Micro-epidemiology and spatial heterogeneity of P. vivax parasitaemia in riverine communities of the Peruvian Amazon: A multilevel analysis
Journal Articles
Overview
Research
Identity
Additional Document Info
View All
Overview
abstract
AbstractMalaria has steadily increased in the Peruvian Amazon over the last five years. This study aimed to determine the parasite prevalence and micro-geographical heterogeneity ofPlasmodium vivaxparasitaemia in communities of the Peruvian Amazon. Four cross-sectional active case detection surveys were conducted between May and July 2015 in four riverine communities in Mazan district. Analysis of 2785 samples of 820 individuals nested within 154 households forPlasmodiumparasitaemia was carried out using light microscopy and qPCR. The spatio-temporal distribution ofPlasmodiumparasitaemia, dominated byP.vivax, was shown to cluster at both household and community levels. Of enrolled individuals, 47% had at least oneP.vivaxparasitaemia and 10%P.falciparum, by qPCR, both of which were predominantly sub-microscopic and asymptomatic. Spatial analysis detected significant clustering in three communities. Our findings showed that communities at small-to-moderate spatial scales differed inP.vivaxparasite prevalence, and multilevel Poisson regression models showed that such differences were influenced by factors such as age, education, and location of households within high-risk clusters, as well as factors linked to a local micro-geographic context, such as travel and occupation. Complex transmission patterns were found to be related to human mobility among communities in the same micro-basin.
