Basic sanitation, socioeconomic conditions, and degree of risk for the presence and maintenance of malaria in a low-transmission area in the Brazilian Amazon

ABSTRACTINTRODUCTION:This study aimed to evaluate basic sanitation and socioeconomic indicators, reported cases of malaria, and risk of contracting malaria in the Ananindeua municipality, State of Pará.METHODS:Data on basic sanitation and socioeconomic dimensions were taken from the Brazilian Institute of Geography and Statistics [ Instituto Brasileiro de Geografia e Estatística (IBGE)] 2010 census. Epidemiological malaria information was taken from the Epidemiological Malaria Surveillance Information System [ Sistema de Informação de Vigilância Epidemiológica de Malária (SIVEP/Malaria)], between 2003 and 2013 of the Ministry of Health and from the SIVEP/Malaria forms of the municipality's Endemic Diseases Unit for 2,013 cases.RESULTS:Our data do not confirm the correlation among indicators of basic sanitation, socioeconomic conditions, and water supply with malaria cases. Of the 1,557 cases evaluated, most were caused by Plasmodium vivax , with rare cases of Plasmodium falciparum and mixed infections. There were 756 notifications in 2003. The number of reported cases was sharply reduced between 2006 and 2012, but a 142-case outbreak occurred in 2013. Ananindeua municipality's Annual Parasite Index indicated low risk in 2003 and no risk in other years, and the 2,013 cases were predominantly male individuals aged ≥40 years.CONCLUSIONS:Our data confirm the non-endemicity of malaria in the Ananindeua municipality, as the Annual Parasite Indices described for the years 2004-2013 classify it as a risk-free area. However, the 2013 outbreak indicates the need to strengthen prevention, surveillance, and control activities to reduce the risk of new outbreaks and consequent economic and social impacts on the population.

Situation of P. vivax malaria in Ahmedabad city – A study in purview of national guidelines.

Background: Malaria is still the most important cause of morbidity-mortality in India. NVBDCP in urban areas is implemented through UHCs. In Gujarat, 89764 malaria cases were reported in 2011 with 127 deaths with 17.9% of them being the P. vivax (Pv) cases. Ahmedabad is at the receiving end of malaria menace due to its rapid growth. Compared to 2011, significant rise in number of Pv cases has been observed in Ahmedabad in 2012. Aims & Objective: The study was carried out to assess the Pv malaria detection modalities, relevant indices, existing radical treatment strategies and adherence to national guidelines in the urban areas of Ahmedabad. Material and Methods: Data of all 9 UHCs of south zone, catering total population of approximately 1 million and showing significant rise in Pv cases were verified clubbed with field analysis, for the corresponding quarters of March, April and May of two consecutive years–2011-2012. Concerned healthcare staff was interviewed. Guidelines and definitions of national anti-malarial guidelines and operational manual were followed. Process indicators for surveillance, case finding and disease burden were considered. Results: Out of total blood smears examined, Pv cases raised from 97 (2011) to 382 (2012). Statistically significant rise of Pv% was 0.35% and 2.79% in active and passive slide collection respectively. 71% slides were actively collected in both years. QBER rose from 1.50% to 2.41%. QPI rose from 0.12 to 0.39. Successful RT completion decreased from 59.8% to 29.1%. Knowledge regarding national-anti-malarial-guidelines was satisfactory in more than 70% of healthcare functionaries. Conclusion: Number of cases significantly increased in two years, Pv-positivity rise being 1.04%. Active slide collection is static. Rise in Pv-positivity should trigger improvement in the same. Average QBER and QPI rose in two years. QBER never reached prescribed levels. Successful RT-completion is the key towards drug-resistance and relapse prevention. Adherence to national-anti-malarial-guideline is imperative.