title: Basic sanitation, socioeconomic conditions, and degree of risk for the presence and maintenance of malaria in a low-transmission area in the Brazilian Amazon.
abstract: BACKGROUND
  This study aimed to evaluate basic sanitation and socioeconomic indicators, reported cases of malaria, and risk of contracting malaria in the Ananindeua municipality, State of Pará.
  
  
  METHODS
  Data on basic sanitation and socioeconomic dimensions were taken from the Brazilian Institute of Geography and Statistics [ Instituto Brasileiro de Geografia e Estatística (IBGE)] 2010 census. Epidemiological malaria information was taken from the Epidemiological Malaria Surveillance Information System [ Sistema de Informação de Vigilância Epidemiológica de Malária (SIVEP/Malaria)], between 2003 and 2013 of the Ministry of Health and from the SIVEP/Malaria forms of the municipality's Endemic Diseases Unit for 2,013 cases.
  
  
  RESULTS
  Our data do not confirm the correlation among indicators of basic sanitation, socioeconomic conditions, and water supply with malaria cases. Of the 1,557 cases evaluated, most were caused by Plasmodium vivax , with rare cases of Plasmodium falciparum and mixed infections. There were 756 notifications in 2003. The number of reported cases was sharply reduced between 2006 and 2012, but a 142-case outbreak occurred in 2013. Ananindeua municipality's Annual Parasite Index indicated low risk in 2003 and no risk in other years, and the 2,013 cases were predominantly male individuals aged ≥40 years.
  
  
  CONCLUSIONS
  Our data confirm the non-endemicity of malaria in the Ananindeua municipality, as the Annual Parasite Indices described for the years 2004-2013 classify it as a risk-free area. However, the 2013 outbreak indicates the need to strengthen prevention, surveillance, and control activities to reduce the risk of new outbreaks and consequent economic and social impacts on the population.
authors.affiliation: Programa de Pós-Graduação em Biologia dos Agentes Infecciosos e Parasitários, Universidade Federal do Pará, Belém, Pará, Brazil.
authors.forename: Thais Hetierre Abreu
authors.initials: TH
authors.lastname: Monteiro
authors.affiliation: Instituto Evandro Chagas, Secretaria de Vigilância Sanitária, Ministério da Saúde, Ananindeua, Pará, Brazil.
authors.forename: Tânia do Socorro Souza
authors.initials: Tdo S
authors.lastname: Chaves
authors.affiliation: Instituto Evandro Chagas, Secretaria de Vigilância Sanitária, Ministério da Saúde, Ananindeua, Pará, Brazil.
authors.forename: Haroldo José de
authors.initials: HJ
authors.lastname: Matos
authors.affiliation: Instituto Evandro Chagas, Secretaria de Vigilância Sanitária, Ministério da Saúde, Ananindeua, Pará, Brazil.
authors.forename: Nelson Fernando de Lisboa
authors.initials: NF
authors.lastname: Sofffiatti
authors.affiliation: Instituto Evandro Chagas, Secretaria de Vigilância Sanitária, Ministério da Saúde, Ananindeua, Pará, Brazil.
authors.forename: Ricardo José de Paula Souza e
authors.initials: RJ
authors.lastname: Guimarães
authors.affiliation: Instituto Evandro Chagas, Secretaria de Vigilância Sanitária, Ministério da Saúde, Ananindeua, Pará, Brazil.
authors.forename: Luis Henrique Rocha
authors.initials: LH
authors.lastname: Guimarães
authors.affiliation: Instituto Evandro Chagas, Secretaria de Vigilância Sanitária, Ministério da Saúde, Ananindeua, Pará, Brazil.
authors.forename: Ana Maria Revoredo
authors.initials: AM
authors.lastname: Ventura
authors.affiliation: Programa de Pós-Graduação em Biologia dos Agentes Infecciosos e Parasitários, Universidade Federal do Pará, Belém, Pará, Brazil.
authors.forename: Ricardo Luiz Dantas
authors.initials: RL
authors.lastname: Machado
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002648:Child; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000453:epidemiology*; D016780:Malaria, Vivax / Q000453:epidemiology*; D008297:Male; D018570:Risk Assessment; D012499:Sanitation / Q000706:statistics & numerical data*; D012621:Seasons; D012959:Socioeconomic Factors; D055815:Young Adult