Abstract
Epidemic malaria has rapidly emerged in Loreto Department, in the Peruvian Amazon region. Peru reports the second highest number of malaria cases in South America (after Brazil), most from Loreto. From 1992 to 1997, malaria increased 50-fold in Loreto but only fourfold in Peru. Plasmodium falciparum infection, which has increased at a faster rate than P. vivax infection in the last 3 years, became the dominant Plasmodium infection in the highest transmission areas in the 1997 rainy season. The vector Anopheles darlingi has also increased during this epidemic in Loreto. Moreover, chloroquine and pyrimethamine-sulfadoxine drug-resistant P. falciparum strains have emerged, which require development of efficacious focal drug treatment schemes.
Highlights
Epidemiology Since 1941, the highest number of malaria cases in Peru was 95,000 in 1944, and the lowest was 1,500 cases in 1965 [1]
Indigenous P. vivax malaria was initially reported in the Iquitos area (Rumococha and Zungarococha) in April 1991, and P. falciparum was first detected (Padrecocha) in November 1994
A small number of P. falciparum cases have been diagnosed in patients who had not traveled outside Iquitos in the 2 months before illness
Summary
Epidemic malaria has rapidly emerged in Loreto Department, in the Peruvian Amazon region. Peru reports the second highest number of malaria cases in South America (after Brazil), most from Loreto. In 1991, 140 cases were reported; the number increased annually until 1997 when 54,290 slide-confirmed P. falciparum. Malaria transmission has been seasonal in the Loreto epidemic, with peaks in the rainy season from November to June (Figure 3). Indigenous P. vivax malaria was initially reported in the Iquitos area (Rumococha and Zungarococha) in April 1991, and P. falciparum was first detected (Padrecocha) in November 1994. Precipitation peaked twice in 1997: 3 months before and the same month that malaria cases reached their highest number (Figure 6B).
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