Abstract
Recent efforts to reduce malaria incidence have had some successes. Nevertheless, malaria persists as a significant public health problem in the Brazilian Amazon. The objective of this study was to describe changes in malaria case characteristics and to identify trends in malaria incidence in the Brazilian Amazon. This study used data from the Malaria Epidemiological Surveillance and Case Notification Information System from 2004 to 2013. The annual parasite incidence (API) was calculated and joinpoint regression was used to assess the trends in API over time. There was a sharp increase in API in the state of Acre, followed by two periods of decrease. Pará also presented inconsistent decreases over the study period. Amapá, Amazonas, Rondônia, and Roraima showed statistically significant decreases over the period. The sharpest decrease occurred in Rondônia, with a reduction of 21.7% in the average annual percent change (AAPC) (AAPC: -21.7%; 95% confidence interval: -25.4%, -17.8%; p < 0.05). This panorama of malaria incidence highlights the importance of integrating evidence-based malaria surveillance and control. Malaria is highly preventable, and eliminating its transmission should be a goal in coming decades.
Highlights
Over the last 15 years (2000-2015), there has been an 18.0% reduction in the number of malaria cases and 48.0% reduction in the number of malaria deaths worldwide (WHO 2015a)
This study described diverse annual parasite incidence (API) trends in selected states of the Brazilian Amazon Region (BAR): Rondônia showed a sustained reduction in this indicator (-21.7%); Amapá, Amazonas, and Roraima showed sustained reductions, with relatively low magnitudes ranging from -9.8% to -16.5%; Pará showed a reduction of -70.4% only in the last two years of the time series (2012-2013); whereas Acre showed no significant reduction in the indicator
This study demonstrated a change in the profile of malaria cases reported over the study period
Summary
Over the last 15 years (2000-2015), there has been an 18.0% reduction in the number of malaria cases and 48.0% reduction in the number of malaria deaths worldwide (WHO 2015a). The National Malaria Control Programme (NMCP) of the Ministry of Health launched the Plan for Elimination of Malaria in Brazil. This plan is aligned with the United Nations’ Sustainable Development Goals, with a primary objective to reduce the worldwide number of malaria cases by 90.0% and to eliminate the disease in 35 countries by 2030 (WHO 2015b). The objective of this study was to describe changes in malaria cases in terms of demographics, socio-economics, and malaria-related variables in selected states of the BAR and to assess trends in malaria incidence (annual parasite incidence - API) between 2004-2013
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