Short-Time Recurrences of Plasmodium vivax Malaria as a Public Health Proxy for Chloroquine-Resistance Surveillance: A Spatio-Temporal Study in the Brazilian Amazon

In Brazil, malaria caused by presents control challenges due to several reasons, among them the increasing possibility of failure of treatment due to chloroquine-resistance (CQR). Despite limited reports of CQR, more extensive studies on the actual magnitude of resistance are still needed. Short-tim...

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Bibliographic Details
Published in:International journal of environmental research and public health 2021-05, Vol.18 (10), p.5061
Main Authors: Balieiro, Antonio A S, Siqueira, Andre M, Melo, Gisely C, Monteiro, Wuelton M, Sampaio, Vanderson S, Mueller, Ivo, Lacerda, Marcus V G, Villela, Daniel A M
Format: Article
Language:English
Subjects:
Antimalarials - therapeutic use
Brazil - epidemiology
Child
Child, Preschool
Chloroquine
Chloroquine - therapeutic use
Clinical trials
Clustering
Health surveillance
Humans
Infections
Malaria
Malaria, Vivax - drug therapy
Malaria, Vivax - epidemiology
Names
Patients
Phonetics
Plasmodium vivax
Public Health
Recurrence
Risk factors
Software
Trends
Vector-borne diseases
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Summary:In Brazil, malaria caused by presents control challenges due to several reasons, among them the increasing possibility of failure of treatment due to chloroquine-resistance (CQR). Despite limited reports of CQR, more extensive studies on the actual magnitude of resistance are still needed. Short-time recurrences of malaria cases were analyzed in different transmission scenarios over three years (2005, 2010, and 2015), selected according to malaria incidence. Multilevel models (binomial) were used to evaluate association of short-time recurrences with variables such as age. The zero-inflated Poisson scan model (scanZIP) was used to detect spatial clusters of recurrences up to 28 days. Recurrences compose less than 5% of overall infection, being more frequent in the age group under four years. Recurrences slightly increased incidence. No fixed clusters were detected throughout the period, although there are clustering sites, spatially varying over the years. This is the most extensive analysis of short-time recurrences worldwide which addresses the occurrence of CQR. As an important step forward in malaria elimination, policymakers should focus their efforts on young children, with an eventual shift in the first line of malaria treatment to .
ISSN:1660-4601
1661-7827
1660-4601
DOI:10.3390/ijerph18105061