Malaria intensity in Colombia by regions and populations

PLoS One. 2018 Sep 12;13(9):e0203673. doi: 10.1371/journal.pone.0203673. eCollection 2018.

Abstract

Determining the distribution of disease prevalence among heterogeneous populations at the national scale is fundamental for epidemiology and public health. Here, we use a combination of methods (spatial scan statistic, topological data analysis and epidemic profile) to study measurable differences in malaria intensity by regions and populations of Colombia. This study explores three main questions: What are the regions of Colombia where malaria is epidemic? What are the regions and populations in Colombia where malaria is endemic? What associations exist between epidemic outbreaks between regions in Colombia? Plasmodium falciparum is most prevalent in the Pacific Coast, some regions of the Amazon Basin, and some regions of the Magdalena Basin. Plasmodium vivax is the most prevalent parasite in Colombia, particularly in the Northern Amazon Basin, the Caribbean, and municipalities of Sucre, Antioquia and Cordoba. We find an acute peak of malarial infection at 25 years of age. Indigenous and Afrocolombian populations experience endemic malaria (with household transmission). We find that Plasmodium vivax decreased in the most important hotspots, often with moderate urbanization rate, and was re-introduced to locations with moderate but sustained deforestation. Infection by Plasmodium falciparum, on the other hand, steadily increased in incidence in locations where it was introduced in the 2009-2010 generalized epidemic. Our findings suggest that Colombia is entering an unstable transmission state, where rapid decreases in one location of the country are interconnected with rapid increases in other parts of the country.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Child
  • Child, Preschool
  • Cluster Analysis
  • Colombia / epidemiology
  • Disease Outbreaks
  • Female
  • Humans
  • Infant
  • Malaria / epidemiology*
  • Malaria / ethnology
  • Malaria / parasitology
  • Malaria / pathology
  • Male
  • Middle Aged
  • Plasmodium falciparum / isolation & purification
  • Plasmodium vivax / isolation & purification
  • Prevalence
  • Sex Factors
  • Young Adult

Associated data

  • figshare/10.6084/m9.figshare.6863780

Grants and funding

The funder Walmartlabs provided support in the form of salaries for author CR, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section. The first author would like to thank Stanford University, the Zaffaroni family, and the Morrison Institute for their financial support. The second author acknowledges and thanks the financial support of the grant P12.160422.004/01- FAPA ANDRES ANGEL from Vicedecanatura de Investigaciones de la Facultad de Ciencias de la Universidad de los Andes, Colombia. The third author acknowledges and thanks the financial support of the grant Proyecto Semilla 2017-1 from Vicedecanatura de Investigaciones de la Facultad de Ciencias de la Universidad de los Andes, Colombia. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.