PAGES: DOI: 10.1590/0074-02760170113 Full paper
Urban malaria transmission in a non-endemic area in the Andean region of Colombia

Pablo E Chaparro1,+, Karen Molina2,3, Alberto Alzate2,3, Julio Padilla4, Myriam Arévalo-Herrera2,5, Sócrates Herrera3

1National Institute of Health of Colombia, Bogotá, Colombia
2Malaria Vaccine and Drug Development Center, Cali, Colombia
3Caucaseco Scientific Research Center, Cali, Colombia
4Ministry of Health and Social Protection of Colombia, Bogotá, Colombia
5Universidad del Valle, School of Health, Cali, Colombia


BACKGROUND Rapid urbanisation in difficult socio-economic conditions such as inadequate housing infrastructure, lack of public services, improper sanitation, and poor water drainage systems in vegetation-rich areas lead to ecological conditions that are conducive to the breeding of mosquitoes and transmission of malaria, in semi-urban and urban settings.

OBJECTIVES This study aimed to describe the cases of malaria that were reported in the peri-urban areas of Pereira (Colombia), between 2008 and 2015.

METHODS A retrospective study was conducted using data from the Malaria Surveillance System 2009-2015 and an outbreak study (between December 2008 and March 2009). Frequency distributions and summary measures, as well as univariate analysis were performed for all the variables in consideration. The annual parasite index (API) was calculated.

FINDINGS Data on 214 cases were obtained from the surveillance system. A majority of the cases were reported in men (63.1%), followed by in children 15 years (23.8%), and were caused predominantly by Plasmodium vivax (86.0%), with most of the infection occurring in the urban areas (52.8% of Pereira. The API, by sex and age group, was higher among men ≥ 80 years. The outbreak study reported 14 cases of malaria in rural/peri-urban neighborhoods, and it was observed that the anopheline breeding sites were in close proximity to the houses in these areas. This population did not use protective measures against mosquitoes and chemical control was conducted through residual and spatial insecticide spraying.

MAIN CONCLUSIONS This study suggested the presence of autochthonous malaria transmission, in Pereira, between 2008 and 2015, most of which were cases of P. vivax. A greater intensity was observed between 2008 and 2009 when malaria was possibly reintroduced to the region. During the years of the study, a gradual decrease in the number of reported cases of malaria was observed in Pereira, except for the time period between 2008 and 2009 when a spike was noted (estimated using the API); this was most likely caused by an outbreak. Interventions that are more aggressive in nature are required to prevent further malarial transmission and dissemination.

Financial support: National Institute of Health of Colombia, Health Secretary of Pereira (grant Red-ETV Colciencias No. 360-2011).
MAH and SH were sponsored by US NIAD/NIH (grant 5U19AI089702).
+ Corresponding author: This e-mail address is being protected from spambots. You need JavaScript enabled to view it.
Received 21 March 2017
Accepted 5 July 2017


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