Complex malaria epidemiology in an international border area between Brazil and French Guiana: challenges for elimination.

ABSTRACT:

Background

The epidemiological surveillance of malaria is a necessary intervention for eliminating the disease from the planet. The international border zones of the Amazon continue to be highly vulnerable to malaria since population mobility impedes elimination. Although in the past few years, cases of malaria have had an essential reduction in Brazil, this trend was not confirmed in municipalities along the border. This study aimed to establish the epidemiology of the disease during the last 13?years in Oiapoque, a Brazilian municipality at the international border with French Guiana, an overseas department, to develop strategies for the control/elimination of malaria in these areas.

Results

Data collected from 2003 to 2015 from the Malaria Epidemiological Surveillance System was used. It was found that, despite the important reduction in cases (68.1%), the annual parasite index remained a high epidemiological risk. The disease is seasonal in that the period of highest transmission occurs between September and December. Between 2003 and 2015, eight outbreaks were identified, with one of these lasting 15?months between August 2006 and October 2007. There were changes in the epidemiological profile, with imported cases representing 67.7% of cases from 2003 to 2007 and representing 32.9% of cases from 2008 to 2015 (p?p?Plasmodium falciparum (p?=?0.01). Children under 15?years old, representing 9.7% of cases at the onset of the study, accounted for 34.2% of case notifications (p?p?ConclusionsThe fragility of local health services in cross-border areas continues to be an obstacle for malaria elimination.

SUBMITTER: da Cruz Franco V 

PROVIDER: S-EPMC6458633 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature