title: The role of spatial mobility in malaria transmission in the Brazilian Amazon: The case of Porto Velho municipality, Rondônia, Brazil (2010-2012).
abstract: BACKGROUND
  This study aims to describe the role of mobility in malaria transmission by discussing recent changes in population movements in the Brazilian Amazon and developing a flow map of disease transmission in this region.
  
  
  RESULTS
  This study presents a descriptive analysis using an ecological approach on regional and local scales. The study location was the municipality of Porto Velho, which is the capital of Rondônia state, Brazil. Our dataset was obtained from the official health database, the population census and an environmental database. During 2000-2007 and 2007-2010, the Porto Velho municipality had an annual population growth of 1.42% and 5.07%, respectively. This population growth can be attributed to migration, which was driven by the construction of the Madeira River hydroelectric complex. From 2010 to 2012, 63,899 malaria-positive slides were reported for residents of Porto Velho municipality; 92% of the identified samples were autochthonous, and 8% were allochthonous. The flow map of patients' movements between residential areas and areas of suspected infection showed two patterns of malaria transmission: 1) commuting between residential areas and the Jirau hydropower dam reservoir, and 2) movements between urban areas and farms and resorts in rural areas. It was also observed that areas with greater occurrences of malaria were characterized by a low rate of deforestation.
  
  
  CONCLUSIONS
  The Porto Velho municipality exhibits high malaria endemicity and plays an important role in disseminating the parasite to other municipalities in the Amazon and even to non-endemic areas of the country. Migration remains an important factor for the occurrence of malaria. However, due to recent changes in human occupation of the Brazilian Amazon, characterized by intense expansion of transportation networks, commuting has also become an important factor in malaria transmission. The magnitude of this change necessitates a new model to explain malaria transmission in the Brazilian Amazon.
authors.affiliation: Departamento de Endemias Samuel Pessoa, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz (ENSP/FIOCRUZ), Rio de Janeiro, Rio de Janeiro, Brasil.
authors.forename: Jussara Rafael
authors.initials: JR
authors.lastname: Angelo
authors.affiliation: Fundação Oswaldo Cruz - Rondônia (Fiocruz-RO), Porto Velho, Rondônia, Brasil.
authors.forename: Tony Hiroshi
authors.initials: TH
authors.lastname: Katsuragawa
authors.affiliation: Departamento de Endemias Samuel Pessoa, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz (ENSP/FIOCRUZ), Rio de Janeiro, Rio de Janeiro, Brasil.
authors.forename: Paulo Chagastelles
authors.initials: PC
authors.lastname: Sabroza
authors.affiliation: Instituto Nacional de Pesquisas Espaciais (INPE), São José dos Campos, São Paulo, Brasil.
authors.forename: Lino Augusto Sander
authors.initials: LA
authors.lastname: de Carvalho
authors.affiliation: Fundação Oswaldo Cruz - Rondônia (Fiocruz-RO), Porto Velho, Rondônia, Brasil.
authors.forename: Luiz Hildebrando Pereira da
authors.initials: LH
authors.lastname: Silva
authors.affiliation: Instituto Nacional de Pesquisas Espaciais (INPE), São José dos Campos, São Paulo, Brasil.
authors.forename: Carlos Afonso
authors.initials: CA
authors.lastname: Nobre
mesh_terms: D000818:Animals; D001938:Brazil / Q000453:epidemiology; D002947:Cities; D003247:Conservation of Natural Resources; D019353:Endemic Diseases; D062306:Geography, Medical; D006801:Humans; D008288:Malaria / Q000453:epidemiology / Q000635:transmission*; D009790:Occupations; D011157:Population Dynamics; D011210:Power Plants; D012424:Rural Population; D014171:Transients and Migrants; D014186:Transportation; D014505:Urban Population