Malaria in Gold Miners in the Guianas and the Amazon: Current Knowledge and Challenges

Abstract

Purpose of Review Following Paraguay and Argentina, several countries from the Amazon region aim to eliminate malaria. To achieve this, all key affected and vulnerable populations by malaria, including people working on gold mining sites, must be considered. What is the situation of malaria in these particular settings and what are the challenges? This literature review aims to compile knowledge to answer these questions. Recent FindingsThe contexts in which gold miners operate are very heterogeneous: size and localization of mines, links with crime, administrative status of the mines and of the miners, mobility of the workers or national regulations. The number of malaria cases has been correlated with deforestation (Brazil, Colombia), gold production (Colombia), gold prices (Guyana), or location of the mining region (Peru, Colombia, Venezuela, Guyana). The burden of malaria in gold mines differs between territories: significant in Guyana, French Guiana, or Venezuela; lower in Brazil. Although Plasmodium vivax causes 75% of malaria cases in the Americas, P. falciparum is predominant in several gold mining regions, especially in the Guiana Shield. Because of the remoteness from health facilities, self-medication with under-the-counter antimalarials is frequent. This constitutes a significant risk for the emergence of new P. falciparum parasites resistant to antimalarial drugs. Summary Because of the workers' mobility, addressing malaria transmission in gold mines is essential, not only for miners, but also to prevent the (re-)emergence of malaria. Strategies among these populations should be tailored to the context because of the heterogeneity of situations in different territories. The transnational environment favoring malaria transmission also requires transborder and regional cooperation, where innovative solutions should be considered and evaluated.

Cross-border malaria in Northern Brazil

“…In the case of Guyana (Fig. 5 b), cross-border cases are predominantly Brazilian nationals travelling for economic opportunity (mainly gold mining, mostly illegal) [ 44 ]. These movements are likely to occur repeatedly and present a challenge to both Brazil and Guyana [ 42 , 44 ].…”

“…5 b), cross-border cases are predominantly Brazilian nationals travelling for economic opportunity (mainly gold mining, mostly illegal) [ 44 ]. These movements are likely to occur repeatedly and present a challenge to both Brazil and Guyana [ 42 , 44 ]. In Guyana, 94% of malaria cases reported occurred in major gold mining regions, and the malaria scenario in Venezuela demonstrates the potential for small, isolated, malaria-dense populations with minimal resources to spur outbreaks of the disease and reverse progress toward elimination.…”

Vector-Focused Approaches to Curb Malaria Transmission in the Brazilian Amazon: An Overview of Current and Future Challenges and Strategies

“…Furthermore, culturally determined activities such as hunting, fishing, working in the fields, and bathing along rivers and streams expose indigenous people to the risk of malaria infection. Gold mining plays a major role in spreading malaria in the area [ 37 ] since this activity creates puddles of water, ideal habitat for the reproduction of Anopheles mosquitoes. Transmission of malaria among miners (garimpeiros) is greatly affected by their constant mobility and a work regime that coincides with the peak of biting activity of vector mosquitoes.…”

Vector-focused Approaches to Curb Malaria Transmission in the Brazilian Amazon: An Overview of Current and Future Challenges and Strategies

“…Furthermore, culturally determined activities such as hunting, fishing, working in the fields, bathing along rivers and streams expose indigenous people to the risk of malaria infection. Gold mining plays a major role in spreading malaria in the area [36] since this activity creates puddles of water, ideal habitat for the reproduction of Anopheles mosquitoes. Transmission of malaria among miners (garimpeiros) is greatly affected by their constant mobility, and a work regime that coincides with the peak of biting activity of vector mosquitoes.…”