Spatial distribution of malaria and primary healthcare in Cametá and Tucuruí, Pará state, Brazil.

Maira Cibelle Da Silva Peixoto,Nelson Veiga Gonçalves,João Sérgio De Sousa Oliveira,Claudia Do Socorro Carvalho Miranda,Pedro Silvestre Da Silva Campos,Alba Lucia Ribeiro Raithy Pereira,Adriana Veiga Da Conceição Silva,Roberto Carlos Figueiredo,Marília De Souza Araújo,Emerson Cordeiro Morais

doi:10.3855/jidc.15260

Abstract

Malaria cases in Brazil are concentrated in the Amazon region. In the state of Pará, malaria is considered an endemic disease, and the population has different levels of exposure, which contributes to different types of occurrence in the municipalities. A descriptive, cross-sectional, and ecological study was conducted using data from the Malaria Epidemiological Surveillance System of the municipalities of Cametá and Tucuruí, PA, Brazil, from 2014 to 2018; the Brazilian Institute of Geography and Statistics; and the National Registry of Health Institutions of the Ministry of Health. Statistical and spatial analyses of epidemiological, laboratory and public health service coverage variables were performed using the Bioestat 5.0 and ArcGis 10.5 software. 11,381 Malaria cases were reported in the two municipalities. The highest percentage of case notifications was reported in brown-skinned men aged from 19 and 59 years, and who had primary education levels. The predominant occupations were farming and livestock in Cametá and domestic activity in Tucuruí. The most common diagnostic examination used was a thick blood smear, and Plasmodium vivax was the species most often encountered. The percentage of primary care coverage increased during the study period. The spatial distribution of the disease was not homogeneous, and there were clusters of cases with different densities in Cametá and Tucuruí. Malaria is a public health problem in the municipalities of Cametá and Tucuruí, because of its transmission dynamics and variable spatial distribution as well as the coexistence of factors that favor the exposure of resident populations to epidemiological situations, thus reflecting health inequities.

Highlights

Malaria cases in Brazil are concentrated in the Amazon region
Malaria has affected more men than women in both municipalities, a classic Malaria profile that may be related to the higher degree of exposure to risk factors, such as the development of occupational activities near sites favorable to the development of Anopheles spp [1,17]
The 19-59 age group, which was the most affected, was associated with greater exposure to Malaria in the economically active phase, which corroborated the findings of some studies that reported on the characteristics of workplaces [17,18,19,20,21]

Summary

Introduction

Malaria cases in Brazil are concentrated in the Amazon region. In the state of Pará, malaria is considered an endemic disease, and the population has different levels of exposure, which contributes to different types of occurrence in the municipalities. Conclusions: Malaria is a public health problem in the municipalities of Cametá and Tucuruí, because of its transmission dynamics and variable spatial distribution as well as the coexistence of factors that favor the exposure of resident populations to epidemiological situations, reflecting health inequities. Malaria is an acute infectious disease caused by unicellular protozoan species belonging to the genus Plasmodium and transmitted to humans through the bite of infected female Anopheles mosquitoes. It is considered the main endemic parasitic disease in the world and commonly occurs in tropical and subtropical countries [1,2]. Malaria is considered a compulsorily notifiable disease in the Amazon region by the Brazilian Unified Health System, through the Computerized Malaria Surveillance System (SIVEPMalaria) [1,4,5,6]

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