Malaria time series in the extra-Amazon region of Brazil: epidemiological scenario and a two-year prediction model

Abstract Background In Brazil, malaria is caused mainly by the Plasmodium vivax and Plasmodium falciparum species. Its transmission occurs in endemic and non-endemic areas. Malaria geography in Brazil has retracted and is now concentrated in the North region. The Brazilian Amazon region accounts for...

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Bibliographic Details
Published in:Malaria Journal
Main Authors: Klauss Kleydmann Sabino Garcia, Amanda Amaral Abrahão, Ana Flávia de Morais Oliveira, Karina Medeiros de Deus Henriques, Anielle de Pina-Costa, André Machado Siqueira, Walter Massa Ramalho
Format: Article in Journal/Newspaper
Language:English
Published: BMC 2022
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Online Access:https://doi.org/10.1186/s12936-022-04162-1
https://doaj.org/article/a4fabdb038144900ba8615b417c3b24b
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Summary:Abstract Background In Brazil, malaria is caused mainly by the Plasmodium vivax and Plasmodium falciparum species. Its transmission occurs in endemic and non-endemic areas. Malaria geography in Brazil has retracted and is now concentrated in the North region. The Brazilian Amazon region accounts for 99% of Brazil's cases. Brazil’s extra-Amazon region has a high frequency of imported cases and in 2019 presented a mortality rate 123 times higher than the Amazon region. Extra-Amazon cases present risks of reintroduction. This study aims to characterize the epidemiological scenario for malaria in the extra-Amazon region of Brazil from 2011 to 2020 with a two-year forecast. Methods Time-series study with description of malaria cases and deaths registered in Brazilian extra-Amazon region from 2011 to 2020. Public data from the Notifiable Diseases Information System (Sinan) and the Mortality Information System (SIM) were used. Descriptive analysis, incidence, and notification rates were calculated. Flow charts analysed the flux between Places of Probable Infection (PI) and places of notification. The prediction model utilized a multiplicative Holt-winters model for trend and seasonality components. Results A total of 6849 cases were registered. Cases were predominantly white males with 9 to 11 years of education, mostly between 30 and 39 years old. Imported cases accounted for 78.9% of cases. Most frequent occupations for imported cases are related to travelling and tourism activities. Among autochthonous cases, there is a higher frequency of agriculture and domestic economic activities. In the period there were 118 deaths due to malaria, of which 34.7% were caused by P. falciparum infections and 48.3% were not specified. The most intense flows of imported cases are from Amazonas and Rondônia to São Paulo, Rio de Janeiro, and Paraná. The prediction estimates around 611 cases for each of the following two years. Conclusion The time series allows a vast epidemiological visualization with a short-term prediction analysis ...