A snapshot of a representative Brazilian state of illegal mining in indigenous areas during the era of malaria elimination.

Malaria is a public health problem and the cases diagnosed in the capital of Roraima, Brazil, show potential to characterize the burden of the disease in the state. This study aimed to describe the epidemiological, clinical, and laboratory aspects of malaria cases diagnosed in Boa Vista. For this purpose, a descriptive, cross-sectional study was conducted in two health units in the city, with individuals diagnosed and who agreed to respond the questionnaire. Of the total of 206 participants, characterized as men, mixed-race, and young, 96% (198) reported participating in illegal mining activity. Among the group of miners, 66% (131) came from other states of Brazil or other countries. The mines were mainly located in the Yanomami territory in Roraima. Plasmodium vivax infection occurred in 74% (153) of participants. In the miner's group, hospitalizations for severe malaria, previous malaria attacks, and delays in treatment after the onset of symptoms were reported. Although 73% (145) of miners reported knowing how malaria was transmitted, only 54% (107) used mosquito nets or repellents. The use of Artecom and chloroquine by miners is not for the complete treatment but only to relieve symptoms for returning to gold mines, highlighting the importance of molecular surveillance to antimalarial resistance. Indigenous peoples are considered vulnerable to malaria and miners promotes the increase of malaria in Roraima Indigenous Lands. Therefore, access to diagnosis and treatment in Indigenous areas invaded by miners is imperative to confront this disease that ravages Indigenous communities and threatens public health on a large scale to achieve the goal of eliminating malaria in the state.

A snapshot of a representative Brazilian state of illegal mining in indigenous areas during the era of malaria elimination / Um retrato de um estado brasileiro representativo do garimpo ilegal em áreas indígenas durante a campanha de erradicação da malária / Un retrato de un estado brasileño representativo de la minería ilegal en zonas indígenas durante la campaña de erradicación de la malaria

Abstract: Malaria is a public health problem and the cases diagnosed in the capital of Roraima, Brazil, show potential to characterize the burden of the disease in the state. This study aimed to describe the epidemiological, clinical, and laboratory aspects of malaria cases diagnosed in Boa Vista. For this purpose, a descriptive, cross-sectional study was conducted in two health units in the city, with individuals diagnosed and who agreed to respond the questionnaire. Of the total of 206 participants, characterized as men, mixed-race, and young, 96% (198) reported participating in illegal mining activity. Among the group of miners, 66% (131) came from other states of Brazil or other countries. The mines were mainly located in the Yanomami territory in Roraima. Plasmodium vivax infection occurred in 74% (153) of participants. In the miner's group, hospitalizations for severe malaria, previous malaria attacks, and delays in treatment after the onset of symptoms were reported. Although 73% (145) of miners reported knowing how malaria was transmitted, only 54% (107) used mosquito nets or repellents. The use of Artecom and chloroquine by miners is not for the complete treatment but only to relieve symptoms for returning to gold mines, highlighting the importance of molecular surveillance to antimalarial resistance. Indigenous peoples are considered vulnerable to malaria and miners promotes the increase of malaria in Roraima Indigenous Lands. Therefore, access to diagnosis and treatment in Indigenous areas invaded by miners is imperative to confront this disease that ravages Indigenous communities and threatens public health on a large scale to achieve the goal of eliminating malaria in the state.

Resumo: A malária é um problema de saúde pública e os casos diagnosticados na capital de Roraima, Brasil, têm potencial para caracterizar a carga da doença em todo o estado. O objetivo deste estudo foi descrever os aspectos epidemiológicos, clínicos e laboratoriais dos casos de malária diagnosticados em Boa Vista. Para tanto, foi realizado um estudo descritivo e transversal em duas unidades de saúde do município, com indivíduos diagnosticados com malária e que concordaram em responder ao questionário. De 206 participantes, caracterizados como homens, pardos e jovens, 96% (198) relataram atividade de garimpo ilegal. Entre garimpeiros, 66% (131) vieram de outros estados do Brasil ou de outros países. As minas estavam localizadas principalmente no território Yanomami, em Roraima. A infecção por Plasmodium vivax ocorreu em 74% (153) dos participantes. Entre garimpeiros, houve relatos de internações por malária grave, ataques prévios de malária e atrasos no tratamento após o início dos sintomas. Embora 73% (145) dos garimpeiros tenham relatado saber como a malária era transmitida, apenas 54% (107) usavam mosquiteiros ou repelentes. O uso de Artecom e cloroquina pelos garimpeiros não se destina ao tratamento completo, mas apenas ao alívio dos sintomas, permitindo o retorno às minas de ouro. Isso ressalta a importância da vigilância molecular para detectar a resistência antimalárica. Os indígenas são considerados uma população vulnerável à malária, e os garimpeiros promovem o aumento da malária nas Terras Indígenas de Roraima. Portanto, o acesso ao diagnóstico e tratamento em áreas indígenas invadidas por garimpeiros é imperativo para o enfrentamento dessa doença que assola as comunidades indígenas e ameaça a saúde pública em larga escala na meta de erradicar a malária no estado.

Resumen: La malaria es un problema de salud pública y los casos diagnosticados en la capital de Roraima, Brasil, tienen el potencial de caracterizar la carga de la enfermedad en todo el estado. El objetivo de este estudio fue describir los aspectos epidemiológicos, clínicos y de laboratorio de los casos de malaria diagnosticados en Boa Vista. Para ello, se realizó un estudio descriptivo y transversal en dos unidades de salud del municipio, con personas diagnosticadas con malaria y que aceptaron responder el cuestionario. De 206 participantes, caracterizados como hombres, pardos y jóvenes, el 96% (198) reportó actividad minera ilegal. Entre los mineros, el 66% (131) procedían de otros estados de Brasil o de otros países. Las minas estaban ubicadas principalmente en el territorio Yanomami, en Roraima. La infección por Plasmodium vivax se produjo en el 74% (153) de los participantes. Entre los mineros, hubo relatos de hospitalizaciones por malaria grave, ataques previos de malaria y retrasos en el tratamiento tras de la aparición de los síntomas. Aunque el 73% (145) de los mineros informó saber cómo se transmitía la malaria, solo el 54% (107) usaba mosquiteros o repelentes. El uso de Artecom y cloroquina por parte de los mineros no está destinado a un tratamiento completo, sino al alivio de los síntomas para permitir el regreso a las minas de oro. Esto resalta la importancia de la vigilancia molecular para detectar la resistencia a los antipalúdicos. Los indígenas son considerados una población vulnerable a la malaria, y los mineros promueven el aumento de la malaria en las Tierras Indígenas de Roraima. Por lo tanto, el acceso al diagnóstico y tratamiento en zonas indígenas invadidas por mineros es imperativo para combatir esta enfermedad que asola a las comunidades indígenas y amenaza la salud pública a gran escala en el objetivo de erradicar la malaria en el estado.