predicciones globales a escala fina.
Principales resultados:
- La carga global de P. vivax malaria disminuyó en un 41.6% entre 2000 y 2017, de 24.5 millones a 14.3 millones de casos.
- Se observaron reducciones significativas en las Américas (56,8%), el sudeste asiático (50,5%) y el Pacífico occidental (51,3%).
- El progreso se ha estancado en los últimos años, con aumentos observados en las regiones afectadas por la inestabilidad política y económica.
Conclusiones:
- Se han logrado avances sustanciales a nivel mundial en la reducción de la carga de P. vivax, pero las disminuciones estancadas y el aumento de la carga en algunas áreas indican desafíos para la eliminación de la malaria.
- Estos hallazgos respaldan los sistemas globales de monitoreo y pueden orientar estrategias de diagnóstico y tratamiento específicas.
- La optimización de las intervenciones es fundamental, especialmente en las regiones que se enfrentan a la inestabilidad y donde el impacto de P. vivax sigue siendo alto.
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