Determinantes ambientais e não-ambientais da transmissão do plasmódio na paisagem urbana amazônica e suas consequências clínicas: estudo de base populacional em Mâncio Lima, Acre / Environmental and non- environmental determinants of plasmodium transmission in the Amazonian urban ladscape and its clinical consequences: a population- based study in Mâncio Lima, Acre

Este estudo avaliou as mudanças ambientais da paisagem urbana deum município com alta incidência de malária na Amazônia brasileira(Mâncio Lima, Acre) e sua relação com a doença, com o objetivo deprover evidências de que a transmissão do Plasmódio é causada pelomodo como os seres humanos interagem com o meio-ambiente. Foramefetuados três estudos populacionais consecutivos, entre 2012 e 2013,com 1260 indivíduos, com identificação do plasmódio por microscopiae técnicas moleculares. Casos de malária foram analisados medianteum questionário clinico. O estudo entomológico envolveu 8 inquéritostransversais com coleta de formas imaturas em 90 corpos d’água, bemcomo avaliação espacial desses dados. Os resultados mostraram quea transmissão de malária na área deveu-se em grande parte a criaçãode tanques de piscicultura, que elevaram em cerca de 10 vezes aprodutividade de imaturos de Anopheles darlingi, e à grande mobilidadeda população, que se desloca para áreas de maior transmissão (comoárea ribeirinha e rural) e retorna infectada para a área urbana. Foramidentificados casos de portadores assintomáticos do Plasmódio, emboraem pequena quantidade. Os fatores associados a ausência de sintomas(infecção assintomática) foram o sexo e o tempo da última malária.Em pacientes sintomáticos, a frequência dos sintomas se relacionoucom idade, número de malárias previas e parasitemia. A concentraçãogeográfica dos casos deveu-se em parte a características socioeconômicasagregadas no espaço, em conjunto com fatores ambientais comopresença do vetor, visto que o uso infrequente de mosquiteiro associousecom a incidência maior de malária(AU)

This study evaluated the environmental changes of the urban landscapeof a municipality with a high incidence of malaria in the BrazilianAmazon (Mâncio Lima, Acre) and its relation with the disease, in orderto provide evidence that the transmission of Plasmodium is causedby the way humans interact with the environment. Three consecutivepopulation studies were carried out between 2012 and 2013, with1260 individuals, with plasmodium identification by microscopy andmolecular techniques. Malaria cases were analyzed using a clinicalquestionnaire. The entomological study involved 8 cross-sectionalsurveys with collection of immature forms in 90 bodies of water, aswell as spatial evaluation of these data. The results showed that thetransmission of malaria in the area was largely due to the creation offish tanks, which increased the immature productivity of Anophelesdarlingi by around 10 times, and the great mobility of the population,which moves to areas of greater transmission (as riverside and ruralarea) and returns infected to the urban area. Cases of asymptomaticPlasmodium carriers have been identified, albeit in small numbers.Factors associated with absence of symptoms (asymptomatic infection)were the sex and time of the last malaria. In symptomatic patients, thefrequency of symptoms was related to age, number of previous malariaand parasitemia. The geographic concentration of the cases was due inpart to aggregate socioeconomic characteristics in space, together withenvironmental factors such as vector presence, since the infrequent useof mosquito nets was associated with a higher incidence of malaria(AU)

Determinantes ambientais e não-ambientais da transmissão do plasmódio na paisagem urbana amazônica e suas consequências clínicas: estudo de base populacional em Mâncio Lima, Acre / Environmental and non- environmental determinants of plasmodium transmission in the Amazonian urban ladscape and its clinical consequences: a population- based study in Mâncio Lima, Acre

Este estudo avaliou as mudanças ambientais da paisagem urbana de um município com alta incidência de malária na Amazônia brasileira (Mâncio Lima, Acre) e sua relação com a doença, com o objetivo de prover evidências de que a transmissão do Plasmódio é causada pelo modo como os seres humanos interagem com o meio-ambiente. Foram efetuados três estudos populacionais consecutivos, entre 2012 e 2013, com 1260 indivíduos, com identificação do plasmódio por microscopia e técnicas moleculares. Casos de malária foram analisados mediante um questionário clinico. O estudo entomológico envolveu 8 inquéritos transversais com coleta de formas imaturas em 90 corpos d’água, bem como avaliação espacial desses dados. Os resultados mostraram que a transmissão de malária na área deveu-se em grande parte a criação de tanques de piscicultura, que elevaram em cerca de 10 vezes a produtividade de imaturos de Anopheles darlingi, e à grande mobilidade da população, que se desloca para áreas de maior transmissão (como área ribeirinha e rural) e retorna infectada para a área urbana. Foram identificados casos de portadores assintomáticos do Plasmódio, embora em pequena quantidade. Os fatores associados a ausência de sintomas (infecção assintomática) foram o sexo e o tempo da última malária. Em pacientes sintomáticos, a frequência dos sintomas se relacionou com idade, número de malárias previas e parasitemia. A concentração geográfica dos casos deveu-se em parte a características socioeconômicas agregadas no espaço, em conjunto com fatores ambientais como presença do vetor, visto que o uso infrequente de mosquiteiro associouse com a incidência maior de malária.

This study evaluated the environmental changes of the urban landscape of a municipality with a high incidence of malaria in the Brazilian Amazon (Mâncio Lima, Acre) and its relation with the disease, in order to provide evidence that the transmission of Plasmodium is caused by the way humans interact with the environment. Three consecutive population studies were carried out between 2012 and 2013, with 1260 individuals, with plasmodium identification by microscopy and molecular techniques. Malaria cases were analyzed using a clinical questionnaire. The entomological study involved 8 cross-sectional surveys with collection of immature forms in 90 bodies of water, as well as spatial evaluation of these data. The results showed that the transmission of malaria in the area was largely due to the creation of fish tanks, which increased the immature productivity of Anopheles darlingi by around 10 times, and the great mobility of the population, which moves to areas of greater transmission (as riverside and rural area) and returns infected to the urban area. Cases of asymptomatic Plasmodium carriers have been identified, albeit in small numbers. Factors associated with absence of symptoms (asymptomatic infection) were the sex and time of the last malaria. In symptomatic patients, the frequency of symptoms was related to age, number of previous malaria and parasitemia. The geographic concentration of the cases was due in part to aggregate socioeconomic characteristics in space, together with environmental factors such as vector presence, since the infrequent use of mosquito nets was associated with a higher incidence of malaria.

Prevalence of anemia in non-severe malaria cases in Mâncio Lima, Acre

Malaria, a parasitic disease, is a serious public health problem. In Brazil, the majority of cases are found in the Amazon. The clinical manifestations of malaria depend on several factors and they may be related to the development of anemia. This study evaluated the prevalence of anemia in malaria cases and its associated factors. The study was conducted in Mâncio Lima (Acre, Brazil). Participants were chosen through passive detection of malaria cases in the municipal health services. They were interviewed and blood samples analyzed for Plasmodium detection and for hemoglobin measurement. SPSS 13.0, software was applied for statistical analysis. One hundred and twenty patients with malaria were studied, of which 58.3% male and 41.7% female. There was a 25% prevalence of anemia, mainly among the women, and in those presenting symptoms for more than four days as well as headaches. The prevalence of anemia and its associated factors in these malaria patients may be connected, not only to the infection, but also to previous or overlapping diseases

Child Health in the Peruvian Amazon: Prevalence and Factors Associated with Referred Morbidity and Health Care Access in the City of Iñapari.

Introduction. Children under 5 years of age are more susceptible to developing morbidities such as diarrhea, respiratory infections, anemia, and malnutrition. The objective of the study is to evaluate the prevalence of reported morbidities in this age group in the city of Iñapari (Peru) and the access to health services in this municipality. Methods. Data collection using interviews that assessed socioeconomic and demographic conditions, child morbidity, and access to health services was performed in 2011. Statistical analysis was performed using SPSS 13.0. Results. Regarding morbidities that occurred during lifetime, 39.8% reported previous anemia and intestinal parasite infection. About 53.7% of the children reported any type of morbidities in the last 15 days before interview, being most frequent respiratory symptoms (38.9%), diarrhea (23,4%), and fever (23,1%). Only 63.1% of those reporting recent morbidities sought health care. These morbidities were associated with precarious sanitation and lack of infrastructure, the presence of other comorbidities, and poor access to health services. Conclusion. The main referred morbidities in Amazonian Peruvian children were diarrhea, respiratory symptoms, anemia, and vomiting. Incentives and improvements in the health and sanitation conditions would be important measures to improve the quality of life of the Amazonian child population.