Integrating Parasitological and Entomological Observations to Understand Malaria Transmission in Riverine Villages in the Peruvian Amazon

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Rosas-Aguirre, Angel
Moreno, Marta
Moreno-Gutierrez, Diamantina
Llanos-Cuentas, Alejandro
Saavedra, Marlon
Contreras-Mancilla, Juan
Barboza, Jose
Alava, Freddy
Aguirre, Kristhian
Carrasco, Gabriel
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Oxford University Press
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Background. Remote rural riverine villages account for most of the reported malaria cases in the Peruvian Amazon. As transmission decreases due to intensive standard control efforts, malaria strategies in these villages will need to be more focused and adapted to local epidemiology. Methods. By integrating parasitological, entomological, and environmental observations between January 2016 and June 2017, we provided an in-depth characterization of malaria transmission dynamics in 4 riverine villages of the Mazan district, Loreto department. Results. Despite variation across villages, malaria prevalence by polymerase chain reaction in March 2016 was high (>25% in 3 villages), caused by Plasmodium vivax mainly and composed of mostly submicroscopic infections. Housing without complete walls was the main malaria risk factor, while households close to forest edges were more commonly identified as spatial clusters of malaria prevalence. Villages in the basin of the Mazan River had a higher density of adult Anopheles darlingi mosquitoes, and retained higher prevalence and incidence rates compared to villages in the basin of the Napo River despite test-and-treat interventions. Conclusions. High heterogeneity in malaria transmission was found across and within riverine villages, resulting from interactions between the microgeographic landscape driving diverse conditions for vector development, housing structure, and human behavior.
This work was supported by the Consejo Nacional de Ciencia, Tecnologia e Innovacion Tecnologica (grant number 008-2014-FONDECYT); the Academie de Recherche et d'Enseignement Superieur-Commission de la Cooperation au Developpement of Belgium (grant number ARES-CCD, PRD-Peru 2014-2019 to N. S., A. L. C., and A. R. A.); World Health Organization Special Programme for Research and Training in Tropical Diseases (grant number 201460655 to D. G.); and National Institutes of Health, National Institute of Allergy and Infectious Diseases (grant numbers U19AI089681 to J. M. V. and R01AI110112 to J. E. C.). A. R. A. is a Postdoctoral Researcher of the Fonds de la Recherche Scientifique (FNRS, Belgium).
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transmission, malaria, heterogeneity, Amazon, incidence, prevalence, human biting rate, entomological inoculation rate, Peru