Effectiveness of a Malaria Surveillance Strategy Based on Active Case Detection during High Transmission Season in the Peruvian Amazon.

Background: Faced with the resurgence of malaria, malaria surveillance in the Peruvian Amazon incorporated consecutive active case detection (ACD) interventions using light microscopy (LM) as reactive measure in communities with an unusual high number of cases during high transmission season (HTS). We assessed the effectiveness in malaria detection of this local ACD-based strategy. Methods: A cohort study was conducted in June⁻July 2015 in Mazan, Loreto. Four consecutive ACD interventions at intervals of 10 days were conducted in four riverine communities (Gamitanacocha, Primero de Enero, Libertad and Urco Miraño). In each intervention, all inhabitants were visited at home, and finger-prick blood samples collected for immediate diagnosis by LM and on filter paper for later analysis by quantitative real-time polymerase chain reaction (qPCR). Effectiveness was calculated by dividing the number of malaria infections detected using LM by the number of malaria infections detected by delayed qPCR. Results: Most community inhabitants (88.1%, 822/933) were present in at least one of the four ACD interventions. A total of 451 infections were detected by qPCR in 446 participants (54.3% of total participants); five individuals had two infections. Plasmodium vivax was the predominant species (79.8%), followed by P. falciparum (15.3%) and P. vivax-P. falciparum co-infections (4.9%). Most qPCR-positive infections were asymptomatic (255/448, 56.9%). The ACD-strategy using LM had an effectiveness of 22.8% (detection of 103 of the total qPCR-positive infections). Children aged 5⁻14 years, and farming as main economic activity were associated with P. vivax infections. Conclusions: Although the ACD-strategy using LM increased the opportunity of detecting and treating malaria infections during HTS, the number of detected infections was considerably lower than the real burden of infections (those detected by qPCR).

Evidence for Aedes aegypti (Diptera: Culicidae) Oviposition on Boats in the Peruvian Amazon.

Dengue vector Aedes aegypti L. is invading peri-urban and rural areas throughout Latin America. Our previous research in the Peruvian Amazon has shown that river boats are heavily infested with immature and adult Ae. aegypti mosquitoes, likely playing a major role in their long-distance dispersal and successful invasion. However, the presence of immature mosquitoes provides no information about the timing of oviposition, and whether it took place in the boats. Here, we used baited ovitraps deployed on river boats to test the hypothesis that Ae. aegypti oviposition occurs during boat travel. We deployed 360 ovitraps on 60 different barges during August and October of 2013, and February 2014 (with 20 barges sampled during each month). We found that Ae. aegypti mosquitoes in 22 individual ovitraps from 15 of the 60 barges (premise index 25%) across all sampling dates. Further, the distribution of Ae. aegypti egg abundance was highly aggregated: 2.6% of traps (N=7) were responsible for 71.8% of eggs found, and 1.5% of traps (N=4) were responsible for all (100%) of the larvae found. Similarly, 5% of boats were responsible for the 71.47% of eggs. Our results provide strong evidence that Ae. aegypti oviposition commonly occurs during boat travel. Baited ovitraps could represent a cost-effective means of monitoring and controlling mosquito populations on boats.