PLoS computational biology
Mobility hinders malaria elimination goals in the Brazilian Amazon
By Arisco NJ, Fontoura PS, Peterka C and 1 others.
Abstract
Introduction
Human mobility across the Brazilian Amazon-shaped by frontier development, land-use change, mining activity, and climatic shocks-remains a major barrier to malaria elimination. Brazil aims to eliminate Plasmodium falciparum (Pf) by 2030 and Plasmodium vivax (Pv) by 2035, yet malaria incidence has plateaued since 2020. We quantify parasite-specific mobility and assess how importations drive malaria reintroduction and reestablishment in areas approaching elimination.
Methods
We analyzed 5,521,411 de-identified malaria cases from Sivep-Malaria (2003-2023) across 808 municipalities in the nine-state Brazilian Amazon. We (i) used multivariable monthly sequence analysis to classify "Municipal Malaria Importation Trajectories" (MMITs) using local/imported composition, incidence per 1,000, and source/sink network typologies; (ii) characterized mobility networks by parasite species and locality type (rural, urban, settlement, indigenous, mining); and (iii) developed a parasite-specific rule-based classification procedure to identify reintroduction, and defined reestablishment as sustained local transmission.