title: Socio-demographics and the development of malaria elimination strategies in the low transmission setting.
abstract: This analysis presents a comprehensive description of malaria burden and risk factors in Peruvian Amazon villages where malaria transmission is hypoendemic. More than 9000 subjects were studied in contrasting village settings within the Department of Loreto, Peru, where most malaria occurs in the country. Plasmodium vivax is responsible for more than 75% of malaria cases; severe disease from any form of malaria is uncommon and death rare. The association between lifetime malaria episodes and individual and household covariates was studied using polychotomous logistic regression analysis, assessing effects on odds of some vs. no lifetime malaria episodes. Malaria morbidity during lifetime was strongly associated with age, logging, farming, travel history, and living with a logger or agriculturist. Select groups of adults, particularly loggers and agriculturists acquire multiple malaria infections in transmission settings outside of the main domicile, and may be mobile human reservoirs by which malaria parasites move within and between micro-regions within malaria endemic settings. For example, such individuals might well be reservoirs of transmission by introducing or reintroducing malaria into their home villages and their own households, depending on vector ecology and the local village setting. Therefore, socio-demographic studies can identify people with the epidemiological characteristic of transmission risk, and these individuals would be prime targets against which to deploy transmission blocking strategies along with insecticide treated bednets and chemoprophylaxis.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, University of California San Diego, La Jolla, United States. rachuqui@ucsd.edu
authors.forename: Raul
authors.initials: R
authors.lastname: Chuquiyauri
authors.forename: Maribel
authors.initials: M
authors.lastname: Paredes
authors.forename: Pablo
authors.initials: P
authors.lastname: Peñataro
authors.forename: Sonia
authors.initials: S
authors.lastname: Torres
authors.forename: Silvia
authors.initials: S
authors.lastname: Marin
authors.forename: Alexander
authors.initials: A
authors.lastname: Tenorio
authors.forename: Kimberly C
authors.initials: KC
authors.lastname: Brouwer
authors.forename: Shira
authors.initials: S
authors.lastname: Abeles
authors.forename: Alejandro
authors.initials: A
authors.lastname: Llanos-Cuentas
authors.forename: Robert H
authors.initials: RH
authors.lastname: Gilman
authors.forename: Margaret
authors.initials: M
authors.lastname: Kosek
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Vinetz
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003140:Communicable Disease Control / Q000379:methods; D003625:Data Collection / Q000379:methods; D003710:Demography; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008288:Malaria / Q000469:parasitology / Q000517:prevention & control* / Q000635:transmission; D008297:Male; D008875:Middle Aged; D010568:Peru / Q000453:epidemiology; D010961:Plasmodium / Q000472:pathogenicity*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult
references.citation: Am J Trop Med Hyg. 2003 Jul;69(1):45-52
references.pmid: 12932096
references.citation: Am J Trop Med Hyg. 2009 Dec;81(6):950-60
references.pmid: 19996422
references.citation: Trans R Soc Trop Med Hyg. 2001 Nov-Dec;95(6):577-83
references.pmid: 11816424
references.citation: Proc Natl Acad Sci U S A. 2006 Feb 14;103(7):2452-7
references.pmid: 16461902
references.citation: Am J Trop Med Hyg. 2004 Mar;70(3):229-37
references.pmid: 15031509
references.citation: Emerg Infect Dis. 1999 Mar-Apr;5(2):209-15
references.pmid: 10221872
references.citation: Am J Trop Med Hyg. 2006 Jan;74(1):3-11
references.pmid: 16407338
references.citation: J Parasitol. 1991 Oct;77(5):758-61
references.pmid: 1919925
references.citation: PLoS Negl Trop Dis. 2010 Aug 03;4(8):e774
references.pmid: 20689816
references.citation: Infect Immun. 2011 May;79(5):2070-8
references.pmid: 21383051
references.citation: Am J Trop Med Hyg. 2002 Jun;66(6):641-8
references.pmid: 12224567
references.citation: Am J Trop Med Hyg. 2007 Dec;77(6 Suppl):79-87
references.pmid: 18165478
references.citation: Am J Trop Med Hyg. 2009 Jul;81(1):5-12
references.pmid: 19556558
references.citation: Am J Trop Med Hyg. 2002 Jun;66(6):639-40
references.pmid: 12224566
references.citation: PLoS Med. 2011 Jan 25;8(1):e1000400
references.pmid: 21311581
references.citation: Am J Trop Med Hyg. 2001 Jan-Feb;64(1-2 Suppl):97-106
references.pmid: 11425182
references.citation: Rev Saude Publica. 1991 Jun;25(3):165-78
references.pmid: 1687929
references.citation: J Am Mosq Control Assoc. 2003 Dec;19(4):286-96
references.pmid: 14710728
references.citation: Lancet. 1999 Apr 24;353(9162):1415-6
references.pmid: 10227233
references.citation: Int J Epidemiol. 1977 Sep;6(3):259-67
references.pmid: 591173
references.citation: PLoS Med. 2011 Jan 25;8(1):e1000406
references.pmid: 21311579
references.citation: Mem Inst Oswaldo Cruz. 1989 Oct-Dec;84(4):485-91
references.pmid: 2487445
references.citation: East Afr Med J. 1968 May;45(5):266-75
references.pmid: 5674005
references.citation: Am J Trop Med Hyg. 2009 Mar;80(3):452-9
references.pmid: 19270298
references.citation: Am J Trop Med Hyg. 1994 Jul;51(1):16-25
references.pmid: 8059911
references.citation: Bull World Health Organ. 2000;78(12):1401-11
references.pmid: 11196487
references.citation: Parassitologia. 1989 Apr;31(1):101-11
references.pmid: 2487889
references.citation: Am J Trop Med Hyg. 1994 Sep;51(3):260-70
references.pmid: 7943543
references.citation: Int J Parasitol. 2002 Dec 4;32(13):1617-24
references.pmid: 12435446
references.citation: Trends Parasitol. 2007 Nov;23(11):533-9
references.pmid: 17933585
references.citation: Am J Trop Med Hyg. 2000 Feb;62(2):247-56
references.pmid: 10813480
references.citation: Trends Parasitol. 2002 Jul;18(7):287-9
references.pmid: 12379943
references.citation: Acta Trop. 1999 Jan 15;72(1):1-11
references.pmid: 9924956
references.citation: J Med Entomol. 2004 May;41(3):489-94
references.pmid: 15185955
references.citation: PLoS Med. 2011 Jan 25;8(1):e1000404
references.pmid: 21283603
references.citation: Science. 2007 Aug 31;317(5842):1233-6
references.pmid: 17690260