Outbreak of autochthonous cases of malaria in coastal regions of Northeast Brazil: the diversity and spatial distribution of species of Anopheles

Survey and Analysis of Chemoprophylaxis Policies for Domestic Travel in Malaria-Endemic Countries

The prevention of malaria in travelers with the use of antimalarials often occurs in connection with international travel to areas of significant risk of infection. Although these travelers sometimes cause outbreaks in their malaria-free home countries, the cardinal objective of prescribed chemoprophylaxis is to protect the traveler from patent malaria during travel. Here we consider the chemoprophylaxis of domestic travelers from malaria-free but -receptive areas within malaria-endemic countries. The main objective in this setting is the protection of those areas from reintroduced malaria transmission. In order to better understand policy and practices in this regard, we surveyed malaria prevention and treatment guidelines of 36 malaria-endemic countries and 2 that have recently eliminated malaria (Sri Lanka, China) for recommendations regarding malaria chemoprophylaxis for domestic travel. Among them, just 8 provided specific and positive recommendations, 1 recommended without specific guidance, and 4 advised against the practice. Most nations (25/38; 66%) did not mention chemoprophylaxis for domestic travel, though many of those did offer guidance for international travel. The few positive recommendations for domestic travel were dominated by the suppressive prophylaxis options of daily doxycycline or atovaquone-proguanil or weekly mefloquine. The incomplete protection afforded by these strategies, along with impractical dosing in connection with the typically brief domestic travel, may in part explain the broad lack of policies and practices across malaria-endemic nations regarding chemoprophylaxis.

Phenotypic traits of individuals in a long-term colony of Anopheles (Nyssorhynchus) aquasalis (Diptera: Culicidae) show variable susceptibility to Plasmodium and suggest cryptic speciation

Anopheles aquasalis is an important malaria vector in coastal regions of South America and islands of the Caribbean. In its original description, the species was divided into two varieties, based on the scaling patterns of their hind-tarsomere 2. Specimens from our 25-year established colony, used for Plasmodium experimental infections, still exhibit both scaling tarsomere patterns. This study examined the DNA sequence of the nuclear Internal Transcribed Spacer 2 (ITS2) and susceptibility to Plasmodium, looking for differences among the phenotypes 30BS and 50BS. One hundred mosquitoes, 25 males and 25 females of each sex, and phenotype were analyzed. Twenty-seven novel haplotypes were identified. Three were found in both phenotypes (30BS and 50BS) regardless of gender. Among the other 27 genotypes, we observed a male-oriented bias in both phenotypic categories. Evaluation of Plasmodium yoelii N67 infections, based on oocyst counts, showed a higher susceptibility of 30BS compared with 50BS. Future studies need to be conducted to evaluate if these genotype assortments among the phenotypic groups reflect differences in fitness, mating, and their susceptibility to infection by Plasmodium parasites.