Abstract
Background
Malaria continues to pose a significant public health challenge in the Loreto region of the Peruvian Amazon, prompting the implementation of the "Plan Malaria Cero" to minimize cases and eliminate malaria in the region. However, the need for reliable diagnostic tools to monitor changes in transmission intensity and guide interventions remains a critical concern.
Methods
A cross-sectional malaria survey was conducted in the Zungarococha community, comprising four villages, utilizing microscopic, molecular, and serological techniques to evaluate the intensity of malaria transmission. Statistical analysis, including multivariate-adjusted analysis, seroprevalence curves, and spatial clustering analysis were conducted to assess malaria prevalence, exposure, and risk factors.
Results
The survey revealed a high prevalence of asymptomatic infections of 6% by microscopy and 18% by PCR, indicating a higher sensitivity of molecular methods in detecting asymptomatic infections. Seroprevalence varied significantly between villages, reflecting heterogeneous malaria transmission dynamics. Multivariate analysis identified age, village, and limited bednet usage as significant risk factors for malaria infection and species-specific exposure. Seroprevalence curves demonstrated community-specific patterns, with LL and PA showing the highest seroconversion rates for both Plasmodium species.
Conclusions
The study highlights the diversity of malaria transmission in the Loreto region, with pronounced heterogeneity as transmission rates decline, particularly in residual malaria scenarios. The use of molecular and serological techniques enhances the detection of current infections and past exposure, aiding in the identification of epidemiological risk factors. These findings underscore the importance of employing molecular and serological tools to characterize malaria transmission patterns in low-endemicity areas, which is crucial for regions implementing or planning targeted interventions and elimination strategies in malaria-endemic areas, such as the PMC in the Peruvian Amazon.