Serological study on toxoplasmosis in the Haliti-Paresí community of the Utiariti indigenous territory, Campo Novo do Parecis, Mato Grosso, Brazil.

Toxoplasma gondii is the etiological agent of toxoplasmosis, a widespread zoonosis that affects several homeothermic animals, including humans. This disease causes serious health problems, such that 10% of infected individuals develop clinical manifestations. Some studies on indigenous human populations have indicated variations in seroprevalence from 10.6% to 80.4% in such populations in different regions of Brazil and in other countries like Venezuela and Malaysia. To date, there have been no studies regarding the prevalence of anti-T. gondii antibodies in Haliti-Paresí Indians living in Campo Novo do Parecis, Mato Grosso, Brazil. Our objective here was to determine the frequency of occurrence of antibodies against this protozoon in nine Haliti-Paresí villages by correlating seroprevalence with locations and variables. Serodiagnoses were made using the indirect immunofluorescence antibody test (IFAT) and enzyme-linked immunosorbent assay (ELISA) in the Laboratory for Toxoplasmosis and Other Protozoan Diseases of IOC/Fiocruz. It was considered that samples tested positive for T. gondii infection if IgG/IgM antibodies against this protozoon were detected through serodiagnosis using either IFAT or ELISA. Among the 293 samples analyzed, 66.9% presented anti-T. gondii IgG and 3.4% presented anti-T. gondii IgM. It was observed that there were no statistically significant differences in frequency of antibody occurrence among infected individuals, based on sex, schooling or occupation/activities. However, there were statistical differences based on age and villages. The prevalence observed in this study is in agreement with values found in other studies on indigenous populations in Latin America. Like among other such populations, the Haliti-Paresí villages are located close to forests and the individuals have domestic cats as pets, are involved in hunting and farming and consume water directly from water accumulation sources. These factors might cause exposure to T. gondii tissue cysts and oocysts.

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.

[Congenital defects in the cities with high use of pesticides in the state of Mato Grosso, Brazil]. / Malformações congênitas em municípios de grande utilização de agrotóxicos em Mato Grosso, Brasil.

Mato Grosso is the largest agricultural producer and the largest national consumer of pesticides in Brazil. Maternal exposure to pesticides in the periconceptional period has been associated with increased risk of congenital malformations. This article aims to analyze the association between the use of pesticides and congenital malformations in cities with highest exposure to pesticides in Mato Grosso. It was a case-control study conducted with 219 live births with congenital malformations and 862 live births. The average use of pesticides was estimated in the prior and subsequent trimester to the date of fertilization and throughout the periconceptional period per city, month and year of use. Subsequently, these measures were quartilized and transformed into indicator-type (dummy) variables, attributing an exposure level for each interquartile interval. Bivariate and multivariate logistic regression analysis was conducted. Significant associations were observed (p < 0.05) in the third (OR = 1.66, 95% CI 0.98 to 2.79) and fourth quartile (OR = 1.88, 95% CI 1.09 to 3.24) of the post-fertilization period and the fourth quartile (OR = 2.04, 95% CI 1.17 to 3.56) throughout the periconceptional period. Maternal exposure to pesticides was associated with higher incidence of congenital malformations.

Malformações congênitas em municípios de grande utilização de agrotóxicos em Mato Grosso, Brasil / Congenital defects in the cities with high use of pesticides in the state of Mato Grosso, Brazil

Mato Grosso é o maior produtor agrícola e também o maior consumidor nacional de agrotóxicos. A exposição materna aos agrotóxicos no período periconcepcional tem sido associada com aumento no risco de malformações congênitas. O objetivo deste artigo é analisar a associação entre o uso de agrotóxicos e as malformações congênitas em municípios com maior exposição aos agrotóxicos em Mato Grosso. Estudo de caso-controle realizado com 219 nascidos vivos com malformação congênita e 862 nascidos vivos sadios. Estimou-se a média de utilização dos agrotóxicos nos trimestres anterior e posterior à data da fecundação e durante todo o período periconcepecional segundo município e mês e ano de sua utilização. Posteriormente, estas medidas foram quartilizadas e transformadas em variáveis do tipo indicadoras (dummy ), atribuindo-se um nível de exposição para cada intervalo interquartil. Foi realizada análise bivariada e regressão logística. Foram observadas associações significantes (p < 0,05) no terceiro (OR=1,66, IC95% 0,98 - 2,79) e quarto quartil (OR=1,88, IC95% 1,09 - 3,24) do período pós-fecundação e no quarto quartil (OR=2,04, IC95%1,17-3,56) durante todo o período periconcepecional. A exposição materna aos agrotóxicos foi associada à maior ocorrência de malformações congênitas.

Mato Grosso is the largest agricultural producer and the largest national consumer of pesticides in Brazil. Maternal exposure to pesticides in the periconceptional period has been associated with increased risk of congenital malformations. This article aims to analyze the association between the use of pesticides and congenital malformations in cities with highest exposure to pesticides in Mato Grosso. It was a case-control study conducted with 219 live births with congenital malformations and 862 live births. The average use of pesticides was estimated in the prior and subsequent trimester to the date of fertilization and throughout the periconceptional period per city, month and year of use. Subsequently, these measures were quartilized and transformed into indicator-type (dummy) variables, attributing an exposure level for each interquartile interval. Bivariate and multivariate logistic regression analysis was conducted. Significant associations were observed (p < 0.05) in the third (OR = 1.66, 95% CI 0.98 to 2.79) and fourth quartile (OR = 1.88, 95% CI 1.09 to 3.24) of the post-fertilization period and the fourth quartile (OR = 2.04, 95% CI 1.17 to 3.56) throughout the periconceptional period. Maternal exposure to pesticides was associated with higher incidence of congenital malformations.

Geographic information systems and logistic regression for high-resolution malaria risk mapping in a rural settlement of the southern Brazilian Amazon.

BACKGROUND: In Brazil, 99% of the cases of malaria are concentrated in the Amazon region, with high level of transmission. The objectives of the study were to use geographic information systems (GIS) analysis and logistic regression as a tool to identify and analyse the relative likelihood and its socio-environmental determinants of malaria infection in the Vale do Amanhecer rural settlement, Brazil. METHODS: A GIS database of georeferenced malaria cases, recorded in 2005, and multiple explanatory data layers was built, based on a multispectral Landsat 5 TM image, digital map of the settlement blocks and a SRTM digital elevation model. Satellite imagery was used to map the spatial patterns of land use and cover (LUC) and to derive spectral indices of vegetation density (NDVI) and soil/vegetation humidity (VSHI). An Euclidian distance operator was applied to measure proximity of domiciles to potential mosquito breeding habitats and gold mining areas. The malaria risk model was generated by multiple logistic regression, in which environmental factors were considered as independent variables and the number of cases, binarized by a threshold value was the dependent variable. RESULTS: Out of a total of 336 cases of malaria, 133 positive slides were from inhabitants at Road 08, which corresponds to 37.60% of the notifications. The southern region of the settlement presented 276 cases and a greater number of domiciles in which more than ten cases/home were notified. From these, 102 (30.36%) cases were caused by Plasmodium falciparum and 174 (51.79%) cases by Plasmodium vivax. Malaria risk is the highest in the south of the settlement, associated with proximity to gold mining sites, intense land use, high levels of soil/vegetation humidity and low vegetation density. CONCLUSIONS: Mid-resolution, remote sensing data and GIS-derived distance measures can be successfully combined with digital maps of the housing location of (non-) infected inhabitants to predict relative likelihood of disease infection through the analysis by logistic regression. Obtained findings on the relation between malaria cases and environmental factors should be applied in the future for land use planning in rural settlements in the Southern Amazon to minimize risks of disease transmission.

Epidemiologia da malária no município de Colniza, Estado de Mato Grosso, Brasil: estudo descritivo do período de 2003 a 2009* / Epidemiology of malaria in the municipality of Colniza, Mato Grosso State, Brazil: descriptive study in the period 2003 to 2009

Objetivo: descrever as características epidemiológicas da malária no município de Colniza, Estado de Mato Grosso, Brasil, entre 2003 e 2009. Método: foi realizado estudo descritivo dos casos de malária registrados no Sistema de Vigilância Epidemiológica – Malária (Sivep_malária). Resultados: a maioria dos 18.903 casos foi autóctone (90,5 por cento), predominantemente em homens (71,4 por cento) na faixa etária de 15 a 59 anos (74,4 por cento), com 4 a 7 anos de estudos (19,5 por cento) e idade média de 27,7 anos; detectou-se 77,7 por cento de Plasmodium vivax e 21,6 por cento de Plasmodium falciparum na amostra; comparando os registros das Unidades Notificantes por Região (UNR), o maior número de casos ocorreu na UNR Guariba, entre 2005 e 2006. Conclusão: o município apresentou Índice Parasitário Anual crescente entre 2003 e 2007, e decrescente entre 2008 e 2009; a tendência e o processo epidêmico-endêmico da malária foram distintos para cada UNR do município de Colniza-MT.

Objective: this study’s aim was to describe the epidemiological characteristics of malaria in the municipality of Colniza, Mato Grosso state, Brazil between 2003 and 2009. Method: the descriptive epidemiology of malaria cases registered in Colniza was done using Malaria Epidemiological Surveillance System (SIVEP_malaria) data for the period 2003-2009. Results: most of the of 18,903 cases (90.5 per cent) were autochthonous, predominantly in men (71.4 per cent) aged 15 to 59 (74.4 per cent), with 4 to 7 years of formal education (19.5 per cent) and average age of 27.7 years, caused by Plasmodium vivax (77.7 per cent) and by Plasmodium falciparum (21.6 per cent). Comparing cases by Notifying Unit Region (UNR), most cases between 2005 and 2006 occurred in Guariba. Conclusion: Colniza showed an increase in malaria prevalence between 2003 and 2007 and a decrease in 2008 and 2009. Distinct epidemic-endemic processes and trends were verified for each of the municipality’s UNRs.

Factors associated with the incidence of malaria in settlement areas in the district of Juruena, Mato Grosso state, Brazil.

Factors associated with the incidence of malaria in the Vale do Amanhecer settlement, Juruena, Mato Grosso in 2005 were analyzed. Two hundred settlers of both genders and aged 18 years and above were interviewed. The prevalence of malaria reported in 2005 was 33%. The prevalence ratio showed that the highest prevalence of malaria was found in individuals involved in gold mining activities (67%); who came from non-endemic areas (43%); had inadequate knowledge about the time of greatest activity of the vector (71%); and who reported being outside after 5 p.m. (59%). It was concluded that in the Vale do Amanhecer settlement, factors such as occupation, origin, inadequate knowledge about where malaria is transmitted, inadequate knowledge about the time the mosquito usually bites and individual practices in relation to the peak period of mosquito activity were associated with malaria in 2005.

Factors associated with the incidence of malaria in settlement areas in the district of Juruena, Mato Grosso state, Brazil / Fatores associados à incidência da malária em área de assentamento, município de Juruena, Mato Grosso, Brasil

Factors associated with the incidence of malaria in the Vale do Amanhecer settlement, Juruena, Mato Grosso in 2005 were analyzed. Two hundred settlers of both genders and aged 18 years and above were interviewed. The prevalence of malaria reported in 2005 was 33%. The prevalence ratio showed that the highest prevalence of malaria was found in individuals involved in gold mining activities (67%); who came from non-endemic areas (43%); had inadequate knowledge about the time of greatest activity of the vector (71%); and who reported being outside after 5 p.m. (59%). It was concluded that in the Vale do Amanhecer settlement, factors such as occupation, origin, inadequate knowledge about where malaria is transmitted, inadequate knowledge about the time the mosquito usually bites and individual practices in relation to the peak period of mosquito activity were associated with malaria in 2005.

Analisaram-se fatores associados à ocorrência da malária no Assentamento Vale do Amanhecer, Juruena - Mato Grosso em 2005. Foram entrevistados 200 indivíduos assentados, de ambos os sexos e idade igual ou superior a 18 anos. A prevalência de malária referida em 2005 foi de 33,0%. A análise através da razão de prevalência mostrou que as maiores prevalências de malária foram nos indivíduos que exerciam atividade garimpeira (67,0%); procedentes de área não endêmica (43,0%); com conhecimento inadequado sobre o horário de maior atividade do vetor (71,0%) e indivíduos que referiram estar na roça após as 17:00 horas (59,0%). Concluiu-se que no Assentamento Vale do Amanhecer fatores como, ocupação, procedência, conhecimento inadequado sobre onde a malária é transmitida, horário que o mosquito costuma picar, e as atividades de cada indivíduo em relação ao horário de pico do vetor, mostraram-se associadas à malária em 2005.

Spatial patterns of malaria in a land reform colonization project, Juruena municipality, Mato Grosso, Brazil.

BACKGROUND: In Brazil, 99% of malaria cases are concentrated in the Amazon, and malaria's spatial distribution is commonly associated with socio-environmental conditions on a fine landscape scale. In this study, the spatial patterns of malaria and its determinants in a rural settlement of the Brazilian agricultural reform programme called "Vale do Amanhecer" in the northern Mato Grosso state were analysed. METHODS: In a fine-scaled, exploratory ecological study, geocoded notification forms corresponding to malaria cases from 2005 were compared with spectral indices, such as the Normalized Difference Vegetation Index (NDVI) and the third component of the Tasseled Cap Transformation (TC_3) and thematic layers, derived from the visual interpretation of multispectral TM-Landsat 5 imagery and the application of GIS distance operators. RESULTS: Of a total of 336 malaria cases, 102 (30.36%) were caused by Plasmodium falciparum and 174 (51.79%) by Plasmodium vivax. Of all the cases, 37.6% (133 cases) were from residents of a unique road. In total, 276 cases were reported for the southern part of the settlement, where the population density is higher, with notification rates higher than 10 cases per household. The local landscape mostly consists of open areas (38.79 km²). Training forest occupied 27.34 km² and midsize vegetation 7.01 km². Most domiciles with more than five notified malaria cases were located near areas with high NDVI values. Most domiciles (41.78%) and malaria cases (44.94%) were concentrated in areas with intermediate values of the TC_3, a spectral index representing surface and vegetation humidity. CONCLUSIONS: Environmental factors and their alteration are associated with the occurrence and spatial distribution of malaria cases in rural settlements.

[Socioenvironmental factors associated with the spatial distribution of malaria in the Vale do Amanhecer settlement, Municipality of Juruena, State of Mato Grosso, 2005]. / Fatores socioambientais associados à distribuição espacial de malária no assentamento Vale do Amanhecer, Município de Juruena, Estado de Mato Grosso, 2005.

Malaria is a disease with focal distribution. In Brazil, settlement and gold mining areas in the Legal Amazon region present a great concentration of cases. This paper analyzes the spatial distribution of malaria cases taking into consideration environmental and social factors in the Vale do Amanhecer settlement in the municipality of Juruena, Mato Grosso, Brazil. In 2005, 359 autochthonous cases were notified in the settlement. Using the Kernel method, areas of greater and lesser intensities of case numbers were identified. The areas of greater intensity presented 290 cases and those of lesser intensity, 64 cases. The intensity of distribution varied within the settlement, thus indicating areas of great intensity of cases favoring transmission, like gold mining areas. Therefore, although the settlement was considered to be the main focus for malaria, there were specific factors within it that, once identified, could contribute towards the disease control.

Fatores socioambientais associados à distribuição espacial de malária no assentamento Vale do Amanhecer, Município de Juruena, Estado de Mato Grosso, 2005 / Socioenvironmental factors associated with the spatial distribution of malaria in the Vale do Amanhecer settlement, Municipality of Juruena, State of Mato Grosso, 2005

Malaria é uma doença de distribuição focal. No Brasil, áreas de assentamento e garimpos de ouro na Amazônia Legal apresentam grande concentração de casos. Este artigo analisa a distribuição espacial de casos de malária, considerando fatores ambientais e sociais, no assentamento Vale do Amanhecer, Município de Juruena, Mato Grosso, Brasil. Em 2005, notificou-se 359 casos autóctones no assentamento e pelo método de Kernel identificaram-se áreas de maior e menor intensidade de número de casos. As áreas de maior intensidade apresentaram 290 casos e na de menor intensidade 64 casos. A intensidade da distribuição variou no assentamento, indicando áreas de grande intensidade de casos favoráveis para transmissão como área de garimpos. Assim, apesar de assentamentos serem considerados como foco de malária, existem no seu interior, especificidades que, uma vez identificadas, podem contribuir para o controle da doença.

Malaria is a disease with focal distribution. In Brazil, settlement and gold mining areas in the Legal Amazon region present a great concentration of cases. This paper analyzes the spatial distribution of malaria cases taking into consideration environmental and social factors in the Vale do Amanhecer settlement in the municipality of Juruena, Mato Grosso, Brazil. In 2005, 359 autochthonous cases were notified in the settlement. Using the Kernel method, areas of greater and lesser intensities of case numbers were identified. The areas of greater intensity presented 290 cases and those of lesser intensity, 64 cases. The intensity of distribution varied within the settlement, thus indicating areas of great intensity of cases favoring transmission, like gold mining areas. Therefore, although the settlement was considered to be the main focus for malaria, there were specific factors within it that, once identified, could contribute towards the disease control.

Spatial analysis for stratification of priority malaria control areas, Mato Grosso State, Brazil.

The goal of this study was to stratify priority areas for malaria control in the State of Mato Grosso, Brazil, based on spatial analysis. The variables used were: Annual Parasite Index (API), Plasmodium falciparum/Plasmodium vivax ratio, population variation, number of families settled, and percent of deforested area. The Moran's I and Local Moran Test were applied, visualized with the Box Map and Moran Map, for 1986- 1991, 1992-1997, and 1998-2003. Box Map identified areas with high, low, and intermediate priority for control, and Moran Map identified municipalities with significant autocorrelation. In the high priority area, located in the North of Mato Grosso, malaria incidence decreased drastically despite the increase in the number of municipalities from the first to the last period. Other municipalities were added to the lower priority area, from the Southeast, Southwest, and Central-South of the State. The intermediate priority area was located along the border with neighboring States and municipalities classified as high and low priority. Spatial analysis showed the importance of the neighboring phenomenon between municipalities in defining priority areas, thus highlighting the technique's advantages for use in malaria control and surveillance.

Spatial analysis for stratification of priority malaria control areas, Mato Grosso State, Brazil

The goal of this study was to stratify priority areas for malaria control in the State of Mato Grosso, Brazil, based on spatial analysis. The variables used were: Annual Parasite Index (API), Plasmodium falciparum/Plasmodium vivax ratio, population variation, number of families settled, and percent of deforested area. The Moran's I and Local Moran Test were applied, visualized with the Box Map and Moran Map, for 1986- 1991, 1992-1997, and 1998-2003. Box Map identified areas with high, low, and intermediate priority for control, and Moran Map identified municipalities with significant autocorrelation. In the high priority area, located in the North of Mato Grosso, malaria incidence decreased drastically despite the increase in the number of municipalities from the first to the last period. Other municipalities were added to the lower priority area, from the Southeast, Southwest, and Central-South of the State. The intermediate priority area was located along the border with neighboring States and municipalities classified as high and low priority. Spatial analysis showed the importance of the neighboring phenomenon between municipalities in defining priority areas, thus highlighting the technique's advantages for use in malaria control and surveillance.

Pautado em técnicas de análise espacial, analisou-se a estratificação de áreas prioritárias para controle da malária no Estado de Mato Grosso, Brasil. Trabalhou-se Incidência Parasitária Anual, relação Plasmodium falciparum/Plasmodium vivax, variação populacional, número de famílias assentadas e percentuais da área desmatada. Foram utilizados os testes de I de Moran e Moran Local, visualizadas pelo Box Map e Moran Map, nos períodos de: 1986 a 1991, 1992 a 1997 e 1998 a 2003. Pelo Box Map identificaram-se áreas de prioridade maior, menor e intermediária, e pelo Moran Map localizaram-se municípios com autocorrelação estatisticamente significante. Na área de maior prioridade, localizada na região norte mato-grossense, a incidência reduziu drasticamente apesar do aumento do número de municípios de primeiro a último período. A área de menor prioridade agregou municípios da região sudeste, sudoeste e centro-sul. A área de prioridade intermediária localizou-se na fronteira com estados vizinhos e entre os municípios de maior e menor prioridade. A análise espacial apontou a importância da vizinhança na determinação de áreas de prioridade, constituindo em importante ferramenta para a vigilância e controle de malária.

[Epidemiological trends of malaria in the State of Mato Grosso, from 1980 to 2003]. / Comportamento epidemiológico da malária no Estado de Mato Grosso, 1980-2003.

The temporal and spatial evolution of malaria in Mato Grosso was determined in periods from 1980-1985, 1986-1991, 1992-1997 and 1998-2003 and distributed by homogeneous microregion. The annual parasitic index of the state rose until 1992 and then diminished to 1.9 cases/1,000 inhabitants in 2003, the ratio of mortality and the lethality rate were greater in the 1980s. Of the 22 microregions, 13 presented an API inferior to 10 cases/1,000 inhabitants in all periods. Cases were concentrated in the microregions of Colíder, Alta Floresta, Aripuanã and Alto Guaporé. In 2003, only the microregion of Aripuanã continued to present an API superior to 50 cases/1,000 inhabitants. The microregions of Colíder, in 1983, 1985 to 1988 and 1990 and Alta Floresta, in 1991 presented deaths over 50/100,000 inhabitants, mainly in males aged 20-49 years. The distribution of the disease in microregions showed that malaria is predominantly found in concentrated sites.

Comportamento epidemiológico da malária no Estado de Mato Grosso, 1980-2003 / Epidemiological trends of malaria in the State of Mato Grosso, from 1980 to 2003

Descreveu-se a evolucão temporal e espacial de malária em Mato Grosso, discriminadas em períodos de 1980-1985; 1986-1991; 1992-1997 e 1998-2003, distribuídas por microrregião homogênea. O índice parasitário anual do estado cresceu até 1992, reduzindo para 1,9 casos/mil habitantes em 2003; o coeficiente de mortalidade e a taxa de letalidade foram maiores nos anos de 1980 a 1989. Das 22 microrregiões, 13 apresentaram IPA inferior a 10 casos/1.000 habitantes em todos os períodos, ocorrendo concentracão de casos nas microrregiões de Colíder, Alta Floresta, Aripuanã e Alto Guaporé. Em 2003, apenas a microrregião de Aripuanã persistia com IPA superior a 50 casos/1.000 habitantes. As microrregiões de Colíder, em 1983, 1985 a 1988 e 1990 e Alta Floresta, em 1991, apresentaram óbitos acima de 50/100.000 habitantes, sendo a maioria do sexo masculino, na faixa etária de 20 a 49 anos. A distribuicão da doenca por microrregiões evidenciou que a malária é predominantemente focal.

Análise espacial na determinação de áreas de risco para malária em Mato Grosso: uma inovação para os programas de controle / Spatial analysis in the risk areas determination for malaria in Mato Grosso: an innovation for the programs of control

O presente estudo tem por objetivo analisar a distribuição temporal e espacial da malária no Mato Grosso, entre o período de 1980 a 2003, utilizando a análise espacial como ferramenta para identificação de áreas prioritárias pra controle da malária e contribuir para o aprimoramento dos métodos de estratificação epidemiológica do risco de adoecer por malária. O trabalho está apresentado em três artigos. No primeiro artigo, analisou-se a evolução dos casos de malária no Estado de Mato Grosso, entre 1980 e 2003, segundo microrregião homogênea de residência. No segundo artigo, analisou-se a estratificação de áreas prioritárias e os fatores envolvidos na ocorrência de malária em Mato Grosso, de 1986 a 2003, utilizando-se análise espacial através das medidas de autocorrelação de Moran, global e local. No terceiro artigo buscou-se verificar a aplicabilidade do método de estratificação de área prioritária para controle da malária adotando a técnica de análise espacial utilizada no segundo artigo. Este artigo comparou a estratificação de risco adotada pelo Plano de Intensificação das Ações de Controle da Malária na Amazônia Legal, desenvolvido pela FUNASA e a estratificação de área prioritária determinada pela análise espacial, antes e depois de um ano de implantação do Plano, utilizando-se dados de 1999 e de 2001. Concluiu-se que houve variação na distribuição da mortalidade e morbidade por microrregiões e esta variação esteve influenciada por contextos específicos de cada localidade. A metodologia de análise espacial utilizada permitiu a determinação de áreas prioritárias que contemplam a dinâmica da epidemia/endemia para além dos limites estritos de municípios. O uso da análise espacial mostrou-se um recurso importante para estratificação de áreas prioritárias e úteis para instrumentalização dos níveis, central e regional, no planejamento das ações de controle, monitoramento e avaliação...