Deforestation, drainage network, indigenous status, and geographical differences of malaria in the State of Amazonas.

Wagner Cosme Morhy Terrazas,Rosemary Costa Pinto,Bernardino Cláudio De Albuquerque,Megumi Sadahiro,Ricardo Augusto Dos Passos,Vanderson De Souza Sampaio,Daniel Barros De Castro,José Ueleres Braga

doi:10.1186/s12936-015-0859-0

Abstract

BackgroundMalaria is a major public health problem worldwide. In Brazil, an average of 420,000 cases of malaria have been reported annually in the last 12 years, of which 99.7 % occurred in the Amazon region. This study aimed to analyse the distribution of malaria in the State of Amazonas and the influence of indigenous malaria in this scenario, to evaluate the correlation between incidence rates and socio-economic and environmental factors, and to evaluate the performance of health surveillance services.MethodsThis ecological study used secondary data obtained from the SIVEP-MALARIA malaria surveillance programme. The relationship between demographic, socio-economic and environmental factors, the performance of health surveillance services and the incidence of malaria in Amazonas, a multiple linear regression model was used.ResultsThe crude rate of malaria in Amazonas was 4142.72 cases per 100,000 inhabitants between 2003 and 2012. The incidence rates for the indigenous and non-indigenous populations were 12,976.02 and 3749.82, respectively, with an indigenous population attributable fraction of only 8 %. The results of the linear regression analysis indicated a negative correlation between the two socio-economic indicators (municipal human development index (MHDI) and poverty rate) and the incidence of malaria in the period. With regard to the environmental indicators (average annual deforestation rate and percentage of areas under the influence of watercourses), the correlation with the incidence rate was positive.ConclusionsThe findings underscore the importance of implementing economic and social development policies articulated with strategic actions of environmental protection and health care for the population.

Highlights

Malaria is a major public health problem worldwide
In all regions of the State, incidence rates were higher among the indigenous population compared to the non-indigenous population
The results indicated that the risk of acquiring malaria among the indigenous population was three times greater than that among the non-indigenous population, corroborating previous studies that revealed the susceptibility of this group to the endemic disease [35, 36]

Summary

Introduction

Malaria is a major public health problem worldwide. In Brazil, an average of 420,000 cases of malaria have been reported annually in the last 12 years, of which 99.7 % occurred in the Amazon region. This study aimed to analyse the distribution of malaria in the State of Amazonas and the influence of indigenous malaria in this scenario, to evaluate the correlation between incidence rates and socio-economic and environmental factors, and to evaluate the performance of health surveillance services. Malaria is a major public health problem worldwide, with approximately 198 million cases and 584,000 deaths in 2013. This endemic disease occurs predominantly in Asia, Africa, and Latin America [1]. Some authors have identified a Terrazas et al Malar J (2015) 14:379 correlation between deforestation and high malaria incidence rates [8,9,10,11,12,13,14,15], whereas other authors have reported an increased number of malaria cases in the forest fringes [16,17,18,19]

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