Malaria in Gold Miners in the Guianas and the Amazon: Current Knowledge and Challenges

“Purpose of Review Following Paraguay and Argentina, several countries from the Amazon region aim to eliminate malaria. To achieve this, all key affected and vulnerable populations by malaria, including people working on gold mining sites, must be considered. What is the situation of malaria in these particular settings and what are the challenges? This literature review aims to compile knowledge to answer these questions. Recent Findings The contexts in which gold miners operate are very heterogeneous: size and localization of mines, links with crime, administrative status of the mines and of the miners, mobility of the workers or national regulations. The number of malaria cases has been correlated with deforestation (Brazil, Colombia), gold production (Colombia), gold prices (Guyana), or location of the mining region (Peru, Colombia, Venezuela, Guyana). The burden of malaria in gold mines differs between territories: significant in Guyana, French Guiana, or Venezuela; lower in Brazil. Although Plasmodium vivax causes 75% of malaria cases in the Americas, P. falciparum is predominant in several gold mining regions, especially in the Guiana Shield. Because of the remoteness from health facilities, self-medication with under-the-counter antimalarials is frequent. This consti- tutes a significant risk for the emergence of new P. falciparum parasites resistant to antimalarial drugs. Summary Because of the workers’ mobility, addressing malaria transmission in gold mines is essential, not only for miners, but also to prevent the (re-)emergence of malaria. Strategies among these populations should be tailored to the context because of the heterogeneity of situations in different territories. The transnational environment favoring malaria transmission also requires transborder and regional cooperation, where innovative solutions should be considered and evaluated

Investigation of Host Candidate Malaria-Associated Risk/Protective SNPs in a Brazilian Amazonian Population

The Brazilian Amazon is a hypo-endemic malaria region with nearly 300,000 cases each year. A variety of genetic polymorphisms, particularly in erythrocyte receptors and immune response related genes, have been described to be associated with susceptibility and resistance to malaria. In order to identify polymorphisms that might be associated with malaria clinical outcomes in a Brazilian Amazonian population, sixty-four human single nucleotide polymorphisms in 37 genes were analyzed using a Sequenom massARRAY iPLEX platform. A total of 648 individuals from two malaria endemic areas were studied, including 535 malaria cases (113 individuals with clinical mild malaria, 122 individuals with asymptomatic infection and 300 individuals with history of previous mild malaria) and 113 health controls with no history of malaria. The data revealed significant associations (p<0.003) between one SNP in the IL10 gene (rs1800896) and one SNP in the TLR4 gene (rs4986790) with reduced risk for clinical malaria, one SNP in the IRF1 gene (rs2706384) with increased risk for clinical malaria, one SNP in the LTA gene (rs909253) with protection from clinical malaria and one SNP in the TNF gene (RS1800750) associated with susceptibility to clinical malaria. Also, a new association was found between a SNP in the CTL4 gene (rs2242665), located at the major histocompatibility complex III region, and reduced risk for clinical malaria. This study represents the first association study from an Amazonian population involving a large number of host genetic polymorphisms with susceptibility or resistance to Plasmodium infection and malaria outcomes. Further studies should include a larger number of individuals, refined parameters and a fine-scale map obtained through DNA sequencing to increase the knowledge of the Amazonian population genetic diversity

Association of the presence of residual anti- Toxoplasma gondii IgM in pregnant women and their respective family groups in Miracema, Northwest Rio de Janeiro, Brazil

The seroprevalence of toxoplasmosis in 832 pregnant women in Miracema, Rio de Janeiro, was determined and 75.1% (625) and 2.0% (17) were anti- Toxoplasma gondii IgG and IgM positive, respectively. Out of the 17 IgM positive pregnant women, only one had low avidity IgG corresponding to the acute phase of the infection. All the other women presented with high avidity IgG and also presented with residual IgM anti-T. gondii. Of this sample, 106 received home visits (this includes 11 family nuclei of pregnant women with residual IgM anti-T. gondii, 68 nuclei of only IgG positive pregnant women and 27 nuclei of pregnant women with no antibodies to anti-T. gondii), resulting in 267 individuals visited. Out of these 267 individuals, 21 were positive for IgG and IgM anti-T. gondii and were candidates for the IgG avidity test. All of them presented with high avidity IgG and residual IgM. Five of these IgM+ individuals were (5/238; 2.1%) relatives of IgM negative pregnant women. The other 16 (16/29; 55.2%) were relatives of IgM+ pregnant women who were positive for residual IgM anti-T. gondii. This association was statistically significant (p = 0.0000). The analysis presented herein raises questions regarding the presence of residual IgM anti-T. gondii such as genetic determinants or even constant antigenic stimuli for the same family cluster

Association of the presence of residual anti-Toxoplasma gondii IgM in pregnant women and their respective family groups in Miracema, Northwest Rio de Janeiro, Brazil

Submitted by Sandra Infurna ([email protected]) on 2018-10-23T11:34:22Z No. of bitstreams: 1 octavio_fernandes_etal_IOC_2008.pdf: 270153 bytes, checksum: 1f9f91f3dd7ab1498b8a4fa38d598c13 (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2018-10-23T11:39:51Z (GMT) No. of bitstreams: 1 octavio_fernandes_etal_IOC_2008.pdf: 270153 bytes, checksum: 1f9f91f3dd7ab1498b8a4fa38d598c13 (MD5)Made available in DSpace on 2018-10-23T11:39:51Z (GMT). No. of bitstreams: 1 octavio_fernandes_etal_IOC_2008.pdf: 270153 bytes, checksum: 1f9f91f3dd7ab1498b8a4fa38d598c13 (MD5) Previous issue date: 2008Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Laboratório de Parasitologia. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Doenças Parasitárias. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Epidemiologia Molecular de Doenças Infecciosas. Rio de Janeiro, RJ. Brasil.The seroprevalence of toxoplasmosis in 832 pregnant women in Miracema, Rio de Janeiro, was determined and 75.1% (625) and 2.0% (17) were anti-Toxoplasma gondii IgG and IgM positive, respectively. Out of the 17 IgM positive pregnant women, only one had low avidity IgG corresponding to the acute phase of the infection. All the other women presented with high avidity IgG and also presented with residual IgM anti-T. gondii. Of this sample, 106 received home visits (this includes 11 family nuclei of pregnant women with residual IgM anti-T. gondii, 68 nuclei of only IgG positive pregnant women and 27 nuclei of pregnant women with no antibodies to anti-T. gondii), resulting in 267 individuals visited. Out of these 267 individuals, 21 were positive for IgG and IgM anti-T. gondii and were candidates for the IgG avidity test. All of them presented with high avidity IgG and residual IgM. Five of these IgM+ individuals were (5/238; 2.1%) relatives of IgM negative pregnant women. The other 16 (16/29; 55.2%) were relatives of IgM+ pregnant women who were positive for residual IgM anti-T. gondii. This association was statistically significant (p = 0.0000). The analysis presented herein raises questions regarding the presence of residual IgM anti-T. gondii such as genetic determinants or even constant antigenic stimuli for the same family cluster

Villes frontalières entre le Brésil et la Guyane française : un contexte de vulnérabilité sanitaire

International audienc

From an interventional study to a national scale-up: lessons learned from the Malakit strategy at the French Guiana–Suriname border

Abstract Scaling-up an experimental intervention is always a challenge. On the border between French Guiana, Brazil and Suriname, an interventional study demonstrated the effectiveness of distributing self-diagnosis and self-treatment kits (Malakits) to control malaria in mobile and hard-to-reach populations. Its integration into the Suriname’s National Malaria Elimination Plan after a 2-year experiment faced numerous challenges, including human resources to cope with the additional workload of coordinators and to maintain the motivation of community health workers. The economic recession in Suriname, the Covid pandemic, and logistical issues also hampered the scale-up. Finally, thanks to the commitment of stakeholders in Suriname and French Guiana, the integration of Malakit distribution into the Surinamese national programme was proved possible

Malakit: an innovative pilot project to self-diagnose and self-treat malaria among illegal gold miners in the Guiana Shield

Submitted by Sandra Infurna ([email protected]) on 2019-02-14T12:39:13Z No. of bitstreams: 1 martasuarez_mutis_etal_IOC_2018.pdf: 1670835 bytes, checksum: fce688cd775b99c4574fec6e1d7bdc7a (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2019-02-14T12:50:11Z (GMT) No. of bitstreams: 1 martasuarez_mutis_etal_IOC_2018.pdf: 1670835 bytes, checksum: fce688cd775b99c4574fec6e1d7bdc7a (MD5)Made available in DSpace on 2019-02-14T12:50:11Z (GMT). No. of bitstreams: 1 martasuarez_mutis_etal_IOC_2018.pdf: 1670835 bytes, checksum: fce688cd775b99c4574fec6e1d7bdc7a (MD5) Previous issue date: 2018Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424). Cayenne Hospital, Cayenne, French Guiana.Health Regional Agency, Cayenne. French Guiana, France.Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424). Cayenne Hospital, Cayenne, French Guiana.Institut Pasteur de la Guyane. Centre National de Référence du Paludisme. Laboratoire de Parasitologie. Cayenne, French Guiana.French Armed Forces Center for Epidemiology and Public Health (CESPA). Camp Militaire de Sainte Marthe. Marseille, France / IRD, AP‑HM, VITROME, SSA, IHU‑Méditerranée Infection, Aix Marseille Univ. Marseille, France.Ministério da Saúde. Programa Nacional de Controle da Malária. Brasilia, DF, Brasil.Ministério da Saúde. Escritório de Assuntos Internacionais. Brasília, DF, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Parasitologia. Rio de Janeiro, RJ. Brasil.National Malaria Programme. Ministry of Health. Paramaribo, Suriname.Centre d’Investigation Clinique Antilles-Guyane (Inserm 1424). Cayenne Hospital, Cayenne, French Guiana / Université de Guyane. Epidemiology of Tropical Parasitoses. Cayenne, French Guiana.Foundation for Scientific Research Suriname (SWOS). Paramaribo, Suriname.Pan American Health Organization. Barbados Office, Bridgetown, Barbados.Illegal gold miners in French Guiana, a French overseas territory ('département') located in Amazonia, often carry malaria parasites (up to 46.8%). While the Guiana Shield Region aims at malaria elimination, the high prevalence of Plasmodium in this hard-to-reach population in conjunction with frequent incorrect use of artemisinin-based anti-malarials could favour the emergence of resistant parasites. Due to geographical and regulatory issues in French Guiana, usual malaria control strategies cannot be implemented in this particular context. Therefore, new strategies targeting this specific population in the forest are required