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Doctoral Thesis
DOI
https://doi.org/10.11606/T.42.2011.tde-04082011-102334
Document
Author
Full name
Natal Santos da Silva
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2011
Supervisor
Committee
Ferreira, Marcelo Urbano (President)
Carvalho, Marília Sá
Waldman, Eliseu Alves
Wunderlich, Gerhard
Zanetta, Dirce Maria Trevisan
Title in Portuguese
Epidemiologia da malária: incidência, distribuição espacial e fatores de risco em uma coorte rural amazônica.
Keywords in Portuguese
Amazonas
Assentamento rural (Amazonas)
Distribuição Espacial (Amazonas)
Fatores de risco
Malária (Epidemiologia)
Sobrevida
Abstract in Portuguese
Um estudo foi desenvolvido numa coorte localizada em um assentamento agrícola no Acre, Brasil, com o objetivo de identificar fatores de risco de malária. Ao longo de 70 meses, acompanharam-se 531 indivíduos, que contribuíram com 2.281,53 pessoas-ano. Registraram-se 443 casos de malária por Plasmodium vivax, 129 por P. falciparum e 27 de malária mista (P. vivax e P. falciparum). A análise espacial de varredura identificou clusters de malária no final da área de estudo, próximo ao limite da floresta. Nessa análise, 69,1% de todos os casos de malária ocorreram em apenas 27 domicílios (22,3% do total), os quais estavam dentro de um raio de 2,2 Km ao centro do cluster. Quatro estudos transversais foram realizados ao longo do seguimento e infecções assintomáticas foram detectadas pela PCR aninhada. Modelos de fragilidade identificaram o local de moradia como a principal covariável relacionada ao risco de aquisição de malária tanto nos modelos não ajustado quanto nos ajustado. Este tipo de análise pode otimizar as ações de combate à malária e reduzir custos operacionais.
Title in English
Epidemiology of malaria: incidence, spatial distribution and risk factors in a rural Amazon cohort.
Keywords in English
Amazonas
Malaria (Epidemiology)
Risk factors
Rural settlement (Amazonas)
Spatial distribution (Amazonas)
Survival
Abstract in English
A study was developed in a cohort located in an agricultural settlement in Acre, Brazil, aiming to identify risk factors of malaria. Over 70 months followed up 531 individuals who contributed 2281.53 people-years. It was recorded 443 cases of malaria by Plasmodium vivax, 129 by P. falciparum and 27 mixed malaria (P. vivax and P. falciparum). The spatial analysis canning identified clusters of malaria at the end of the study area, near the forest border. In this analysis, 69.1% of all malaria cases occurred in only 27 households (22.3% of total), which were within a radius of 2.2 km from the clusters center. Four cross-sectional studies were conducted along the follow-up and asymptomatic infections were detected by nested PCR. Frailty models identified the housing location as the main covariate related risk of acquiring malaria in both unadjusted and adjusted models. This type of analysis may optimize actions against malaria, and reduce operational costs.
 
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Publishing Date
2011-08-24
 
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