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Mahittikorn A, Mala W, Wilairatana P, Siri S, Masangkay FR, Kotepui KU, Kotepui M. Prevalence, anti-malarial chemoprophylaxis and causes of deaths for severe imported malaria: A systematic review and meta-analysis. Travel Med Infect Dis 2022; 49:102408. [PMID: 35985533 DOI: 10.1016/j.tmaid.2022.102408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/16/2022] [Accepted: 07/25/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND There are limited data regarding prevalence, anti-malarial chemoprophylaxis, and causes of death for severe imported malaria. Thus, we conducted a systematic review and meta-analysis to characterise these variables. METHODS We searched studies reporting deaths attributable to severe imported malaria. The following pooled prevalence rates were determined: 1) the pooled prevalence of severe malaria among patients with imported malaria, 2) the pooled prevalence of deaths among patients with severe imported malaria, 3) the pooled prevalence of anti-malarial chemoprophylaxis among patients with severe imported malaria, and 4) the causes of death among patients with severe imported malaria. RESULTS The search identified 52 studies that were mainly conducted in Europe (25, 48.1%), North America (16, 30.8%) and Asia (7, 13.5%). The pooled prevalence of severe imported malaria was 12.5% (95% confidence interval [CI] = 10.3%-14.6%, I2 = 99.32%, 12393 severe cases/118325 imported cases). The pooled prevalence of deaths attributable to severe imported malaria was 5.1% (95% CI = 4.0%-6.2%, I2 = 91.72%, 721 deaths/16310 severe cases). The pooled prevalence of adequate anti-malarial chemoprophylaxis among patients with severe imported malaria was 9.7% (95% CI = 6.5%-13.0%, I2 = 89.9%, 203/2049 cases). The most common cause of death was multi-organ failure (12.3%). CONCLUSION The results highlighted the need for education and preventative measures for travellers, immigrants, or workers who plan to visit malaria-endemic areas to minimize the risk of severe disease or death.
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Affiliation(s)
- Aongart Mahittikorn
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| | - Wanida Mala
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
| | - Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| | - Sukhontha Siri
- Department of Epidemiology, Faculty of Public Health, Mahidol University, Bangkok, Thailand.
| | | | - Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
| | - Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
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Prevalence of Malaria Infection and Risk Factors Associated with Anaemia among Pregnant Women in Semiurban Community of Hazaribag, Jharkhand, India. BIOMED RESEARCH INTERNATIONAL 2015; 2015:740512. [PMID: 26783526 PMCID: PMC4691455 DOI: 10.1155/2015/740512] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 08/13/2015] [Indexed: 01/11/2023]
Abstract
The escalating burden, pathogenesis, and clinical sequel of malaria during pregnancy have combinatorial adverse impact on both mother and foetus that further perplexed the situation of diagnosis, treatment, and prevention. This prompted us to evaluate the status of population at risk of MIP in Hazaribag, Jharkhand, India. Cross-sectional study was conducted over a year at Sadar Hospital, Hazaribag. Malaria was screened using blood smear and/or RDT. Anaemia was defined as haemoglobin concentration. Pretested questionnaires were used to gather sociodemographic, clinical, and obstetrical data. The prevalence of MIP was 5.4% and 4.3% at ANC and DU, and 13.2% malaria was in women without pregnancy. Interestingly, majority were asymptomatically infected with P. vivax (over 85%) at ANC and DU. Peripheral parasitemia was significantly associated with fever within past week, rural origin of subjects, and first/second pregnancies in multivariate analysis, with the highest risk factor associated with fever followed by rural residence. Strikingly in cohort, anaemia was prevalent in 86% at ANC as compared to 72% at DU, whereas severe anaemia was 13.6% and 7.8% at ANC and DU. Even more anaemia prevalence was observed in MIP group (88% and 89% at ANC and DU), whereas severe anaemia was 23% and 21%, respectively. In view of observed impact of anaemia, parasitemia and asymptomatic infection of P. vivax during pregnancy and delivery suggest prompt diagnosis regardless of symptoms and comprehensive drug regime should be offered to pregnant women in association with existing measures in clinical spectrum of MIP, delivery, and its outcome.
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Rodríguez-Morales AJ, Orrego-Acevedo CA, Zambrano-Muñoz Y, García-Folleco FJ, Herrera-Giraldo AC, Lozada-Riascos CO. Mapping malaria in municipalities of the Coffee Triangle region of Colombia using Geographic Information Systems (GIS). J Infect Public Health 2015; 8:603-11. [PMID: 26106039 DOI: 10.1016/j.jiph.2015.05.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 04/06/2015] [Accepted: 05/02/2015] [Indexed: 11/24/2022] Open
Abstract
Geographical Information Systems (GIS) have been used extensively for the development of epidemiological maps of malaria but not in the Coffee Triangle region of Colombia, endemic for P. vivax, P. falciparum and P. malariae. Surveillance case data (2007-2011) were used to estimate annual incidence rates per Plasmodium spp. (cases/100,000 pop) to develop the first malaria maps in the 53 municipalities of this region (departments Caldas, Quindío, Risaralda). The GIS software used was Kosmo Desktop 3.0RC1(®). Thirty thematic maps were developed according to the municipalities, years, parasite etiology, and uncomplicated and complicated cases. A total of 6582 cases were reported (6478 uncomplicated and 104 complicated, 77.8% Risaralda), for a cumulated rate of 269.46 cases/100,000 pop. Among uncomplicated cases, 5722 corresponded to P. vivax (234.25 cases/100,000 pop), 475 to P. falciparum (19.45 cases/100,000 pop), 8 to P. malariae (0.33 cases/100,000 pop) and 273 mixed (P. falciparum/P. vivax) (11.18 cases/100,000 pop). The highest rate reported was in the more undeveloped and rural municipality of Risaralda (Pueblo Rico, 57.7 cases/1000 pop, 2009). The burden of disease was concentrated in one department (>75% of the region). The use of GIS-based epidemiological maps helps to guide decision-making for the prevention and control of this public health problem that still represents a significant issue in the region and the country, particularly in children.
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Affiliation(s)
- Alfonso J Rodríguez-Morales
- Research Group Public Health and Infection, Faculty of Health Sciences, Universidad Tecnológica de Pereira (UTP), Pereira, Risaralda, Colombia; Committee on Zoonoses and Hemorrhagic Fevers of the Colombian Association of Infectious Diseases (Asociación Colombiana de Infectología, ACIN), Bogotá, Colombia; School of Medicine, Faculty of Health Sciences, Universidad Tecnológica de Pereira (UTP), Pereira, Risaralda, Colombia.
| | - César A Orrego-Acevedo
- Research Group Public Health and Infection, Faculty of Health Sciences, Universidad Tecnológica de Pereira (UTP), Pereira, Risaralda, Colombia; School of Medicine, Faculty of Health Sciences, Universidad Tecnológica de Pereira (UTP), Pereira, Risaralda, Colombia
| | - Yazmin Zambrano-Muñoz
- School of Medicine, Faculty of Health Sciences, Universidad Tecnológica de Pereira (UTP), Pereira, Risaralda, Colombia
| | - Francisco J García-Folleco
- School of Medicine, Faculty of Health Sciences, Universidad Tecnológica de Pereira (UTP), Pereira, Risaralda, Colombia
| | - Albert C Herrera-Giraldo
- School of Medicine, Faculty of Health Sciences, Universidad Tecnológica de Pereira (UTP), Pereira, Risaralda, Colombia; Operative Direction of Public Health, Risaralda Department Secretary of Health, Pereira, Risaralda, Colombia
| | - Carlos O Lozada-Riascos
- Regional Information System, Universidad Tecnológica de Pereira (UTP), Pereira, Risaralda, Colombia
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Rodriguez-Morales AJ, Bolívar-Mejía A, Alarcón-Olave C, Calvo-Betancourt LS. Plasmodium vivax Malaria in Latin America. NEGLECTED TROPICAL DISEASES 2015. [DOI: 10.1007/978-3-7091-1422-3_5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Larréché S, Rapp C, Delacour H, Sanmartin N, Ficko C, Bigaillon C, Andriamanantena D, Pilo JE, Mérens A. Sensitivity of parasitological tests in imported Plasmodium vivax malaria in adults and impact of chemoprophylaxis and attack type. J Travel Med 2014; 21:195-200. [PMID: 24629014 DOI: 10.1111/jtm.12116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 10/22/2013] [Accepted: 11/12/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Plasmodium vivax is the second most common species among cases of imported malaria diagnosed in Europe. The objective of this study is to describe the sensitivity of the parasitological tests in imported P. vivax malaria, and the impact of chemoprophylaxis and attack type (primary infection or relapse). METHODS A retrospective study included the imported vivax malaria cases admitted in a French military hospital between 2001 and 2013. The reference diagnosis method was microscopy corrected by polymerase chain reaction (PCR). Thin and thick blood films examination, quantitative buffy coat (QBC) test, and a rapid diagnostic test (RDT) had been systematically performed. PCR had been carried out for ambiguous profiles. RESULTS Eighty-nine cases recorded from 78 patients were included, 65 of them having recently traveled to French Guyana. Forty-two patients had properly followed chemoprophylaxis. Forty-six cases were primary infections while 43 were relapses. The sensitivity was 91% for the thin blood smear, 96% for the concentration techniques (Giemsa thick blood smear and QBC test), and 76% for the RDT. The combination of the three conventional tools has an imperfect sensitivity, both for the positive diagnosis of malaria (96%) and for the diagnosis of vivax species (80%). In 4% of the cases, the positive diagnosis was established only by the PCR. The species identification was established in 20% by the PCR. The sensibility of thin blood smear and of RDT decreased significantly with full compliance of chemoprophylaxis or primary infection, whereas the decrease of sensibility of concentration techniques was not significant. CONCLUSIONS This study illustrates the difficulties encountered in vivax malaria diagnosis, especially in patients who properly followed chemoprophylaxis or with primary infection due to a lower parasitemia. It underlines the lack of sensitivity of RDT for P. vivax and emphasizes the need for systematically combining various diagnosis methods.
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Demaison X, Rapp C, de Laval F, Simon F. Malaria attacks due to P. vivax or P. ovale in two French military teaching hospitals (2000 to 2009). Med Mal Infect 2013; 43:152-8. [DOI: 10.1016/j.medmal.2013.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 11/12/2012] [Accepted: 01/09/2013] [Indexed: 01/01/2023]
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Baird JK. Evidence and implications of mortality associated with acute Plasmodium vivax malaria. Clin Microbiol Rev 2013; 26:36-57. [PMID: 23297258 PMCID: PMC3553673 DOI: 10.1128/cmr.00074-12] [Citation(s) in RCA: 268] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Vivax malaria threatens patients despite relatively low-grade parasitemias in peripheral blood. The tenet of death as a rare outcome, derived from antiquated and flawed clinical classifications, disregarded key clinical evidence, including (i) high rates of mortality in neurosyphilis patients treated with vivax malaria; (ii) significant mortality from zones of endemicity; and (iii) the physiological threat inherent in repeated, very severe paroxysms in any patient, healthy or otherwise. The very well-documented course of this infection, with the exception of parasitemia, carries all of the attributes of "perniciousness" historically linked to falciparum malaria, including severe disease and fatal outcomes. A systematic analysis of the parasite biomass in severely ill patients that includes blood, marrow, and spleen may ultimately explain this historic misunderstanding. Regardless of how this parasite is pernicious, recent data demonstrate that the infection comes with a significant burden of morbidity and associated mortality. The extraordinary burden of malaria is not heavily weighted upon any single continent by a single species of parasite-it is a complex problem for the entire endemic world, and both species are of fundamental importance. Humanity must rally substantial resources, intellect, and energy to counter this daunting but profound threat.
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Affiliation(s)
- J Kevin Baird
- Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia, and the Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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Nurleila S, Syafruddin D, Elyazar IRF, Baird JK. Serious and fatal illness associated with falciparum and vivax malaria among patients admitted to hospital at West Sumba in eastern Indonesia. Am J Trop Med Hyg 2012; 87:41-49. [PMID: 22764290 PMCID: PMC3391056 DOI: 10.4269/ajtmh.2012.11-0577] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Records of 3,449 patients admitted to Karitas Hospital at Waitabula in eastern Indonesia with microscopy-confirmed malaria through 2008 and 2009 were systematically reviewed. Falciparum, vivax, and mixed species malaria occurred among 1,541, 1,837, and 71 admissions, respectively. Among these, 400 (26%), 199 (11%), and 15 (21%) had serious illness. Fatalities occurred in 46 (12%), 18 (9%), and 2 (13%) of these patients, respectively. Although patients with a diagnosis of falciparum malaria were more likely to have serious illness compared with those with vivax malaria (odds ratio [OR] = 2.9; 95% confidence interval [CI]: 2.4–3.5), this diagnosis nonetheless was associated with 32% of serious illness and 27% of fatalities. Among the seriously ill with a diagnosis of falciparum or vivax malaria, no significant difference in risk of death occurred (OR = 1.3; 95% CI: 0.7–2.5). Serious and fatal illness was predominantly anemia or altered mental state syndromes among patients with either of the species diagnoses. Plasmodium vivax was associated with a substantial share of the burden of morbidity and mortality caused by malaria in this hypo- to meso-endemic community.
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MESH Headings
- Adolescent
- Adult
- Child
- Child, Preschool
- Female
- Humans
- Indonesia/epidemiology
- Infant
- Malaria, Falciparum/complications
- Malaria, Falciparum/epidemiology
- Malaria, Falciparum/mortality
- Malaria, Falciparum/physiopathology
- Malaria, Vivax/complications
- Malaria, Vivax/epidemiology
- Malaria, Vivax/mortality
- Malaria, Vivax/physiopathology
- Male
- Middle Aged
- Pregnancy
- Pregnancy Complications, Parasitic/epidemiology
- Pregnancy Complications, Parasitic/mortality
- Pregnancy Complications, Parasitic/physiopathology
- Severity of Illness Index
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Affiliation(s)
- Siti Nurleila
- *Address correspondence to Kevin Baird, Eijkman-Oxford Clinical Research Unit, Jalan Diponegoro No. 69, Jakarta 10430 – Indonesia. E-mail:
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Arnott A, Barry AE, Reeder JC. Understanding the population genetics of Plasmodium vivax is essential for malaria control and elimination. Malar J 2012; 11:14. [PMID: 22233585 PMCID: PMC3298510 DOI: 10.1186/1475-2875-11-14] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 01/10/2012] [Indexed: 11/22/2022] Open
Abstract
Traditionally, infection with Plasmodium vivax was thought to be benign and self-limiting, however, recent evidence has demonstrated that infection with P. vivax can also result in severe illness and death. Research into P. vivax has been relatively neglected and much remains unknown regarding the biology, pathogenesis and epidemiology of this parasite. One of the fundamental factors governing transmission and immunity is parasite diversity. An understanding of parasite population genetic structure is necessary to understand the epidemiology, diversity, distribution and dynamics of natural P. vivax populations. In addition, studying the population structure of genes under immune selection also enables investigation of the dynamic interplay between transmission and immunity, which is crucial for vaccine development. A lack of knowledge regarding the transmission and spread of P. vivax has been particularly highlighted in areas where malaria control and elimination programmes have made progress in reducing the burden of Plasmodium falciparum, yet P. vivax remains as a substantial obstacle. With malaria elimination back on the global agenda, mapping of global and local P. vivax population structure is essential prior to establishing goals for elimination and the roll-out of interventions. A detailed knowledge of the spatial distribution, transmission and clinical burden of P. vivax is required to act as a benchmark against which control targets can be set and measured. This paper presents an overview of what is known and what is yet to be fully understood regarding P. vivax population genetics, as well as the importance and application of P. vivax population genetics studies.
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Affiliation(s)
- Alicia Arnott
- Centre for Population Health, Burnet Institute, Melbourne, Australia
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van Vugt M, van Beest A, Sicuri E, van Tulder M, Grobusch MP. Malaria treatment and prophylaxis in endemic and nonendemic countries: evidence on strategies and their cost–effectiveness. Future Microbiol 2011; 6:1485-500. [DOI: 10.2217/fmb.11.138] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Artemisinin combination treatment is currently the preferred treatment strategy to combat malaria. However, the drug costs are considerably higher than for previously used therapies. This review discusses the cost–effectiveness of current malaria treatment and prophylaxis in endemic and nonendemic countries. For endemic countries, a systematic search for economic evaluations (i.e., cost–effectiveness, cost–utility and cost–benefit analyses) was conducted, looking at the use of Artemisinin combination treatments in children, pregnant women and other adults. In total, 24 studies were identified investigating the cost–effectiveness of malaria treatments with the focus on uncomplicated malaria, severe or prereferral treatment, all in combination with adequate diagnosis, and malaria prevention by intermittent preventive treatment, respectively. In areas with both Plasmodium falciparum and Plasmodium vivax transmission, artemether–lumefantrine and dihydroartemisinin–piperaquine, respectively, are currently the most cost-effective treatment options. Treatment of severe malaria with artesunate is more cost effective compared with treatment with quinine. For patients that live more than 6 h away from an appropriate healthcare facility, prereferral treatment proved to be more cost-effective compared with no prereferral intervention. Cost–effectiveness of intermittent preventive treatment in pregnant women (IPTp) was dependent an clinical attendance. IPT in infants with sulphadoxine–pyrimethamine (SP) is cost effective in sites with high malaria transmission. IPT in children with artesunate (AS + SP), amodiaquine (AQ) + SPQ or SP alone is a cost effective and safe intervention for reducing the burden of malaria in children in areas with markedly seasonal malaria transmission. Although there is a need for it, little is known about the cost–effectiveness of current approaches to malaria therapy in nonendemic countries and the cost–effectiveness of antimalarial chemoprophylaxis.
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Affiliation(s)
- Michèle van Vugt
- Infectious Diseases, Center for Tropical Medicine & Travel Medicine, Division of Internal Medicine, AIGHD, Academic Medical Center, University of Amsterdam, Meibergdreef 9, PO Box 22660, 1100 DD Amsterdam, The Netherlands
| | - Anne van Beest
- Department of economics, VU University Medical Center, Amsterdam, The Netherlands
| | - Elisa Sicuri
- Barcelona Centre for International Health Research (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Maurits van Tulder
- Department of economics, VU University Medical Center, Amsterdam, The Netherlands
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Quintero JP, Siqueira AM, Tobón A, Blair S, Moreno A, Arévalo-Herrera M, Lacerda MVG, Valencia SH. Malaria-related anaemia: a Latin American perspective. Mem Inst Oswaldo Cruz 2011; 106 Suppl 1:91-104. [PMID: 21881762 PMCID: PMC4830680 DOI: 10.1590/s0074-02762011000900012] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Accepted: 07/04/2011] [Indexed: 11/22/2022] Open
Abstract
Malaria is the most important parasitic disease worldwide, responsible for an estimated 225 million clinical cases each year. It mainly affects children, pregnant women and non-immune adults who frequently die victims of cerebral manifestations and anaemia. Although the contribution of the American continent to the global malaria burden is only around 1.2 million clinical cases annually, there are 170 million inhabitants living at risk of malaria transmission in this region. On the African continent, where Plasmodium falciparum is the most prevalent human malaria parasite, anaemia is responsible for about half of the malaria-related deaths. Conversely, in Latin America (LA), malaria-related anaemia appears to be uncommon, though there is a limited knowledge about its real prevalence. This may be partially explained by several factors, including that the overall malaria burden in LA is significantly lower than that of Africa, that Plasmodium vivax, the predominant Plasmodium species in the region, appears to display a different clinical spectrus and most likely because better health services in LA prevent the development of severe malaria cases. With the aim of contributing to the understanding of the real importance of malaria-related anaemia in LA, we discuss here a revision of the available literature on the subject and the usefulness of experimental animal models, including New World monkeys, particularly for the study of the mechanisms involved in the pathogenesis of malaria.
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Affiliation(s)
- Juan Pablo Quintero
- Caucaseco Scientific Research Center, Cali, Colômbia
- Centro Latino Americano de Investigación en Malaria, Cali, Colombia
| | - André Machado Siqueira
- Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, AM, Brasil
- Universidade do Estado do Amazonas, Manaus, AM, Brasil
| | | | | | - Alberto Moreno
- Emory Vaccine Centre, Yerkes National Primate Research Centre, Atlanta, GA, USA
- Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, GA, USA
| | - Myriam Arévalo-Herrera
- Caucaseco Scientific Research Center, Cali, Colômbia
- Centro Latino Americano de Investigación en Malaria, Cali, Colombia
| | | | - Sócrates Herrera Valencia
- Caucaseco Scientific Research Center, Cali, Colômbia
- Centro Latino Americano de Investigación en Malaria, Cali, Colombia
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Rodriguez-Morales AJ, Herrera-Martínez AD, Herrera-Martínez Y. Imported cases of malaria admitted to a hospital in Western Venezuela, 1998–2009. Travel Med Infect Dis 2010; 8:269-71. [DOI: 10.1016/j.tmaid.2010.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Revised: 07/06/2010] [Accepted: 07/07/2010] [Indexed: 11/28/2022]
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Oliveira-Ferreira J, Lacerda MVG, Brasil P, Ladislau JLB, Tauil PL, Daniel-Ribeiro CT. Malaria in Brazil: an overview. Malar J 2010; 9:115. [PMID: 20433744 PMCID: PMC2891813 DOI: 10.1186/1475-2875-9-115] [Citation(s) in RCA: 268] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2009] [Accepted: 04/30/2010] [Indexed: 12/17/2022] Open
Abstract
Malaria is still a major public health problem in Brazil, with approximately 306,000 registered cases in 2009, but it is estimated that in the early 1940s, around six million cases of malaria occurred each year. As a result of the fight against the disease, the number of malaria cases decreased over the years and the smallest numbers of cases to-date were recorded in the 1960s. From the mid-1960s onwards, Brazil underwent a rapid and disorganized settlement process in the Amazon and this migratory movement led to a progressive increase in the number of reported cases. Although the main mosquito vector (Anopheles darlingi) is present in about 80% of the country, currently the incidence of malaria in Brazil is almost exclusively (99,8% of the cases) restricted to the region of the Amazon Basin, where a number of combined factors favors disease transmission and impair the use of standard control procedures. Plasmodium vivax accounts for 83,7% of registered cases, while Plasmodium falciparum is responsible for 16,3% and Plasmodium malariae is seldom observed. Although vivax malaria is thought to cause little mortality, compared to falciparum malaria, it accounts for much of the morbidity and for huge burdens on the prosperity of endemic communities. However, in the last few years a pattern of unusual clinical complications with fatal cases associated with P. vivax have been reported in Brazil and this is a matter of concern for Brazilian malariologists. In addition, the emergence of P. vivax strains resistant to chloroquine in some reports needs to be further investigated. In contrast, asymptomatic infection by P. falciparum and P. vivax has been detected in epidemiological studies in the states of Rondonia and Amazonas, indicating probably a pattern of clinical immunity in both autochthonous and migrant populations. Seropidemiological studies investigating the type of immune responses elicited in naturally-exposed populations to several malaria vaccine candidates in Brazilian populations have also been providing important information on whether immune responses specific to these antigens are generated in natural infections and their immunogenic potential as vaccine candidates. The present difficulties in reducing economic and social risk factors that determine the incidence of malaria in the Amazon Region render impracticable its elimination in the region. As a result, a malaria-integrated control effort--as a joint action on the part of the government and the population--directed towards the elimination or reduction of the risks of death or illness, is the direction adopted by the Brazilian government in the fight against the disease.
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Affiliation(s)
- Joseli Oliveira-Ferreira
- Laboratório de Pesquisa em Malária, Instituto Oswaldo Cruz, Fiocruz, Pavilhão Leônidas Deane - 5° andar, Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ - CEP 21.045-900, RJ - Brazil
- Centro de Pesquisa Diagnóstico e Treinamento em Malária (CPD-Mal), Fiocruz and Secretaria de Vigilância em Saúde (SVS) - Ministério da Saúde (MS), Brazil
- Laboratório de Imunoparasitologia, Instituto Oswaldo Cruz, Fiocruz. Pavilhão Leônidas Deane - 4° andar. Av. Brasil 4365. Manguinhos, Rio de Janeiro, RJ - CEP 21.045-900, RJ - Brazil
| | - Marcus VG Lacerda
- Fundação de Medicina Tropical do Amazonas, Av. Pedro Teixeira 25, Manaus, Amazonas - CEP 69.040-000, Brazil
| | - Patrícia Brasil
- Centro de Pesquisa Diagnóstico e Treinamento em Malária (CPD-Mal), Fiocruz and Secretaria de Vigilância em Saúde (SVS) - Ministério da Saúde (MS), Brazil
- Instituto de Pesquisa Clínica Evandro Chagas, Fiocruz, Av. Brasil 4365. Manguinhos, Rio de Janeiro, RJ - CEP 21.045-900, RJ - Brazil
| | - José LB Ladislau
- Programa Nacional de Controle da Malária, SVS-MS, Esplanada dos Ministérios, Bloco G, Sobreloja, sala 151. Brasília - CEP 70.058-900, Brazil
| | - Pedro L Tauil
- Área de Medicina Social, Faculdade de Medicina, Universidade de Brasília, Brasília - CEP 70.910-900, Brazil
| | - Cláudio Tadeu Daniel-Ribeiro
- Laboratório de Pesquisa em Malária, Instituto Oswaldo Cruz, Fiocruz, Pavilhão Leônidas Deane - 5° andar, Av. Brasil 4365, Manguinhos, Rio de Janeiro, RJ - CEP 21.045-900, RJ - Brazil
- Centro de Pesquisa Diagnóstico e Treinamento em Malária (CPD-Mal), Fiocruz and Secretaria de Vigilância em Saúde (SVS) - Ministério da Saúde (MS), Brazil
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14
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Diseases and injuries associated with travel among students, employees and teachers of the Central University of Venezuela during the national summer vacations. Travel Med Infect Dis 2010; 8:41-6. [DOI: 10.1016/j.tmaid.2009.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2009] [Revised: 10/26/2009] [Accepted: 10/27/2009] [Indexed: 11/21/2022]
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15
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Diagnostic importance of headache as a key symptom in suspecting malaria in adult returning travelers. Travel Med Infect Dis 2009; 7:383-4. [PMID: 19945019 DOI: 10.1016/j.tmaid.2009.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2009] [Revised: 09/04/2009] [Accepted: 09/15/2009] [Indexed: 11/24/2022]
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