Short-Time Recurrences of Plasmodium vivax Malaria as a Public Health Proxy for Chloroquine-Resistance Surveillance: A Spatio-Temporal Study in the Brazilian Amazon

Antonio A. S. Balieiro, Andre M. Siqueira, Gisely C. Melo, Wuelton M. Monteiro, Vanderson S. Sampaio, Ivo Mueller, Marcus V. G. Lacerda and Daniel A. M. Villela
Additional contact information
Antonio A. S. Balieiro: Instituto Leônidas & Maria Deane, Fundação Oswaldo Cruz (ILMD/Fiocruz), Amazonas 69057-070, Brazil
Andre M. Siqueira: Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI/Fiocruz), Rio de Janeiro 21040-360, Brazil
Gisely C. Melo: Fundação de Medicina Tropical Heitor Vieira Dourado (FMT-HVD), Amazonas 69040-000, Brazil
Wuelton M. Monteiro: Fundação de Medicina Tropical Heitor Vieira Dourado (FMT-HVD), Amazonas 69040-000, Brazil
Vanderson S. Sampaio: Fundação de Medicina Tropical Heitor Vieira Dourado (FMT-HVD), Amazonas 69040-000, Brazil
Ivo Mueller: Walter & Elisa Hall Institute, Melbourne 3052, Australia
Marcus V. G. Lacerda: Instituto Leônidas & Maria Deane, Fundação Oswaldo Cruz (ILMD/Fiocruz), Amazonas 69057-070, Brazil
Daniel A. M. Villela: Programa de Pós-Graduação em Biologia Parasitaria—Instituto Oswaldo Cruz (IOC/Fiocruz), Rio de Janeiro 21040-900, Brazil

IJERPH, 2021, vol. 18, issue 10, 1-11

Abstract: In Brazil, malaria caused by Plasmodium vivax presents control challenges due to several reasons, among them the increasing possibility of failure of P. vivax treatment due to chloroquine-resistance (CQR). Despite limited reports of CQR, more extensive studies on the actual magnitude of resistance are still needed. Short-time recurrences of malaria cases were analyzed in different transmission scenarios over three years (2005, 2010, and 2015), selected according to malaria incidence. Multilevel models (binomial) were used to evaluate association of short-time recurrences with variables such as age. The zero-inflated Poisson scan model (scanZIP) was used to detect spatial clusters of recurrences up to 28 days. Recurrences compose less than 5% of overall infection, being more frequent in the age group under four years. Recurrences slightly increased incidence. No fixed clusters were detected throughout the period, although there are clustering sites, spatially varying over the years. This is the most extensive analysis of short-time recurrences worldwide which addresses the occurrence of P. vivax CQR. As an important step forward in malaria elimination, policymakers should focus their efforts on young children, with an eventual shift in the first line of malaria treatment to P. vivax .

Keywords: Plasmodium vivax; malaria; chloroquine; resistance; disease elimination (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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