Análisis de las interacciones entre los actores de la Red de Gestión del Conocimiento, Investigación e Innovación en Malaria de Colombia / Analysis of interactions between actors of the Red de Gestión del Conocimiento e Innovación en Malaria de Colombia

Introducción. La malaria, o paludismo, es una enfermedad de gran impacto en la población colombiana, que debe ser abordada desde el punto de vista del trabajo en equipo de instituciones para el intercambio de conocimiento. Objetivo. Analizar las interacciones de la Red de Gestión del Conocimiento, Investigación e Innovación en Malaria de Colombia. Materiales y métodos. Se hizo un análisis de redes sociales que permitió identificar la proximidad entre los actores y el grado de conocimiento entre ellos; se observaron indicadores de densidad, diámetro, distancia media y centralidad de grado. El corpus documental para el estudio estuvo constituido por 193 documentos técnicos publicados entre el 2016 y el 2021, que fueron analizados empleando técnicas de procesamiento de texto mediante el lenguaje de programación R. La categorización de la red se realizó a partir de cinco variables: atención integral a pacientes, diagnóstico, epidemiología y sistemas de análisis de información en salud, política pública, y promoción y prevención. Resultados. El análisis de las interacciones indicó que la red la conformaban 99 actores, de los cuales 97 (98 %), mostraron más interés en la producción de conocimientos en epidemiología y sistemas de análisis de información en salud, seguido de la categoría de atención integral a pacientes con 79 (80 %). El 54 % de los actores llevó a cabo estudios de promoción y prevención, siendo esta la categoría de menor abordaje. Conclusiones. Este estudio contribuye al fortalecimiento de estrategias clave en la divulgación del conocimiento sobre la malaria en Colombia.

Introduction: Malaria is a disease with a high impact on Colombian population, which must be approached from the point of view of teamwork of institutions for knowledge exchange. Objective: To analyze the interactions of the Red de Gestión del Conocimiento, Investigación e Innovación en Malaria de Colombia. Materials and methods: An analysis of social networks was applied that allowed identifying the proximity between actors and the degree of knowledge between them. Indicators of density, diameter, average distance, and degree of centrality were observed. The documentary corpus for the study consisted of 193 technical documents published between 2016 and 2021, which were analyzed using text mining using the R programming language. The network was categorized based on five variables: comprehensive patient care, diagnosis, epidemiology and health information analysis systems, public policy and promotion and prevention. Results: The analysis of interactions indicated that the network was made up by 99 actors. The main interest in knowledge production was on epidemiology and health information analysis systems (98 % of the actors), followed by the integral patient care (80 % of the actors). On the contrary, the least approached category was malaria promotion and prevention practices (54 % of the actors). Conclusions: In general, this study contributes to the strengthening of key strategies in the dissemination of knowledge about malaria in Colombia.

The socio-environmental production of malaria in three municipalities in the Carajás region, Pará, Brazil / A produção socioambiental da malária em três municípios da região de Carajás, Pará, Brasil

ABSTRACT OBJECTIVE To analyze the environmental production of malaria in the municipalities of Marabá, Parauapebas, and Canaã dos Carajás, in Pará, from 2014 to 2018. METHODS This ecological, cross-sectional study used epidemiological data in the Sistema de Informações de Vigilância Epidemiológica da Malária (Malaria Epidemiological Surveillance Information System) from the Secretaria de Saúde do Estado do Pará (State of Pará Health Department), cartographic data from the Brazilian Institute of Geography and Statistics (IBGE), and environmental data in the Projeto TerraClass (TerraClass Project) from the National Institute of Space Research (INPE). Statistical analyses used the chi-square test, while the spatial ones, the kernel and Moran's (I) global bivariate techniques. RESULTS We analyzed a total of 437 confirmed cases of malaria in the selected area and period. The highest percentage of cases occurred among male miners and farmers, living in rural areas; Plasmodium vivax was the most frequent species; and the most used diagnosis, the thick drop/smear. We also observed a heterogeneous distribution of the disease — with evidence of spatial dependence between incidence areas and different forms of land use, and spatial autocorrelations related to the high variability of anthropic activities in the municipalities. CONCLUSION The environmental production of malaria relates mainly to cattle production and mining — anthropisms related to land use and occupation in the observed municipalities. Spatial data analysis technologies sufficed for the construction of the epidemiological scenario of the disease.

RESUMO OBJETIVO Analisar a produção ambiental da malária nos municípios de Marabá, Parauapebas e Canaã dos Carajás, no Pará, entre 2014 e 2018. MÉTODOS Estudo ecológico e transversal a partir de dados epidemiológicos do Sistema de Informações de Vigilância Epidemiológica da Malária, da Secretaria de Saúde do Estado do Pará. Foram utilizados também dados cartográficos do Instituto Brasileiro de Geografia e Estatística (IBGE) e ambientais do projeto TerraClass, do Instituto Nacional de Pesquisas Espaciais (INPE). As análises estatísticas utilizaram o cálculo de percentuais e o teste qui-quadrado e as espaciais as técnicas de Kernel e de Moran global bivariado (I). RESULTADOS Foram analisados 437 casos confirmados de malária, na área e periodo de estudo. O maior percentual de casos ocorreu em indivíduos do sexo masculino, adultos, morador da zona rural, com atividades de garimpagem e agropecuária, sendo o Plasmodium vivax a espécie de maior frequência e o diagnóstico mais utilizado a gota espessa/esfregaço. A distribuição da malária não ocorreu de forma homogênea, com evidências de dependência espacial entre áreas com ocorrência de casos e diferentes tipos de uso da terra. Foram observadas também autocorrelações espaciais relacionadas à alta variabilidade dos tipos antropismos, ocorrida nos municípios. CONCLUSÃO A produção ambiental da malária está associada principalmente à pastagem e à mineração, antropismos relacionados às formas de uso e ocupação da terra nos municípios estudados. As tecnologias de análises de dados espaciais em saúde foram satisfatórias para a construção do cenário epidemiológico da doença.

Caracterización del paludismo como enfermedad endémica en Ecuador / Characterization of the malaria like endemic illness in Ecuador

RESUMEN Fundamento: el paludismo como problema de salud pública mundial, afecta a un elevado número de personas cada año. Congruente con evaluaciones de la Organización Mundial de la Salud y la Organización Panamericana de la Salud, cada año se presentan entre 50 y 100 millones de casos de la enfermedad. Objetivo: caracterizar el paludismo como enfermedad endémica en Ecuador. Métodos: se realizó una revisión bibliográfica de un total de 23 artículos en las bases de datos Scopus, Latindex y SciELO, mediante un gestor de búsqueda y administrador de referencias Endnote, de ellos 22 corresponden a los últimos cuatro años, 12 corresponden a artículos en diferentes revistas electrónicas y sitios web especializados en el tema y 11 a informes y documentos de organizaciones mundiales, de los cuales se utilizaron 72 citas seleccionadas para la revisión. Resultados: los diferentes documentos relacionados con las estadísticas, destacan el incremento del paludismo en diferentes áreas del planeta, por lo cual se intencionan acciones que contribuyen a su disminución e incluso erradicación, sin embargo en Ecuador, en los últimos dos años los resultados son desfavorables en este sentido. Conclusiones: es evidente que los directivos de la salud pública y factores comunitarios de cada país afectado por paludismo, deben asumir un enfoque preventivo que vele por los problemas de salud de las comunidades y favorezca el medio ambiente, fomenten en iniciativas que promuevan mayor responsabilidad ambiental a favor de erradicarla. En el caso de Ecuador, se muestran resultados desfavorables que tienden al incremento de esta enfermedad.

ABSTRACT Background: the malaria as problem of world public health, affects a high number of persons every year. Coherent with evaluations of the World Health Organization and the Pan-American Health Organization, between 50 and 100 million cases of the illness are presented every year. Objective: to characterize the malaria as an endemic illness in Ecuador. Methods: a bibliographical review of a whole of 23 articles was carried out in the Scopus, Latindex and SciELO databases, by means of a search engine and Endnote references manager, of them 22 correspond to last four years, 12 correspond to articles in different electronic magazines and web sites specializing in the topic and 11 to reports and documents of world organizations, of which 72 quotations selected for the review were used. Results: the different documents related to the statistics, emphasize the increase of the malaria in different areas of the planet, for which actions that contribute to its decrease and even eradication are carried out, nevertheless in Ecuador, in the last two years the results are unfavorable in this sense. Conclusions: it is clear that the managers of the public health and community factors of every country affected by malaria, must assume a preventive approach that looks over the problems of health of the communities and favors the environment, they encourage in initiatives that promote major environmental responsibility in favor of eradicating it. In case of Ecuador, there appear unfavorable results that tend to the increase of this illness.

Environmental and socioeconomic analysis of malaria transmission in the Brazilian Amazon, 2010-2015

ABSTRACT OBJECTIVE To analyze the environmental and socioeconomic risk factors of malaria transmission at municipality level, from 2010 to 2015, in the Brazilian Amazon. METHODS The municipalities were stratified into high, moderate, and low transmission based on the annual parasite incidence. A multinomial logistic regression that compared low with medium transmission and low with high transmission was performed. For each category, three models were analyzed: one only with socioeconomic risk factors (Gini index, illiteracy, number of mines and indigenous areas); a second with the environmental factors (forest coverage and length of the wet season); and a third with all covariates (full model). RESULTS The full model showed the best performance. The most important risks factors for high transmission were Gini index, length of the wet season and illiteracy, OR 2.06 (95%CI 1.19-3.56), 1.73 (95%CI 1.19-2.51) and 1.10 (95%CI 1.03-1.17), respectively. The medium transmission showed a weaker influence of the risk factors, being illiteracy, forest coverage and indigenous areas statistically significant but with marginal influence. CONCLUSIONS As a disease of poverty, the reduction in wealth inequalities and, therefore, health inequalities, could reduce the transmission considerably. Besides, environmental risk factors as length of the wet season should be considered in the planning, prevention and control. Municipality-level and fine-scale analysis should be done together to improve the knowledge of the local dynamics of transmission.

EPIDEMIOLOGIA DA MALÁRIA EM ÁREA DE ASSENTAMENTO NA AMAZONIA MATOGROSSENSE / EPIDEMIOLOGY OF MALARIA IN SETTLEMENT AREA IN AMAZON MATOGROSSENSE / EPIDEMIOLOGÍA DE LA MALARIA EN ZONA DE ASENTAMIENTO EN AMAZON MATOGROSSENSE

Objetivo: caracterizar a epidemiologia da malária em área de Assentamento na Amazônia mato-grossense. Método: estudo ecológico, realizado no Assentamento Vale do Amanhecer, no Município de Juruena, Mato Grosso. Foram analisadas 336 fichas. Utilizou-se o software EpiInfo 3.3.2 para a construção dos bancos de dados e software Terraview 3.1.4 e ArcGIS 9.2 para análise espacial, construção do mapa de distribuição de casos e os mapas temáticos de uso e ocupação do solo. Resultados: em 2005, o Assentamento era composto por 718 habitantes, 394 (54,87%) sexo masculino e 324 (45,13.%) sexo feminino. Dos 336 casos de malária, 133 era residente na Estrada 08, 37,60% das notificações. Nas Estradas 13 e 5, foram notificados 124 (35,10%) e 58 (16,40%) casos de malária, respectivamente. A região sul do assentamento apresentou 276 casos e maior número de notificações acima de 10 casos/domicílio. Desses, 102 (30,36%) casos foram causados pelo P. falciparum e 174 (51,79%) por P. vivax. A região norte apresentou 60 casos e notificações abaixo de 10 casos/domicílio. A área de formações florestais apresentou 70 (20,83%) casos. Conclusão: a ocorrência e distribuição de malária no assentamento são influenciadas pelos fatores ambientais e suas alterações.

Objective: to characterize the epidemiology of malaria in settlement area in Mato Grosso Amazon. Method: ecological study conducted in settlement Vale do Amanhecer, in the municipality of Juruena, Mato Grosso. 336 records were analyzed. the software was used EpiInfo 3.3.2 for the construction of databases and Terraview 3.1.4 and ArcGIS 9.2 software for spatial analysis, case distribution map construction and thematic maps of land use and occupation. Results: in 2005, the settlement was composed of 718 inhabitants, 394 (54.87%) male and 324 (45.13%.) Female. Of the 336 cases of malaria, 133 were resident on Highway 08, 37.60% of notifications. Roads in 13:05, were reported 124 (35.10%) and 58 (16.40%) cases of malaria, respectively. South of the settlement region had 276 cases and more up to 10 cases / home notifications. Of these, 102 (30.36%) cases were caused by P. falciparum and 174 (51.79%) by P. vivax. The northern region had 60 cases and 10 cases notifications under / home. The area of forest formations had 70 (20.83%) cases. Conclusion: the occurrence and distribution of malaria in the settlement are influenced by environmental factors, as amended.

Objetivo: caracterizar la epidemiología de la malaria en el área de asentamiento en Mato Grosso del Amazonas. Método: estudio ecológico con datos de asentamiento Vale do Amanhecer, en el municipio de Juruena, Mato Grosso. Se analizaron 336 registros. el software se utilizó EpiInfo 3.3.2 para la construcción de bases de datos y Terraview 3.1.4 y el software ArcGIS 9.2 para el análisis espacial, la construcción caja de mapa de distribución y mapas temáticos de uso y ocupación del suelo. Resultados: en 2005, el asentamiento se compone de 718 habitantes, 394 (54,87%) y 324 hombres (45.13%). Mujer. De los 336 casos de malaria, 133 eran residentes en la autopista 08, 37.60% de las notificaciones. Las carreteras de 13:05, se reportaron casos de malaria 124 (35.10%) y 58 (16,40%), respectivamente. Al sur de la región de asentamiento tenía 276 casos y más casos hasta 10 / notificaciones de origen. De éstos, 102 (30,36%) casos fueron causados por P. falciparum y 174 (51,79%) por P. vivax. La región del norte tenía 60 casos y 10 notificaciones de casos bajo / home. El área de las formaciones forestales contaba con 70 (20,83%) casos. Conclusión: la presencia y la distribución de la malaria en el asentamiento son influenciados por factores ambientales, en su versión modificada.

Increase in cases of malaria in Mozambique, 2014: epidemic or new endemic pattern? / Aumento dos casos de malária em Moçambique, 2014: epidemia ou novo padrão de endemicidade?

ABSTRACT OBJECTIVE To describe the increase in cases of malaria in Mozambique. METHODS Cross-sectional study conducted in 2014, in Mozambique with national weekly epidemiological bulletin data. I analyzed the number of recorded cases in the 2009-2013 period, which led to the creation of an endemic channel using the quartile and C-Sum methods. Monthly incidence rates were calculated for the first half of 2014, making it possible to determine the pattern of endemicity. Months in which the incidence rates exceeded the third quartile or line C-sum were declared as epidemic months. RESULTS The provinces of Nampula, Zambezia, Sofala, and Inhambane accounted for 52.7% of all cases in the first half of 2014. Also during this period, the provinces of Nampula, Sofala and Tete were responsible for 54.9% of the deaths from malaria. The incidence rates of malaria in children, and in all ages, have showed patterns in the epidemic zone. For all ages, the incidence rate has peaked in April (2,573 cases/100,000 inhabitants). CONCLUSIONS The results suggest the occurrence of an epidemic pattern of malaria in the first half of 2014 in Mozambique. It is strategic to have a more accurate surveillance at all levels (central, provincial and district) to target prevention and control interventions in a timely manner.

RESUMO OBJECTIVO Descrever o aumento de casos de malária em Moçambique. MÉTODOS Estudo transversal conduzido em 2014, em Moçambique com dados do boletim epidemiológico semanal nacional. O número de casos registrados no período de 2009 a 2013 foi analisado e um canal endêmico foi criado usando o método de quartil e C-Sum. Taxas de incidência mensal foram calculadas para o primeiro semestre de 2014, permitindo determinar o padrão de endemicidade. Meses em que as taxas de incidência ultrapassaram o terceiro quartil ou a linha C-Sum foram declaradas como meses epidêmicos. RESULTADOS As províncias de Nampula, Zambézia, Sofala e Inhambane foram responsáveis por 52,7% de todos os casos no primeiro semestre de 2014. Também durante esse período, as províncias de Nampula, Sofala e Tete foram responsáveis por 54,9% das mortes por malária. As taxas de incidência da malária em crianças, e todas as idades, registaram padrões na zona de epidemia. Para todas as idades, a taxa de incidência registou um pico em abril (2.573 casos/100 mil habitantes). CONCLUSÕES Os resultados sugerem a ocorrência de um padrão epidêmico de malária no primeiro semestre de 2014 em Moçambique. É de importância estratégica haver vigilância mais acurada e em todos os níveis (distrital, provincial e central), para direccionar as intervenções de prevenção e controle em tempo útil.

Brazilian mosquito (Diptera: Culicidae) fauna: I. Anopheles species from Porto Velho, Rondônia state, western Amazon, Brazil / Fauna brasileira de mosquitos (Diptera: Culicidae): I. Espécies de Anopheles de Porto Velho, estado de Rondônia, oeste da Amazônia, Brasil

This study contributes to knowledge of Anopheles species, including vectors of Plasmodium from the western Brazilian Amazon in Porto Velho, Rondônia State. The sampling area has undergone substantial environmental changes as a consequence of agricultural and hydroelectric projects, which have caused intensive deforestation and favored habitats for some mosquito species. The purpose of this study was to diagnose the occurrence of anopheline species from collections in three locations along an electric-power transmission line. Each locality was sampled three times from 2010 to 2011. The principal adult mosquitoes captured in Shannon trap were Anopheles darlingi, An. triannulatus, An. nuneztovari l.s., An.gilesi and An. costai. In addition, larvae were collected in ground breeding sites for Anopheles braziliensis, An. triannulatus, An. darlingi, An. deaneorum, An. marajoara, An. peryassui, An. nuneztovari l.s. and An. oswaldoi-konderi. Anopheles darlingi was the most common mosquito in the region. We discuss Culicidae systematics, fauna distribution, and aspects of malaria in altered habitats of the western Amazon.

Este estudo contribui para o conhecimento de espécies de Anopheles, incluindo vetores de Plasmodium do oeste da Amazônia brasileira, em Porto Velho, no estado de Rondônia. Esta região vem passando por mudanças ambientais, como consequência de agricultura extensiva e projetos hidroelétricos que causam desmatamento, favorecendo o desenvolvimento de algumas espécies de mosquitos. Assim, a proposta deste estudo é registrar a presença de espécies de anofelinos na área, sendo conduzidas coletas de mosquitos em três locais, ao longo de uma linha de transmissão de energia elétrica. Cada uma das localidades foi amostrada três vezes, no período de 2010 a 2011. Os principais mosquitos adultos capturados em armadilhas de Shannon foram Anopheles darlingi, An. triannulatus, An. nuneztovari l.s., An.gilesi e An. costai. Assim como as formas larvárias Anopheles braziliensis, An. triannulatus, An. darlingi, An. deaneorum, An. marajoara, An. peryassui, An. nuneztovari l.s. e An. oswaldoi-konderi, coletadas em criadouros. Anopheles darlingi foi a espécie mais coletada na região. Em adição, discutiu-se sistemática de Culicidae, distribuição de fauna e aspectos da malária em ambientes modificados do oeste da Amazônia brasileira.

Impact of changing over of insecticide from synthetic pyrethroids to DDT for indoor residual spray in a malaria endemic area of Orissa, India.

Background & objectives: Development of insecticide resistance in malaria vectors has been a major problem for achieving effective vector control. Due to limited availability of insecticides, the only option is management of resistance by judiciously using the insecticides and rotating them to maintain their effectiveness. This study was carried out in a malaria endemic area of Sundergarh district in Orissa where synthetic pyrethroids (SP) were in use for the last couple of years. The change-over from SP to DDT was done in one arm of study, and the other two arms remained on SP and insecticide-treated nets (ITN). Entomological and parasitological monitoring was done to assess the impact. Methods: The study design comprised of three arms (i) two rounds of indoor residual spraying (IRS) with DDT 1g/m2 as a change-over insecticide in areas previously under synthetic pyrethroids; (ii) two rounds of IRS with synthetic pyrethroid (alphacypermethrin, ACM) @ 25 mg/m2; and (iii) an unsprayed area under ITN/long lasting insecticide nets (LNs). Indoor residual spraying was undertaken under strict supervision to maintain quality and coverage. Contact bioassays were conducted to know the persistence of insecticide on sprayed surfaces and adult vector density was monitored in fixed and randomly selected houses. Malaria incidence was measured through fortnightly domiciliary surveillance under primary health care system in all the study villages. Results: The insecticide susceptibility tests showed that An.culicifacies was resistant to DDT but susceptible to malathion and ACM. However, An. fluviatilis was susceptible to all the three insecticides. ACM was effective in killing An. culicifacies on mud and wooden sprayed surfaces and maintained effective bioefficacy ranging from 92 to 100 per cent up to five months, whereas DDT failed to achieve effective mortality in An.culicifacies. However, there was significant decline in the density of An.culicifacies in ACM and DDT areas in comparison to ITNs/LNs. There was 61 per cent reduction in the slide positivity rate in ACM area in comparison to 48 and 51 per cent in DDT and ITN/LNs areas, respectively. The adjusted incidence rate of malaria cases per 1000 population in three study areas also showed significant declines within each group. Interpretation & conclusions: The present findings show that the change-over of insecticide from synthetic pyrethroids to DDT brings about the same epidemiological impact as envisaged from continuing SP spray or distributing insecticide treated nets/long-lasting insecticidal nets provided there is a good quality spray and house coverage.

Malaria and Anopheles spp in the villages of Salubarana and Kadaila, Mamuju District, South Sulawesi Province, Indonesia.

Malaria epidemiology in Salubarana and Kadaila villages, Mamuju District, South Sulawesi Province, Indonesia was studied from July-December 2002 to obtain baseline data related to the parasite, mosquito vector, human host, and environmental factors. Monthly malariometric surveys conducted during the six- month period revealed a relatively high prevalence of malaria in Kadaila in comparison to Salubarana. Kadaila was mainly inhabited by migrants from Java, Bali, Lombok, and from other districts of South Sulawesi. Salubarana, on the other hand, was inhabited mainly by indigenous Mandarese. Analysis of 1,113 blood smears taken from individuals randomly involved in the survey revealed 59 positive samples, consisting of Plasmodium falciparum or P. vivax. These two species predominated the samples examined and were occasionally found as mixed infection. Anopheles barbirostris was confirmed as a vector for malaria in this area whereas 7 other species An. barbumbrosus, An. parangensis, An. vagus, An. crawfordi, An.pseudobarbirostris, An. Tessellatus, and An. subpictus should be considered as potential vectors. The first mentioned species predominated, using mainly riverbeds and ground pools as breeding places with a habit of indoor or outdoor resting. These findings could be useful for establishing evidence-based malaria control program in the area.

Malaria epidemiolgy in Tuyen Quang province, 2003

In 2003, due to practice effectively malaria prevention programs and intensify supervise malaria epidemiology that malaria prevention in Tuyen Quang provice had good results, gained 3 aims: malaria morbidity reduced 28%, malaria mortality 0%. Malaria epidemiology was stable in Tuyen Quang. However, in 15 malaria parasites in Tuyen Quang in 2003, there was 14 was exotic malaria parasites from the South and other provinces. Therefore, in the later years, beside the investigation, management of Ministy of Health, the government project for malaria prevention, National Institute of Malariology - Parasitology - Entomology, Tuyen Quang needed to implement well malaria epidemiological surveillance in basic levels and malaria preventive plan to maintain gained malaria preventive results

Preliminary results of the study on malaria epidemiology among migrating people in Easup district of DakLak province

A study conducted in 4 communes in Easup district of Daklak province, the result showed that the nomadic people are of the ethnic minority group of Tay, Nung, Thai, Muong coming from Northern provinces. The main reason for their migration is poor economic conditions (100%). Whole families or households moved and settled in new areas (76.42%). Most of them lived in temporary houses (79.1%), near the forest, at edge of the forest or inside the forest (51.9%) Self prevention form mosquito bites was poor with 19.7% of new settles did not regularly sleep under mosquito nets or lack of misquito nets (52.2%). The malaria incidence among the new settlers was found to be higher than that of old settlers as clinical malaria: 4.75% compared to 2.34%, confirmed cases 2.71% compared to 0.20% while it was similar to the local ethnic minority groups with clinical and confirmed cases were equal in both groups

Malária no Estado do Paraná, Brasil / Malaria in the state of Paraná, Brazil

To collect data regarding registered cases of malaria in the state of Paraná, attendance reports of suspected cases of malaria performed by Fundação Nacional de Saúde, Paraná regional center, were analyzed from January, 1994 through December, 1999. Of 31,975 blood samples examined, 7.4% were positive: 86.4% for Plasmodium vivax, 12.7% for P. falciparum, 0.04% for P. malariae and 0.9% for P. vivax and P. falciparum. As to the epidemiological classification, 84.5% represented heterochthonous cases and 15.5% represented autochthonous cases. The municipalities showing higher rates of autochthonous cases were Foz do Iguaçu, Santa Terezinha do Itaipu and Santa Helena, a region influenced by the Itaipu reservoir, where prevention and control actions must be concentrated.

Visando a obtenção de informações sobre os casos de malária registrados no Estado do Paraná, analisaram-se os relatórios de atendimento de casos suspeitos de malária elaborados pela Fundação Nacional de Saúde, regional do Paraná, no período de janeiro de 1994 a dezembro de 1999. Das 31.975 amostras de sangue examinadas, 7,4% mostraram-se positivas, sendo 86,4% para Plasmodium vivax; 12,7% para P. falciparum; 0,04% para P. malariae e 0,9% para P. vivax e P. falciparum. Com relação à classificação epidemiológica, 84,5% representaram casos importados e 15,5% casos autóctones. Os municípios com maior número de casos autóctones foram Foz do Iguaçu, Santa Terezinha do Itaipu e Santa Helena, região de influência do lago de Itaipu, onde devem-se, portanto, concentrar os esforços de vigilância.