Malaria outside the Amazon region: Natural Plasmodium infection in anophelines collected near an indigenous village in the Vale do Rio Branco, Itanhaém, SP, Brazil

Neves, Amanda; Urbinatti, Paulo Roberto; Malafronte, Rosely dos Santos; Fernandes, Antônio Carlos; Paganini, Wanderley da Silva; Natal, Délsio

doi:10.1016/j.actatropica.2012.08.014

Cited by 29 publications

(35 citation statements)

References 23 publications

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“…Despite the low number of autochthonous clinical malaria cases registered in the extra-Amazonian region, the results from serological studies in areas covered by the Atlantic Forest biome indicate that inhabitants of most of these areas produce antibodies against asexual forms of P. vivax and P. malariae , with prevalence as high as 32-49% and 16-19.3%, respectively. Additionally, they produce antibodies against the circumsporozoite of P. vivax and the variants P. malariae and P. falciparum (Carvalho et al 1988, Mattos et al 1993, Azevedo 1997, Curado et al 1997, 2006, Duarte et al 2006, Cerutti et al 2007, Yamasaki et al 2011, Neves et al 2013). A study performed using PCR as a diagnostic tool to detect Plasmodium infection in human populations of Vale do Ribeira identified individuals without classical symptomatology who were infected with P. malariae , P. falciparum , P. vivax and P. falciparum / P. vivax (Curado et al 2006).…”

Section: Malaria In the Extra-amazonian (Non-endemic) Regionmentioning

confidence: 99%

“…In these southeastern mountain valleys, An. cruzii is by far the most frequent species that bites humans in wilderness, transition and modified areas and almost the only species found to naturally carry P. vivax / Plasmodium simium and P. malariae/Plasmodium brasilianum (Curado et al 1997, Marques et al 2008, Rezende et al 2009, 2013, Duarte et al 2013, Neves et al 2013). …”

Section: Malaria In the Extra-amazonian (Non-endemic) Regionmentioning

confidence: 99%

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Malaria in Brazil: what happens outside the Amazonian endemic region

Pina-Costa

Brasil

Santi

et al. 2014

Mem. Inst. Oswaldo Cruz

137

172

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Brazil, a country of continental proportions, presents three profiles of malaria transmission. The first and most important numerically, occurs inside the Amazon. The Amazon accounts for approximately 60% of the nation’s territory and approximately 13% of the Brazilian population. This region hosts 99.5% of the nation’s malaria cases, which are predominantly caused by Plasmodium vivax (i.e., 82% of cases in 2013). The second involves imported malaria, which corresponds to malaria cases acquired outside the region where the individuals live or the diagnosis was made. These cases are imported from endemic regions of Brazil (i.e., the Amazon) or from other countries in South and Central America, Africa and Asia. Imported malaria comprised 89% of the cases found outside the area of active transmission in Brazil in 2013. These cases highlight an important question with respect to both therapeutic and epidemiological issues because patients, especially those with falciparum malaria, arriving in a region where the health professionals may not have experience with the clinical manifestations of malaria and its diagnosis could suffer dramatic consequences associated with a potential delay in treatment. Additionally, because the Anopheles vectors exist in most of the country, even a single case of malaria, if not diagnosed and treated immediately, may result in introduced cases, causing outbreaks and even introducing or reintroducing the disease to a non-endemic, receptive region. Cases introduced outside the Amazon usually occur in areas in which malaria was formerly endemic and are transmitted by competent vectors belonging to the subgenus Nyssorhynchus (i.e., Anopheles darlingi, Anopheles aquasalis and species of the Albitarsis complex). The third type of transmission accounts for only 0.05% of all cases and is caused by autochthonous malaria in the Atlantic Forest, located primarily along the southeastern Atlantic Coast. They are caused by parasites that seem to be (or to be very close to) P. vivax and, in a less extent, by Plasmodium malariae and it is transmitted by the bromeliad mosquito Anopheles (Kerteszia) cruzii. This paper deals mainly with the two profiles of malaria found outside the Amazon: the imported and ensuing introduced cases and the autochthonous cases. We also provide an update regarding the situation in Brazil and the Brazilian endemic Amazon.

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Section: Malaria In the Extra-amazonian (Non-endemic) Regionmentioning

confidence: 99%

Section: Malaria In the Extra-amazonian (Non-endemic) Regionmentioning

confidence: 99%

Malaria in Brazil: what happens outside the Amazonian endemic region

Pina-Costa

Brasil

Santi

et al. 2014

Mem. Inst. Oswaldo Cruz

137

172

View full text Add to dashboard Cite

show abstract

“…However, this result may arise from the fact that the residences of the blood donors are situated in urban areas at the edge of forest fragments. Consequently, the presence of P. vivax is likely to be associated with forest fragments and involves both Kerteszia and Nyssorhynchus species, or even other Anopheles subgenera [48,50]. The evolution of transmission of Plasmodium species that cause malaria in humans is a dynamic process that involves ecological, environmental, and climate factors as well as social, political, and economic determinants.…”

Section: Discussionmentioning

confidence: 99%

Detection of Plasmodium falciparum and Plasmodium vivax subclinical infection in non-endemic region: implications for blood transfusion and malaria epidemiology

Maselli

Levy

Laporta

et al. 2014

Malar J

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BackgroundIn Brazil, malaria is endemic in the Amazon River basin and non-endemic in the extra-Amazon region, which includes areas of São Paulo state. In this state, a number of autochthonous cases of malaria occur annually, and the prevalence of subclinical infection is unknown. Asymptomatic infections may remain undetected, maintaining transmission of the pathogen, including by blood transfusion. In these report it has been described subclinical Plasmodium infection in blood donors from a blood transfusion centre in São Paulo, Brazil.MethodsIn this cross-sectional study, representative samples of blood were obtained from 1,108 healthy blood donors at the Fundação Pró-Sangue Hemocentro de São Paulo, the main blood transfusion centre in São Paulo. Malaria exposure was defined by the home region (exposed: forest region; non-exposed: non-forest region). Real-time PCR was used to detect Plasmodium falciparum and Plasmodium vivax. Subclinical malaria cases were geo-referenced.ResultsEighty-four (7.41%) blood donors tested positive for Plasmodium; 57 of these were infected by P. falciparum, 25 by P. vivax, and 2 by both. The prevalence of P. falciparum and P. vivax was 5.14 and 2.26, respectively. The overall prevalence ratio (PR) was 3.23 (95% confidence interval (CI) 2.03, 5.13); P. falciparum PR was 16.11 (95% CI 5.87, 44.21) and P. vivax PR was 0.47 (95% CI 0.2, 1.12). Plasmodium falciparum subclinical malaria infection in the Atlantic Forest domain was present in the mountain regions while P. vivax infection was observed in cities from forest-surrounded areas.ConclusionsThe presence of Plasmodium in healthy blood donors from a region known as non-endemic, which is important in the context of transfusion biosafety, was described. Infected recipients may become asymptomatic carriers and a reservoir for parasites, maintaining their transmission. Furthermore, P. falciparum PR was positively associated with the forest environment, and P. vivax was associated with forest fragmentation.

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“…The presence of vectors is a determining factor for transmission and for assessing receptivity conditions (Azevedo 1997, Rezende et al 2009, 2013, Laporta et al 2011, da Silva et al 2013, Duarte et al 2013, Neves et al 2013). A study conducted in 2009 by the Brazilian Health System showed that several species occur in RJ.…”

Section: Discussionmentioning

confidence: 99%

Malaria in the state of Rio de Janeiro, Brazil, an Atlantic Forest area: an assessment using the health surveillance service

Miguel¹,

Peiter²,

Albuquerque³

et al. 2014

Mem. Inst. Oswaldo Cruz

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The lethality of malaria in the extra-Amazonian region is more than 70 times higher than in Amazonia itself. Recently, several studies have shown that autochthonous malaria is not a rare event in the Brazilian southeastern states in the Atlantic Forest biome. Information about autochthonous malaria in the state of Rio de Janeiro (RJ) is scarce. This study aims to assess malaria cases reported to the Health Surveillance System of the State of Rio de Janeiro between 2000-2010. An average of 90 cases per year had parasitological malaria confirmation by thick smear. The number of malaria notifications due to Plasmodium falciparum increased over time. Imported cases reported during the period studied were spread among 51% of the municipalities (counties) of the state. Only 35 cases (4.3%) were autochthonous, which represents an average of 3.8 new cases per year. Eleven municipalities reported autochthonous cases; within these, six could be characterised as areas of residual or new foci of malaria from the Atlantic Forest system. The other 28 municipalities could become receptive for transmission reintroduction. Cases occurred during all periods of the year, but 62.9% of cases were in the first semester of each year. Assessing vulnerability and receptivity conditions and vector ecology is imperative to establish the real risk of malaria reintroduction in RJ.

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Malaria outside the Amazon region: Natural Plasmodium infection in anophelines collected near an indigenous village in the Vale do Rio Branco, Itanhaém, SP, Brazil

Cited by 29 publications

References 23 publications

Malaria in Brazil: what happens outside the Amazonian endemic region

Malaria in Brazil: what happens outside the Amazonian endemic region

Detection of Plasmodium falciparum and Plasmodium vivax subclinical infection in non-endemic region: implications for blood transfusion and malaria epidemiology

Malaria in the state of Rio de Janeiro, Brazil, an Atlantic Forest area: an assessment using the health surveillance service

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