The socio-environmental production of malaria in three municipalities in the Carajás region, Pará, Brazil

Pereira, Alba Lucia Ribeiro Raithy; Miranda, Claudia do Socorro Carvalho; Guedes, Juan Andrade; Oliveira, Rafael Aleixo Coelho de; Campos, Pedro Silvestre da Silva; Palácios, Vera Regina Da Cunha Menezes; Faria, Camylle Maia Costa; Filgueiras, Tainara Carvalho G. M.; Figueiredo, Roberto Carlos; Gonçalves, Nelson Veiga

doi:10.11606/s1518-8787.2021055003463

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Original Article • Rev. Saúde Pública 55 • 2021 • https://doi.org/10.11606/s1518-8787.2021055003463 linkcopy

The socio-environmental production of malaria in three municipalities in the Carajás region, Pará, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE To analyze the environmental production of malaria in the municipalities of Marabá, Parauapebas, and Canaã dos Carajás, in Pará, from 2014 to 2018.

METHODS This ecological, cross-sectional study used epidemiological data in the Sistema de Informações de Vigilância Epidemiológica da Malária (Malaria Epidemiological Surveillance Information System) from the Secretaria de Saúde do Estado do Pará (State of Pará Health Department), cartographic data from the Brazilian Institute of Geography and Statistics (IBGE), and environmental data in the Projeto TerraClass (TerraClass Project) from the National Institute of Space Research (INPE). Statistical analyses used the chi-square test, while the spatial ones, the kernel and Moran’s (I) global bivariate techniques.

RESULTS We analyzed a total of 437 confirmed cases of malaria in the selected area and period. The highest percentage of cases occurred among male miners and farmers, living in rural areas; Plasmodium vivax was the most frequent species; and the most used diagnosis, the thick drop/smear. We also observed a heterogeneous distribution of the disease — with evidence of spatial dependence between incidence areas and different forms of land use, and spatial autocorrelations related to the high variability of anthropic activities in the municipalities.

CONCLUSION The environmental production of malaria relates mainly to cattle production and mining — anthropisms related to land use and occupation in the observed municipalities. Spatial data analysis technologies sufficed for the construction of the epidemiological scenario of the disease.

Malaria, epidemiology; Land Use; Anthropological Factors; Risk Factors; Spatial Analysis

Variáveis		Marabá			Parauapebas			Canaã dos Carajás

		n	%	p	n	%	p	n	%	p
Gender	Male	115	74.68	< 0.0001	198	79.84	< 0.0001	21	60.00	< 0.0001
Gender	Female	39	25.32	< 0.0001	50	20.16	< 0.0001	14	40.00	< 0.0001

Age group	Child (0–11 years)	10	6.49	< 0.0001	28	11.29	< 0.0001	1	2.85	< 0.0001
	Teenager (12–18 years)	15	9.74		8	3.22		4	11.42
	Adult (19–59 years)	117	75.98		201	81.06		27	77.16
	Elderly (≥ 60 years)	12	7.79		11	4.43		3	8.57

			0

Race/Ethnicity	Indigenous	3	1.90	< 0.0001	0	0	< 0.0001	0	0	< 0.0001
	Asian	2	1.29		1	0.40		0	0
	White	16	10.9		42	16.94		4	11.42
	Brown/Mixed race	120	77.92		180	72.58		29	82.87
	Black	13	8.01		25	10.08		2	5.71

Occupation	Cattle production	28	18.18	< 0.0001	54	21.77	< 0.0001	16	45.71	< 0.0001
	Hunting/Fishing	2	1.29		7	2.82		0	0
	Mining	46	29.87		67	27.04		5	14.28
	Road/dam construction	3	1.94		20	8.06		1	2.88
	Tourism	12	7.79		5	2.01		0	0
	Domestic service	11	7.14		6	2.41		2	5.71
	Other	52	33.79		89	35.89		11	31.42

Education	Illiterate	2	1.29	< 0.0001	10	4.03	< 0.0001	3	8.57	< 0.0001
	Elementary School	102	66.23		114	45.97		20	57.14
	High School	37	24.05		85	34.28		10	28.57
	Higher Education	9	5.84		31	12.5		2	5.72
	N/A	4	2.59		8	3.22		0	0

Diagnosis	Thick Drop/Smear	147	95.45	< 0.0001	247	99.6	< 0.0001	35	100	< 0.0001
Diagnosis	Quick test	7	4.54	< 0.0001	1	0.40	< 0.0001	0	0	< 0.0001

Plasmodium species	*P. vivax*	152	98.8	< 0.0001	248	100	< 0.0001	34	97.15	< 0.0001
	P. falciparum	2	1.20		0	0		0	0
	Mixed	0	0		0	0		1	2.85

Parasitaemia	“+/2”	2	1.29	< 0.0001	1	0.40	< 0.0001	0	0	< 0.0001
	“+”	1	0.67		3	1.22		1	2.87
	“++”	149	96.75		241	97.18		33	94.28
	“+++”	0	0		1	0.40		0	0
	“++++”	2	1.29		2	0.80		0	0
	Unknown	0	0		0	0		1	2.85

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