ANÁLISE ESPAÇO-TEMPORAL DA MALÁRIA EM INDÍGENAS NO BRASIL DE 2013 A 2022

Abstract

Malaria is an infectious disease that occurs mainly in the tropical and subtropical regions of the planet, posing a risk to around 40% of the world's population. Its occurrence is strongly related to the lack of access to prevention and treatment services, and indigenous communities are a vulnerable population due to their sociocultural particularities. Given this context, the aim of this study was to analyze the spatio-temporal distribution of malaria cases in indigenous people in Brazil from 2013 to 2022. This is an ecological study using secondary data. The study population is the new cases of malaria reported in indigenous people by municipality of infection from 2013 to 2022. The research data was collected through the Epidemiological Surveillance Information System (SIVEP-Malaria) platform. After extracting and creating the Excel spreadsheet with the database, the Annual Parasite Incidence (API) indicator for malaria was calculated. Spatial analysis of the data was carried out by creating a neighborhood matrix between the municipalities. To observe the existence of spatial autocorrelation, the Global Moran's Index was calculated, followed by the Local Moran's Index to delimit risk clusters. The Prais-Winsten generalized linear regression model was used to study the trend. The data was analyzed using QGis and GeoDa software. During the period analyzed, 443,171 cases of malaria were identified in indigenous people, who were identified by municipality of infection in Brazil. Almost all of these cases (99.6%) were concentrated in the North of the country, especially in the states of Amazonas, Roraima and Pará, which have a high concentration of indigenous people. Considering the IPA, the distribution of cases followed a similar pattern over the 10 years analyzed, with a large concentration in the Amazon region, predominantly in areas classified as high risk. The trend of the disease was stable in most Brazilian states, and the spatial analysis of the clusters, after applying the Moran Index, revealed a pattern with few clusters over the period, but with their persistence in different patterns in the northern region, coinciding in some cases with areas of intense anthropic action. The maintenance of the Amazon region as an endemic region and the persistence of a high concentration of cases reinforces the need to implement resolutive actions that unite public health efforts, sustainable environmental care and management and respect for the rights of indigenous people in Brazil.