Amazonian malaria: Asymptomatic human reservoirs, diagnostic challenges, environmentally driven changes in mosquito vector populations, and the mandate for sustainable control strategies
Amazonian malaria: Asymptomatic human reservoirs, diagnostic challenges, environmentally driven changes in mosquito vector populations, and the mandate for sustainable control strategies
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DOI：
10.1016/j.actatropica.2011.10.001
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发表时间：
2012-03-01
期刊：
影响因子：
2.7
通讯作者：
Ferreira, Marcelo U.
中科院分区：
文献类型：
--
作者：
da Silva-Nunes, Monica;Moreno, Marta;Ferreira, Marcelo U.
2008年，美洲和加勒比海地区正式报告了近561,000例经玻片确认的疟疾感染病例。其中亚马逊流域的9个国家占这些感染病例的89%；仅巴西和秘鲁就分别贡献了其中的 56% 和 7%。相对被忽视的寄生虫间日疟原虫的当地种群在遗传和地理结构上极其多样化，目前占该地区疟疾负担的 77%。当消除疟疾被列入几个流行国家的公共卫生议程时，目前尚不清楚为什么疟疾在亚马逊流域等传播水平相对较低的地区如此难以控制。我们假设，无症状的寄生虫携带和影响媒介丰度和行为的大规模环境变化是亚马逊流域流行病学不同地区疟疾传播的主要原因。在这里，我们回顾了支持这一假设的现有数据，并讨论了它们对该地区当前和未来疟疾干预政策的影响。鉴于迫切需要当地产生的科学证据来支持亚马逊流域的疟疾控制干预措施，我们简要描述了目前在秘鲁乡村和金矿飞地以及巴西最近开放的农业定居点进行的实地疟疾研究的目标。 (C) 2011 Elsevier B.V. 保留所有权利。
Across the Americas and the Caribbean, nearly 561,000 slide-confirmed malaria infections were reported officially in 2008. The nine Amazonian countries accounted for 89% of these infections; Brazil and Peru alone contributed 56% and 7% of them, respectively. Local populations of the relatively neglected parasite Plasmodium vivax, which currently accounts for 77% of the regional malaria burden, are extremely diverse genetically and geographically structured. At a time when malaria elimination is placed on the public health agenda of several endemic countries, it remains unclear why malaria proved so difficult to control in areas of relatively low levels of transmission such as the Amazon Basin. We hypothesize that asymptomatic parasite carriage and massive environmental changes that affect vector abundance and behavior are major contributors to malaria transmission in epidemiologically diverse areas across the Amazon Basin. Here we review available data supporting this hypothesis and discuss their implications for current and future malaria intervention policies in the region. Given that locally generated scientific evidence is urgently required to support malaria control interventions in Amazonia, we briefly describe the aims of our current field-oriented malaria research in rural villages and gold-mining enclaves in Peru and a recently opened agricultural settlement in Brazil. (C) 2011 Elsevier B.V. All rights reserved.