Resurgence risk for malaria, and the characterization of a recent outbreak in an Amazonian border area between French Guiana and Brazil

Type Article
Date 2020-05
Language English
Author(s) Mosnier Emilie1, 2, Dusfour Isabelle3, Lacour Guillaume3, 4, Saldanha Raphael5, Guidez Amandine3, Gomes Margarete S.6, Sanna Alice7, Epelboin Yanouk3, Restrepo Johana8, Davy Damien9, Demar Magalie10, 11, Djossou Félix1, Douine Maylis11, 12, Ardillon Vanessa13, Nacher Mathieu12, Musset Lise14, Roux Emmanuel15, 16
Affiliation(s) 1 : Unité des Maladies Infectieuses et Tropicales, Centre Hospitalier Andrée Rosemon, rue des flamboyants, 97306, Cayenne, French Guiana
2 : Aix Marseille University, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
3 : Unité Contrôle et Adaptation des Vecteurs, Institut Pasteur de la Guyane, 23 avenue Pasteur, 97306, Cayenne, French Guiana
4 : Altopictus, 67 avenue Maréchal Juin, 64200, Biarritz, France
5 : LIS, ICICT, Fiocruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, Brazil; International Join Laboratory Sentinela, IRD, Fiocruz, University of Brasília, Rio de Janeiro, Brazil
6 : Superintendência de Vigilância em Saúde do Amapá (SVS-AP), Av. 13 de Setembro, 1889 – Buritizal, Macapá, Amapá, Brazil
7 : Agence Régionale de la Santé, 66 rue des flamboyants, 97306, Cayenne, French Guiana
8 : Service d’Entomologie de la Direction Démoustication et Actions Sanitaires, collectivité Térritoriale de Guyane, carrefour de suzini 4179 route de montabo, 97307, Cayenne, French Guiana
9 : LEEISA (Laboratoire Ecologie, Evolution, Interactions des Systèmes Amazoniens), CNRS, Université de Guyane, IFREMER, 275 route de Montabo, 97300, Cayenne, France
10 : Laboratoire de Parasitologie et Mycologie, Centre Hospitalier Andrée Rosemon, rue des flamboyants, 97306, Cayenne, French Guiana
11 : Université de Guyane, EA3593 Ecosystèmes Amazoniens et Pathologie Tropicale, Cayenne, French Guiana
12 : Centre d’Investigation Clinique Antilles Guyane – Inserm 1424, Centre Hospitalier Andrée Rosemon, rue des flamboyants, 97306, Cayenne, French Guiana
13 : CIRE Guyane, 66 rue des flamboyants, 97306, Cayenne, French Guiana
14 : Laboratoire de parasitologie, Centre National de Référence du Paludisme, Pôle Zones Endémiques, WHO Collaborating Center for Surveillance of Antimalarial Drug Resistance, Institut Pasteur de la Guyane, 23 avenue Pasteur, 97306, Cayenne, French Guiana
15 : ESPACE-DEV, IRD, Universités de Montpellier, de La Réunion, de la Guyane, des Antilles, Montpellier, France: LIS, ICICT, Fiocruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, Brazil
16 : International Join Laboratory Sentinela, IRD, Fiocruz, University of Brasília, Rio de Janeiro, Brazil
Source Bmc Infectious Diseases (1471-2334) (Springer Science and Business Media LLC), 2020-05 , Vol. 20 , N. 1 , P. 373 (14p.)
DOI 10.1186/s12879-020-05086-4
WOS© Times Cited 3
Keyword(s) Plasmodium vivax, Anopheles darlingi, French Guiana, Brazil, Transnational, Outbreak investigation, Indigenous south Americans, Malaria, Amazonia
Abstract

Background

In 2017, inhabitants along the border between French Guiana and Brazil were affected by a malaria outbreak primarily due to Plasmodium vivax (Pv). While malaria cases have steadily declined between 2005 and 2016 in this Amazonian region, a resurgence was observed in 2017.

Methods

Two investigations were performed according to different spatial scales and information details: (1) a local study on the French Guiana border, which enabled a thorough investigation of malaria cases treated at a local village health center and the entomological circumstances in the most affected neighborhood, and (2) a regional and cross-border study, which enabled exploration of the regional spatiotemporal epidemic dynamic. Number and location of malaria cases were estimated using French and Brazilian surveillance systems.

Results

On the French Guianese side of the border in Saint-Georges de l’Oyapock, the attack rate was 5.5% (n = 4000), reaching 51.4% (n = 175) in one Indigenous neighborhood. Entomological findings suggest a peak of Anopheles darlingi density in August and September. Two female An. darlingi (n = 1104, 0.18%) were found to be Pv-positive during this peak. During the same period, aggregated data from passive surveillance conducted by Brazilian and French Guianese border health centers identified 1566 cases of Pv infection. Temporal distribution during the 2007–2018 period displayed seasonal patterns with a peak in November 2017. Four clusters were identified among epidemic profiles of cross-border area localities. All localities of the first two clusters were Brazilian. The localization of the first cluster suggests an onset of the outbreak in an Indigenous reservation, subsequently expanding to French Indigenous neighborhoods and non-Native communities.

Conclusions

The current findings demonstrate a potential increase in malaria cases in an area with otherwise declining numbers. This is a transborder region where human mobility and remote populations challenge malaria control programs. This investigation illustrates the importance of international border surveillance and collaboration for malaria control, particularly in Indigenous villages and mobile populations.

Full Text
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Publisher's official version 14 4 MB Open access
Additional file 1: Supplement S1. Distribution of G6PD deficiency according to the WHO definition of French Guianese participants. Supplement S2. Results of clusters for selected localities in the... 3 405 KB Open access
Additional file 2: Supplement S3. Graphical abstract of the main result of the malaria outbreak investigation, border area between French Guiana and Brazil, 2017 1 907 KB Open access
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How to cite 

Mosnier Emilie, Dusfour Isabelle, Lacour Guillaume, Saldanha Raphael, Guidez Amandine, Gomes Margarete S., Sanna Alice, Epelboin Yanouk, Restrepo Johana, Davy Damien, Demar Magalie, Djossou Félix, Douine Maylis, Ardillon Vanessa, Nacher Mathieu, Musset Lise, Roux Emmanuel (2020). Resurgence risk for malaria, and the characterization of a recent outbreak in an Amazonian border area between French Guiana and Brazil. Bmc Infectious Diseases, 20(1), 373 (14p.). Publisher's official version : https://doi.org/10.1186/s12879-020-05086-4 , Open Access version : https://archimer.ifremer.fr/doc/00632/74387/