A snapshot of a representative Brazilian state of illegal mining in indigenous areas during the era of malaria elimination

Barros, Jacqueline de Aguiar; Granja, Fabiana; Silva, Daniel da Silva e; Citó, Arthur Camurça; Peterka, Cássio; Ferreira-da-Cruz, Maria de Fátima

doi:10.1590/0102-311XEN224023

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ARTICLE • Cad. Saúde Pública 40 (6) • 2024 • https://doi.org/10.1590/0102-311XEN224023 copy

A snapshot of a representative Brazilian state of illegal mining in indigenous areas during the era of malaria elimination

Um retrato de um estado brasileiro representativo do garimpo ilegal em áreas indígenas durante a campanha de erradicação da malária

Un retrato de un estado brasileño representativo de la minería ilegal en zonas indígenas durante la campaña de erradicación de la malaria

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract:

Malaria is a public health problem and the cases diagnosed in the capital of Roraima, Brazil, show potential to characterize the burden of the disease in the state. This study aimed to describe the epidemiological, clinical, and laboratory aspects of malaria cases diagnosed in Boa Vista. For this purpose, a descriptive, cross-sectional study was conducted in two health units in the city, with individuals diagnosed and who agreed to respond the questionnaire. Of the total of 206 participants, characterized as men, mixed-race, and young, 96% (198) reported participating in illegal mining activity. Among the group of miners, 66% (131) came from other states of Brazil or other countries. The mines were mainly located in the Yanomami territory in Roraima. Plasmodium vivax infection occurred in 74% (153) of participants. In the miner’s group, hospitalizations for severe malaria, previous malaria attacks, and delays in treatment after the onset of symptoms were reported. Although 73% (145) of miners reported knowing how malaria was transmitted, only 54% (107) used mosquito nets or repellents. The use of Artecom and chloroquine by miners is not for the complete treatment but only to relieve symptoms for returning to gold mines, highlighting the importance of molecular surveillance to antimalarial resistance. Indigenous peoples are considered vulnerable to malaria and miners promotes the increase of malaria in Roraima Indigenous Lands. Therefore, access to diagnosis and treatment in Indigenous areas invaded by miners is imperative to confront this disease that ravages Indigenous communities and threatens public health on a large scale to achieve the goal of eliminating malaria in the state.

Keywords:
Mining; Indigenous Peoples; Amazon; Malaria

Characteristics	Illegal mining (n = 198)		Agriculture (n = 6)		Hunting/Fishing (n = 1)		Tourism (n = 1)		Total (n = 206)
Characteristics	n	%	n	%	n	%	n	%	n	%
Age group (years)
18-29	92	46.5	3	50.0	0	0.0	0	0.0	95	46.1
30-39	60	30.3	1	16.7	1	100.0	0	0.0	62	30.1
40-49	26	13.1	1	16.7	0	0.0	1	100.0	28	13.6
50-59	17	8.6	1	16.7	0	0.0	0	0.0	18	8.7
≥ 60	3	1.5	0	0.0	0	0.0	0	0.0	3	1.5
Gender
Male	164	82.8	3	50.0	1	100.0	1	100.0	169	82.0
Female	34	17.2	3	50.0	0	0.0	0	0.0	37	18.0
Ethnicity
White	32	16.2	2	33.3	0	0.0	0	0.0	34	16.5
Black	39	19.7	2	33.3	0	0.0	0	0.0	41	19.9
Asian	7	3.5	0	0.0	0	0.0	0	0.0	7	3.4
Mixed-race	115	58.1	2	33.3	1	100.0	1	100.0	119	57.8
Indigenous	5	2.5	0	0.0	0	0.0	0	0.0	5	2.4
Symptoms
Fever	179	90.4	5	83.3	1	100.0	1	100.0	186	90.3
Headache	173	87.4	6	100.0	1	100.0	0	0.0	180	87.4
Chill	136	68.7	2	33.3	1	100.0	0	0.0	139	67.5
Abdominal pain	109	55.1	2	33.3	1	100.0	1	100.0	113	54.9
Myalgia	105	53.0	4	66.7	1	100.0	0	0.0	110	53.4
Nausea/Vomit	87	43.9	2	33.3	0	0.0	0	0.0	89	43.2
Sweating	78	39.4	2	33.3	1	100.0	0	0.0	81	39.3
Diarrhea	36	18.2	1	16.7	0	0.0	0	0.0	37	18.0
Dyspnea	27	13.6	0	0.0	0	0.0	0	0.0	27	13.1
Low back pain	8	4.0	0	0.0	0	0.0	0	0.0	8	3.9
No symptoms	4	2.0	0	0.0	0	0.0	0	0.0	4	1.9
Species
Plasmodium vivax	147	74.2	4	66.7	1	100.0	1	100.0	153	74.3
Plasmodium falciparum + mixed malaria	51	25.8	2	33.3	0	0.0	0	0.0	53	25.7
Have you had malaria before?
Yes	161	81.3	4	66.7	0	0.0	1	100.0	166	80.6
No	37	18.7	2	33.3	1	100.0	0	0.0	40	19.4
Have you ever been hospitalized?
Yes	40	20.2	0	0.0	0	0.0	0	0.0	40	19.4
No	158	79.8	6	100.0	1	100.0	1	100.0	166	80.6
Do you know how malaria is transmitted?
Yes	145	73.2	5	83.3	1	100.0	0	0.0	151	73.3
No	53	26.8	1	16.7	0	0.0	1	100.0	55	26.7
Prophylactic measures
Mosquito nets	47	23.7	1	16.7	0	0.0	0	0.0	48	23.3
Repellent	60	30.3	1	16.7	0	0.0	0	0.0	61	29.6
Antimalarials	12	6.1	0	0.0	0	0.0	0	0.0	12	5.8
No prevention	79	39.9	4	66.7	1	100.0	1	100.0	85	41.3

Onset of symptoms/Treatment initiation	Illegal mining (n = 194)		Agriculture (n = 6)		Hunting/Fishing (n = 1)		Tourism (n = 1)		Total (n = 202)
Onset of symptoms/Treatment initiation	n	%	n	%	n	%	n	%	n	%
Within 24 hours	32	16.5	0	0.0	0	0.0	0	0.0	32	15.8
Within 48 hours	43	22.2	1	16.7	0	0.0	0	0.0	44	21.8
Within 96 hours	62	32.0	4	66.7	1	100.0	0	0.0	67	33.2
After 96 hours	57	29.4	1	16.7	0	0.0	1	100.0	59	29.2

Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Rua Leopoldo Bulhões, 1480 , 21041-210 Rio de Janeiro RJ Brazil, Tel.:+55 21 2598-2511, Fax: +55 21 2598-2737 / +55 21 2598-2514 - Rio de Janeiro - RJ - Brazil
E-mail: cadernos@ensp.fiocruz.br

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[1] Correspondence
M. F. Ferreira-da-Cruz Laboratório de Pesquisas em Malária, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz. Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brasil. mffcruz@ioc.fiocruz.br