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Article

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

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Instituto Leônidas & Maria Deane, Fundação Oswaldo Cruz (ILMD/Fiocruz), Amazonas 69057-070, Brazil
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Programa de Pós-Graduação em Biologia Parasitaria—Instituto Oswaldo Cruz (IOC/Fiocruz), Rio de Janeiro 21040-900, Brazil
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Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI/Fiocruz), Rio de Janeiro 21040-360, Brazil
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Fundação de Medicina Tropical Heitor Vieira Dourado (FMT-HVD), Amazonas 69040-000, Brazil
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Programa de Pós Graduação em Medicina Tropical—Universidade do Estado do Amazonas (UEA), Amazonas 69040-000, Brazil
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Fundação de Vigilância em Saúde (FVS), Amazonas 69093-018, Brazil
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Walter & Elisa Hall Institute, Melbourne 3052, Australia
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Pasteur Institute, 75015 Paris, France
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Programa de Computação Científica, Fundação Oswaldo Cruz (PROCC/Fiocruz), Rio de Janeiro 21040-360, Brazil
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Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Int. J. Environ. Res. Public Health 2021, 18(10), 5061; https://doi.org/10.3390/ijerph18105061
Received: 17 March 2021 / Revised: 25 April 2021 / Accepted: 30 April 2021 / Published: 11 May 2021
(This article belongs to the Section Global Health)
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. View Full-Text
Keywords: Plasmodium vivax; malaria; chloroquine; resistance; disease elimination Plasmodium vivax; malaria; chloroquine; resistance; disease elimination
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MDPI and ACS Style

Balieiro, A.A.S.; Siqueira, A.M.; Melo, G.C.; Monteiro, W.M.; Sampaio, V.S.; Mueller, I.; Lacerda, M.V.G.; Villela, D.A.M. Short-Time Recurrences of Plasmodium vivax Malaria as a Public Health Proxy for Chloroquine-Resistance Surveillance: A Spatio-Temporal Study in the Brazilian Amazon. Int. J. Environ. Res. Public Health 2021, 18, 5061. https://doi.org/10.3390/ijerph18105061

AMA Style

Balieiro AAS, Siqueira AM, Melo GC, Monteiro WM, Sampaio VS, Mueller I, Lacerda MVG, Villela DAM. Short-Time Recurrences of Plasmodium vivax Malaria as a Public Health Proxy for Chloroquine-Resistance Surveillance: A Spatio-Temporal Study in the Brazilian Amazon. International Journal of Environmental Research and Public Health. 2021; 18(10):5061. https://doi.org/10.3390/ijerph18105061

Chicago/Turabian Style

Balieiro, Antonio A. S., Andre M. Siqueira, Gisely C. Melo, Wuelton M. Monteiro, Vanderson S. Sampaio, Ivo Mueller, Marcus V. G. Lacerda, and Daniel A. M. Villela. 2021. "Short-Time Recurrences of Plasmodium vivax Malaria as a Public Health Proxy for Chloroquine-Resistance Surveillance: A Spatio-Temporal Study in the Brazilian Amazon" International Journal of Environmental Research and Public Health 18, no. 10: 5061. https://doi.org/10.3390/ijerph18105061

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