Johansen Igor C, Rodrigues Priscila T, Ferreira Marcelo U
Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo (SP), Brazil.
PLoS One. 2020 Nov 25;15(11):e0242357. doi: 10.1371/journal.pone.0242357. eCollection 2020.
Malaria in the Amazon is often perceived as an exclusively rural disease, but transmission has been increasingly documented within and near urban centers. Here we explore patterns and causes of urban-to-rural mobility, which places travelers at risk of malaria in Mâncio Lima, the main malaria hotspot in northwestern Brazil. We also analyze rural-to-urban mobility caused by malaria treatment seeking, which poses an additional risk of infection to urban residents. We show that the rural localities most frequently visited by urban residents-typically farming settlements in the vicinity of the town-are those with the most intense malaria transmission and also the most frequent source localities of imported malaria cases diagnosed in the town. The most mobile urban residents are typically poor males 16 to 60-years old from multi-sited households who lack a formal job. Highly mobile residents represent a priority target for more intensive and effective malaria control interventions, that cannot be readily delivered to the entire community, in this and similar urbanized endemic settings across the Amazon.
亚马逊地区的疟疾通常被视为一种纯粹的农村疾病，但城市中心及其周边地区的疟疾传播已有越来越多的记录。在这里，我们探讨了城乡流动的模式和原因，这使旅行者在巴西西北部主要疟疾热点地区曼西奥·利马面临感染疟疾的风险。我们还分析了因寻求疟疾治疗而导致的从农村到城市的流动，这给城市居民带来了额外的感染风险。我们发现，城市居民最常前往的农村地区——通常是城镇附近的农业定居点——是疟疾传播最严重的地区，也是该城镇确诊的输入性疟疾病例最频繁的来源地。流动性最强的城市居民通常是来自多地点家庭、没有正式工作的16至60岁贫困男性。在亚马逊地区的这个以及类似的城市化流行地区，流动性高的居民是更密集、有效的疟疾控制干预措施的优先目标，而这些措施无法轻易惠及整个社区。
