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Mem Inst Oswaldo Cruz, Rio de Janeiro, VOLUME 121 | 2026

Review

Epidemiology and social factors of malaria in the Yanomami Indigenous Territory: a critical review of the challenges of control and elimination

Djane Clarys Baia-da-Silva^1,2,+, Alexander Vargas³, Edília Sâmela Freitas Santos³, Karolina Jeaneth Solórzano Chavarría^4,5, Cláudio Tadeu Daniel-Ribeiro^3,6,7,8, Wuelton Marcelo Monteiro^4,5

¹Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Manaus, AM, Brasil
²Universidade Nilton Lins, Manaus, AM, Brasil
³Ministério da Saúde, Secretaria de Vigilância em Saúde e Ambiente, Brasília, DF, Brasil
⁴Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, AM, Brasil
⁵Universidade do Estado do Amazonas, Manaus, AM, Brasil
⁶Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Pesquisa em Malária, Rio de Janeiro, RJ, Brasil
⁷Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Centro de Pesquisa, Diagnóstico e Treinamento da Malária, Rio de Janeiro, RJ, Brasil
⁸Fundação Oswaldo Cruz-Fiocruz, Instituto Nacional de Ciência e Tecnologia em Imunomodulação, Rio de Janeiro, RJ, Brasil

DOI: 10.1590/0074-02760260033

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ABSTRACT

Malaria in the Yanomami Indigenous Territory (YIT) constitutes a serious public health concern and has been hyperendemic since 1987, following the arrival of illegal gold miners in the area. Disease transmission has steadily increased since 2013, particularly among children. It escalated into a crisis in 2019, driven by the intensification of illegal mining and environmental, sociocultural, and political factors, and reached approximately 33,000 cases in 2024. Although the declaration of a Public Health Emergency in 2023 led to advancements in surveillance and diagnosis, the incidence of cases remains elevated. Nevertheless, there was a remarkable reduction in malaria-related mortality, evidenced by a 42% decrease in deaths and a 47% decline in the case-fatality rate, even in the context of persistently high notification rates. Barriers to control include limited access to remote communities, ecological degradation that favours vector proliferation, a high prevalence of submicroscopic infections, and sociocultural constraints. Expanded diagnostic capacity and a reinforced workforce are essential but insufficient without addressing the underlying structural causes. This mini-review summarises and critically discusses the epidemiological trends of malaria in YIT, as well as the social, environmental, cultural, and operational factors that sustain transmission.

key words: Amazon region disease control indigenous health gold mining malaria Yanomami

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