雅诺马米土著领土的人类流动、侏儒和时空疟疾传播：一项回顾性观察研究

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas Pub Date : 2025-07-18 DOI:10.1016/j.lana.2025.101188

Alisson F. Barbieri, Reinaldo O. Santos

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引用次数: 0

摘要

过去关于人类流动和疟疾传播的研究通常使用粗糙的空间尺度，这限制了有针对性的控制策略的有效性——特别是当传播变得更加本地化、发病率更低的时候。在巴西的亚诺马米土著领地（YIT）就可以看到这种情况，那里的非法金矿开采（garimpo）和弱化的环境政策导致疟疾死灰复燃。我们使用流行病学监测数据来识别和区分可能感染的地点以及在YIT内和附近的居住地。然后，我们构建了疟疾流动网络（MMNs）来分析2007年至2023年的疟疾时空传播模式。方法用smmn量化传播效应，区分地方间本地疟疾病例和输入疟疾病例。将疟疾和人口位置数据整合到一个常规网格中，提高了疟疾风险和传播评估的准确性。我们观察到疟疾病例（86%）和人口（91%）的空间集中，并且大多数网格错误地归因于疟疾（94%）和人口（86%）风险。我们改进了12%的疟疾病例的空间识别（在garimpos中为70%），并纠正了20%的不准确坐标。土著地方的本地疟疾达到90%（2023年），与总病例相比，MMN所占比例最高。自2019年以来，涉及garimpos感染的MMN上升，并在2022年达到27%左右的峰值，与城市居住的关系更密切。空间分析揭示了基于居住地的人类流动与疟疾之间的时空联系，为改进流行病学监测提供了支持。MMN展示了疟疾传播的时空模式如何与garimpo动态及其区域联系相一致。土著地区持续出现疟疾的原因是与土著it内的garimpo和促进疾病传播的强大的garimpo-urban网络相互作用。巴西国家研究委员会（CNPq）农业生产补助金（批准号PQ 306567/2016-4）。

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Human mobility, garimpos and spatiotemporal malaria transmission in the Yanomami Indigenous Territory: a retrospective observational study

Background

Past research on human mobility and malaria transmission often used coarse spatial scales, limiting effectiveness for targeted control strategies — especially as transmission becomes more localized with lower incidence. This is seen in Brazil’s Yanomami Indigenous Territory (YIT), where illegal gold mining (garimpo) and weakened environmental policies have contributed to malaria resurgence. We used epidemiological surveillance data to identify and distinguish localities of likely infection and residence within and near the YIT. We then constructed Malaria Mobility Networks (MMNs) to analyse spatiotemporal malaria transmission patterns from 2007 to 2023.

Methods

MMN quantified diffusion effects and differentiated between autochthonous and imported malaria cases among localities. Integrating malaria and population location data into a regular grid improved the accuracy of malaria risk and transmission assessments.

Findings

We observed spatial concentration of malaria cases (86%) and population (91%), and most grids have incorrectly attributed malaria (94%) and population (86%) risks. We improved spatial identification of malaria cases in 12% (70% in garimpos) and corrected 20% inaccurate coordinates. Autochthonous malaria in indigenous localities reached 90% (2023), the highest MMN share compared to total cases. MMN involving infection in garimpos raised since 2019 and peaked around 27% in 2022, being more associated with urban residence.

Interpretation

Spatial analysis reveals spatiotemporal linkages between residence-based human mobility and malaria, supporting improved epidemiological surveillance. MMN demonstrates how spatiotemporal patterns of malaria transmission aligns with garimpo dynamics and their regional connections. Persistent malaria in indigenous localities stems from interactions with garimpos within the YIT and robust garimpo-urban networks that facilitate disease transmission.

Funding

Bolsa de Produtividade de Pesquisa (grant number PQ 306567/2016-4), Brazilian National Research Council (CNPq).

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来源期刊

Lancet Regional Health-Americas Multiple-

CiteScore

8.00

自引率

0.00%

发文量

期刊介绍： The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.