Abstract

BackgroundBrazilian malaria control programmes successfully reduced the incidence and mortality rates from 2005 to 2016. Since 2017, increased malaria has been reported across the Amazon. Few field studies focus on the primary malaria vector in high to moderate endemic areas, Nyssorhynchus darlingi, as the key entomological component of malaria risk, and on the metrics of Plasmodium vivax propagation in Amazonian rural communities.MethodsHuman landing catch collections were carried out in 36 houses of 26 communities in five municipalities in the Brazilian states of Acre, Amazonas and Rondônia states, with API (> 30). In addition, data on the number of locally acquired symptomatic infections were employed in mathematical modelling analyses carried out to determine Ny. darlingi vector competence and vectorial capacity to P. vivax; and to calculate the basic reproduction number for P. vivax.ResultsEntomological indices and malaria metrics ranged among localities: prevalence of P. vivax infection in Ny. darlingi, from 0.243% in Mâncio Lima, Acre to 3.96% in Machadinho D’Oeste, Rondônia; daily human-biting rate per person from 23 ± 1.18 in Cruzeiro do Sul, Acre, to 66 ± 2.41 in Lábrea, Amazonas; vector competence from 0.00456 in São Gabriel da Cachoeira, Amazonas to 0.04764 in Mâncio Lima, Acre; vectorial capacity from 0.0836 in Mâncio Lima, to 1.5 in Machadinho D’Oeste. The estimated R0 for P. vivax (PvR0) was 3.3 in Mâncio Lima, 7.0 in Lábrea, 16.8 in Cruzeiro do Sul, 55.5 in São Gabriel da Cachoeira, and 58.7 in Machadinho D’Oeste. Correlation between P. vivax prevalence in Ny. darlingi and vector competence was non-linear whereas association between prevalence of P. vivax in mosquitoes, vectorial capacity and R0 was linear and positive.ConclusionsIn spite of low vector competence of Ny. darlingi to P. vivax, parasite propagation in the human population is enhanced by the high human-biting rate, and relatively high vectorial capacity. The high PvR0 values suggest hyperendemicity in Machadinho D’Oeste and São Gabriel da Cachoeira at levels similar to those found for P. falciparum in sub-Saharan Africa regions. Mass screening for parasite reservoirs, effective anti-malarial drugs and vector control interventions will be necessary to shrinking transmission in Amazonian rural communities, Brazil.

Highlights

  • Brazilian malaria control programmes successfully reduced the incidence and mortality rates from 2005 to 2016

  • The human population in each municipality, and results of the variables from the field-collected data employed in the mathematical modelling, namely, the P. vivax annual parasite incidence (API), the remaining susceptible human population (­SH), the prevalence of P. vivax infection in Ny. darlingi mosquitoes, IMt /NMt, and the daily human-biting rate per human collector, HBRt, are shown in Table 2 and Additional file 2

  • The second highest API value (API = 241) was estimated for Mâncio Lima, and the prevalence of P. vivax infection in Ny. darlingi was 0.243%, a value slight lower than that found in Cruzeiro do Sul

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Summary

Introduction

Brazilian malaria control programmes successfully reduced the incidence and mortality rates from 2005 to 2016. Few field studies focus on the primary malaria vector in high to moderate endemic areas, Nyssorhynchus darlingi, as the key entomological component of malaria risk, and on the metrics of Plasmodium vivax propagation in Amazonian rural communities. Both the morbidity and mortality associated with malaria have substantially decreased worldwide and in several endemic countries in Africa, South-East Asia and South America, including Brazil [1, 2]. Understanding spatiotemporal heterogeneities in the intensity and risk of transmission is important for planning and delineating measures and strategies to be adopted by an effective malaria control programme, as well as when disease incidence is decreasing, and elimination is forthcoming [7]

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