Resumen

GRILLET, María-Eugenia; MARTINEZ, Juan Eudes  y  BARRERA, Roberto. Malaria hot spot areas: Implications for effective and targeted interventions in Venezuela. Bol Mal Salud Amb [online]. 2009, vol.49, n.2, pp.193-208. ISSN 1690-4648.

This study describes the temporal and spatial pattern of malaria in northeastern Venezuela during a 12 year period in order to detect hot spots or areas of high Plasmodium vivax incidence. The underlying hypothesis is that malaria transmission is highly heterogeneous and rather local in nature, consequently, the infectious risk is not homogeneous in the landscape. Clustering of disease in two geographical areas (Cajigal and Benitez municipalities) within the Sucre state were detected by Kulldorff scan statistic, with a 8.9-fold increased risk of malaria inside the cluster, as compared to outside the area (P < 0.001, all 12 years). One - twelve hot spots of malaria transmission were detected both in epidemic and non-epidemic years in these two regions using the local Getis (P < 0.05). Hot spots accounted for 67 - 90% of parasite transmission in each municipality. The spatial extent or scale of the malaria process around each hot spot varied between 1-5 km. Non-focalized control strategy has reduced the malaria incidence in the region, but transmission remains in persistent foci that are potential sources of outbreaks and spreading of P. vivax to other areas within the Sucre state. This study exemplifies the importance of stratifying the spatial risk of disease for an efficient and more effective control of malaria transmission in northeastern Venezuela.

Palabras clave : heterogeneity; local spatial dependency; spatial epidemiology; Plasmodium vivax; Venezuela.