Evidence-Based Malaria Control and Elimination in the Amazon: Input from the International Center of Excellence in Malaria Research Network in Peru and Brazil

Author:

Ferreira Marcelo U.1,Gamboa Dionicia23,Torres Katherine23,Rodriguez-Ferrucci Hugo4,Soto-Calle Veronica E.5,Pardo Karim6,Fontoura Pablo S.7,Tomko Sheena S.8,Gazzinelli Ricardo T.91011,Conn Jan E.1213,Castro Marcia C.14,Llanos-Cuentas Alejandro2,Vinetz Joseph M.315

Affiliation:

1. Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil;

2. Institute of Tropical Medicine Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru;

3. Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru;

4. Facultad de Medicina Humana, Universidad Nacional de la Amazonia Peruana, Iquitos, Peru;

5. Dirección de Prevención y Control de Enfermedades Metaxénicas y Zoonosis, Ministerio de Salud, Lima, Peru;

6. Universidad de Ciencias Aplicadas and Ejecutiva Adjunta II, Despacho Viceministerial de Salud Pública, Ministerio de Salud, Lima, Peru;

7. Coordenação-Geral de Arboviroses, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Brazil;

8. Department of Biology, University of Pennsylvania, Philadelphia, Pennsylvania;

9. Instituto de Pesquisas Rene Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil;

10. Division of Infectious Disease and immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts;

11. Plataforma de Medicina Translacional, Fundação Oswaldo Cruz, Ribeirão Preto, Brazil;

12. Department of Biomedical Sciences, School of Public Health, University at Albany, State University of New York, Albany, New York;

13. Wadsworth Center, New York State Department of Health, Albany, New York;

14. Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts;

15. Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut

Abstract

ABSTRACT. Malaria remains endemic in 17 countries in the Americas, where 723,000 cases were reported in 2019. The majority (> 90%) of the regional malaria burden is found within the Amazon Basin, which includes nine countries and territories in South America. Locally generated evidence is critical to provide information to public health decision makers upon which the design of efficient and regionally directed malaria control and elimination programs can be built. Plasmodium vivax is the predominant malaria parasite in the Amazon Basin. This parasite species appears to be more resilient to malaria control strategies worldwide. Asymptomatic Plasmodium infections constitute a potentially infectious reservoir that is typically missed by routine microscopy-based surveillance and often remains untreated. The primary Amazonian malaria vector, Nyssorhynchus (formerly Anopheles) darlingi, has changed its behavior to feed and rest predominantly outdoors, reducing the efficiency of core vector control measures such as indoor residual spraying and distribution of long-lasting insecticide-treated bed nets. We review public health implications of recent field-based research carried out by the Amazonia International Center of Excellence in Malaria Research in Peru and Brazil. We discuss the relative role of traditional and novel tools and strategies for better malaria control and elimination across the Amazon, including improved diagnostic methods, new anti-relapse medicines, and biological larvicides, and emphasize the need to integrate research and public health policymaking.

Publisher

American Society of Tropical Medicine and Hygiene

Subject

Virology,Infectious Diseases,Parasitology

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