Escola de Enfermagem de Manaus, Universidade Federal do Amazonas, Manaus, Amazonas, Brazil.
Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas, Brazil.
PLoS One. 2020 Oct 21;15(10):e0240741. doi: 10.1371/journal.pone.0240741. eCollection 2020.
In Brazil malaria is most frequent in the Amazon region, mainly in the Amazonas state, where it is found the most proportion of indigenous people of the whole country. It is remarkable publications about malaria in the Amazon, although information on malaria in indigenous populations is still poorly explored.
Identify factors associated with malaria in indigenous populations.
Cross-sectional study of positive cases of malaria in the state of Amazonas, Brazil, from 2007 to 2016. Secondary data were obtained from the Epidemiological Surveillance Information System for Malaria and from the Mortality Information System, both from Brazil. To tackle with race missing data, cases with no race fulfilled were classified according to the probable location where infection occurred. This way, was imputed indigenous race for those which the probable infection location was indigenous village (aldeia). Variables tested with race were: sex, age, schooling, microscope surveillance slide type, parasitic infection species, parasitemia level, and timeliness of treatment. Multivariate logistic regression was used.
A total of 1,055,852 cases of malaria were notified in the state of Amazonas. Among the factors that associate malaria and indigenous peoples, the most significant were sex, children and high levels of parasitemia. The magnitude of Plasmodium vivax infection is higher than Plasmodium falciparum, although this parasite was more frequent in indigenous than other races. In regards to mortality, 109 deaths were registered, most of them related to P. vivax.
The findings underscore the importance of look at indigenous people differently of other races. The associated factors highlight a profile of cases severity, because of highest parasitemia, many cases of P. falciparum although high frequency of P. vivax, and children. Furthermore, the mortality in indigenous, specially in older people is worrying.
在巴西，疟疾最常见于亚马逊地区，主要在亚马逊州，该州拥有全国最多的土著人口。尽管有关亚马逊地区疟疾的信息仍未得到充分探索，但关于该地区疟疾的出版物却很多。
确定与土著人群疟疾相关的因素。
对巴西亚马逊州 2007 年至 2016 年期间疟疾阳性病例进行横断面研究。从巴西的疟疾流行病学监测信息系统和死亡率信息系统中获取二级数据。为了解决种族缺失数据的问题，对于没有种族信息的病例，根据可能的感染地点进行分类。对于那些可能的感染地点是土著村庄（aldeia）的病例，将其种族推断为土著。经过检验的与种族相关的变量有：性别、年龄、教育程度、显微镜监测玻片类型、寄生虫感染种类、疟原虫水平和治疗及时性。采用多变量逻辑回归分析。
在亚马逊州共报告了 1055852 例疟疾。在与土著人民相关的疟疾因素中，最重要的是性别、儿童和高疟原虫血症水平。间日疟原虫感染的规模高于恶性疟原虫，尽管这种寄生虫在土著人群中比其他种族更为常见。在死亡率方面，共登记了 109 例死亡，其中大部分与间日疟原虫有关。
这些发现强调了对土著人民进行不同于其他种族的关注的重要性。相关因素突出了病例严重程度的特征，因为高疟原虫血症、许多恶性疟原虫病例尽管间日疟原虫感染率高，但还有儿童。此外，土著人群，特别是老年人的死亡率令人担忧。
