Factors associated with timely treatment of malaria in the Brazilian Amazon: a 10-year population-based study / Fatores associados ao trata¬mento precoce da malária na Amazônia brasileira: um estudo populacional de 10 anos / Factores asociados con el tratamiento oportuno de la malaria en la Amazonia brasileña: estudio de 10 años basado en la población

ABSTRACT

Objective. To identify factors associated with timely treatment of malaria in the Brazilian Amazon. Malaria, despite being treatable, has proven difficult to control and continues to be an important public health problem globally. Brazil accounted for almost half of the 427 000 new malaria cases notified in the Americas in 2013. Methods. This was a cross-sectional study using secondary data on all notified malaria cases for the period from 2004 – 2013. Timely treatment was considered to be all treatment started within 24 hours of symptoms onset. Multivariate logistic regression was used to identify independent factors associated with timely treatment. Results. The proportion of cases starting treatment on a timely basis was 41.1%, tending to increase in more recent years (OR = 1.40; 95%CI 1.37 – 1.42 in 2013). Furthermore, people starting within < 24 hours were more likely to reside in the states of Rondônia (OR = 1.50; 95%CI 1.49 – 1.51) or Acre (OR = 1.53; 95%CI 1.55 – 1.57); be 0 – 5 years of age (OR = 1.39; 95%CI 1.34 – 1.44) or 6 – 14 years of age (OR = 1.34; 95%CI 1.32 – 1.36); be indigenous (OR = 1.41; 95%CI 1.37 – 1.45); have a low level of schooling (OR = 1.20; 95%CI 1.19 – 1.22); and be diagnosed by active detection (OR = 1.39; 95%CI 1.38 – 1.39). Conclusion. In the Brazilian Amazon area, individuals were more likely to have timely treatment of malaria if they were young, residing in Acre or Rondônia states, have little schooling, and be identified through active detection. Identifying groups vulnerable to late treatment is important for preventing severe cases and malaria deaths.