Abstract
Gold-mining may play an important role in the maintenance of malaria worldwide. Gold-mining, mostly illegal, has significantly expanded in Colombia during the last decade in areas with limited health care and disease prevention. We report a descriptive study that was carried out to determine the malaria prevalence in gold-mining areas of Colombia, using data from the public health surveillance system (National Health Institute) during the period 2010-2013. Gold-mining was more prevalent in the departments of Antioquia, Córdoba, Bolívar, Chocó, Nariño, Cauca, and Valle, which contributed 89.3% (270,753 cases) of the national malaria incidence from 2010-2013 and 31.6% of malaria cases were from mining areas. Mining regions, such as El Bagre, Zaragoza, and Segovia, in Antioquia, Puerto Libertador and Montelíbano, in Córdoba, and Buenaventura, in Valle del Cauca, were the most endemic areas. The annual parasite index (API) correlated with gold production (R2 0.82, p < 0.0001); for every 100 kg of gold produced, the API increased by 0.54 cases per 1,000 inhabitants. Lack of malaria control activities, together with high migration and proliferation of mosquito breeding sites, contribute to malaria in gold-mining regions. Specific control activities must be introduced to control this significant source of malaria in Colombia.
Highlights
Mining has historically played an important role in the expansion and creation of many productive human settlements and to the national economy of mineral rich countries, but simultaneously it has led to an increase in malaria transmission in mining areas (Knoblauch et al 2014)
Most malaria cases in Brazil come from rural areas related to gold-mining in the Amazon Region, where 52% of the cases are caused by P. vivax, 30% by P. falciparum, and the rest are mix infections and P. malariae; the state of Mato Grosso gold-mining contributed a significant number of cases
Mining districts in Colombia - According to the classification by the Unit of Planning of Mining and Energy in Colombia, the departments with highest gold production are Antioquia, Córdoba, Bolívar, Chocó, Nariño, Cauca, and Valle, which contributed to 89.3% (270,753 cases) of the national malaria incidence from 2010-2013, of which 31.6% came from mining areas (Fig. 1A-C)
Summary
Mining has historically played an important role in the expansion and creation of many productive human settlements and to the national economy of mineral rich countries, but simultaneously it has led to an increase in malaria transmission in mining areas (Knoblauch et al 2014). Likewise in the American continent, Brazil, Colombia, Venezuela, Suriname, and Peru are countries with significant gold extraction associated with high malaria prevalence (Asante et al 2011, da Silva-Nunes et al 2012, Ferreira et al 2012, Mitjà et al 2013, Parker et al 2013), which presents mainly as asymptomatic cases and in age groups involved in mining (de Andrade et al 1995, da Silva-Nunes et al 2012). In countries like Ghana, the overall malaria prevalence was 22.8% in 2006/2007, with ~98% in mining areas that were predominantly Plasmodium falciparum infections (Asante et al 2011), in PNG (Lihir Island) Plasmodium vivax was more prevalent (57%) in 2006-2011, with a small number of Plasmodium malariae cases (< 3%) (Mitjà et al 2013). Gold miners are the only remaining population that is vulnerable to malaria (Hiwat et al 2012, Breeveld et al 2012)
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