RESUMO
The relative contribution of imported vs. locally acquired infections to urban malaria burden remains largely unexplored in Latin America, the most urbanised region in the developing world. Here we use a simple molecular epidemiology framework to examine the transmission dynamics of Plasmodium vivax in Mâncio Lima, the Amazonian municipality with the highest malaria incidence rate in Brazil. We prospectively genotyped 177 P. vivax infections diagnosed in urban residents between June 2014 and July 2015 and showed that local parasites are structured into several lineages of closely related microsatellite haplotypes, with the largest genetic cluster comprising 32% of all infections. These findings are very unlikely under the hypothesis of multiple independent imports of parasite strains from the rural surroundings. Instead, the presence of an endemic near-clonal parasite lineage circulating over 13 consecutive months is consistent with a local P. vivax transmission chain in the town, with major implications for malaria elimination efforts in this and similar urban environments across the Amazon.
Assuntos
Transmissão de Doença Infecciosa , Malária Vivax/epidemiologia , Malária Vivax/transmissão , Plasmodium vivax/classificação , Plasmodium vivax/genética , Adolescente , Adulto , Brasil/epidemiologia , Criança , Pré-Escolar , Análise por Conglomerados , Feminino , Genótipo , Técnicas de Genotipagem , Humanos , Incidência , Masculino , Repetições de Microssatélites , Pessoa de Meia-Idade , Plasmodium vivax/isolamento & purificação , Estudos Prospectivos , População Urbana , Adulto JovemRESUMO
We report on a three-generation Brazilian family with seven patients affected with non-progressive high-frequency sensorineural hearing loss with no associated anomalies first noted in early infancy. To our knowledge this is the first report on this autosomal-dominant condition. Clinical, audiological, and genetic aspects are discussed.