Abstract
BackgroundFifty-three percent of all cases of malaria in the Americas in 2019 came from Venezuela, where the epidemic is heavily focused south of the Orinoco river, and where most of the country’s Amerindian groups live. Although the disease is known to represent a significant public health problem among these populations, little epidemiological data exists on the subject. This study aims to provide information on malaria incidence, geospatial clustering, and risk factors associated to Plasmodium falciparum infection among these groups.MethodsThis is a descriptive study based on the analysis of published and unpublished programmatic data collected by Venezuelan health authorities and non-government organizations between 2014 and 2018. The Annual Parasite Index among indigenous groups (API-i) in municipalities of three states (Amazonas, Bolivar, and Sucre) were calculated and compared using the Kruskal Wallis test, risk factors for Plasmodium falciparum infection were identified via binomial logistic regression and maps were constructed to identify clusters of malaria cases among indigenous patients via Moran’s I and Getis-Ord’s hot spot analysis.Results116,097 cases of malaria in Amerindian groups were registered during the study period. An increasing trend was observed between 2014 and 2016 but reverted in 2018. Malaria incidence remains higher than in 2014 and hot spots were identified in the three states, although more importantly in the south of Bolivar. Most cases (73.3%) were caused by Plasmodium vivax, but the Hoti, Yanomami, and Eñepa indigenous groups presented higher odds for infection with Plasmodium falciparum.ConclusionMalaria cases among Amerindian populations increased between 2014 and 2018 and seem to have a different geographic distribution than those among the general population. These findings suggest that tailored interventions will be necessary to curb the impact of malaria transmission in these groups.
Highlights
Fifty-three percent of all cases of malaria in the Americas in 2019 came from Venezuela, where the epidemic is heavily focused south of the Orinoco river, and where most of the country’s Amerindian groups live
The aim is to provide information on the general burden of malaria among the indigenous people of Amazonas, Bolivar, and Sucre states, describe differences in regional incidence, spatial clustering, risk factors for infection with Plasmodium falciparum, and transmission seasonality. This is a descriptive study based on the analysis of programmatic data collected by Venezuelan health authorities and Non-government organization (NGO) in three Venezuelan states
Morbidity data from 2014 to 2017 was obtained from publicly available sources. These included the 2014, 2015, and 2016 Epidemiological Bulletins published by the Venezuelan Ministry of Popular Power for Health (MPPS), which present aggregated parish-level on malaria morbidity for every state [4, 14, 15], as well as the Pan-American Health Organization’s (PAHO) malaria surveillance dataset [16]
Summary
Fifty-three percent of all cases of malaria in the Americas in 2019 came from Venezuela, where the epidemic is heavily focused south of the Orinoco river, and where most of the country’s Amerindian groups live. This study aims to provide information on malaria incidence, geospatial cluster‐ ing, and risk factors associated to Plasmodium falciparum infection among these groups. Malaria is a major public health concern in the Americas, where 889,000 cases and 550 deaths were estimated to have occurred in 2019. Fifty-three percent of these cases, and 73% of all deaths came from Venezuela, where. Gabaldón‐Figueira et al Malar J (2021) 20:285 vivax causes 77% of all registered cases, followed by Plasmodium falciparum, with 16%, and mixed infections (6.5%). The total Amerindian population in Venezuela was estimated to surpass 720,000 people in 2011 [5], most of which are concentrated in malaria-endemic regions. Amerindians in Venezuela are mostly young, with a median age of 21 years, and 65% of the population are under 30 years old [5]
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