Peru is an upper-middle-income country, but a large part of the population is still unable to benefit from such economic growth, with poverty rates exceeding 40% in rural areas, mainly in the Andean and the Amazon Regions. Malaria remains a significant public health problem in the Peruvian Amazon, mainly in Loreto department where both P.vivax and P. falciparum coexist (ratio: 5/1), accounting for more than 95% of Peru’s malaria cases in 2017 (52,280 cases).

Loreto, covering 28% of Peru's territory with around one million inhabitants, is the department most affected by malaria. In 2017, it reported 53163 malaria cases (about 90% of total cases in the country), of which 75% and 25% were caused by P. vivax and P. falciparum, respectively. Recent reports in South-American co-endemic countries for both species indicated that severe malaria (SM) caused by P. vivax is not rare.

Background: Faced with the resurgence of malaria in the Peruvian Amazon since 2012, malaria surveillance was enhanced by adding a local active case detection (ACD) strategy to the routine passive case detection (PCD) as a reactive measure in selected communities with unusual number of cases during high transmission season (HTS). We assessed the short-effectiveness of this local ACD-based strategy in four Peruvian Amazonian riverine communities. Methods: A cohort study was conducted in June-July 2015 in Mazan, Loreto. Four consecutive ACD interventions (using light microscopy (LM) and treatment of confirmed infections) at intervals of 10 days were conducted in four riverine communities (Gamitanacocha-GAM, Primero de Enero-PRI, Libertad-LIB, and Urco Miraño-URC) that previously reported unusual number of cases. Blood samples were also collected on filter paper for later PCR. The effective...

En áreas donde P. falciparum y P. vivax coexisten, como en la Región Loreto, la incidencia de P. falciparum ha ido disminuyendo más rápidamente respecto a P. vivax, el cual persiste como principal causa de malaria y constituye el principal reto para la eliminación de la malaria (17). El presente estudio confirmará que P. vivax es el principal causante de malaria grave en la Región Loreto, especie considerada por mucho tiempo como causante de malaria “benigna”(18). Por ello, la importancia de conocer las características clínicas y epidemiológicas de malaria grave por especie, complicaciones más frecuentes, comorbilidades, evolución; lo cual, permitirá a los profesionales de la Salud una mejor vigilancia y manejo de la enfermedad. Los estudios sobre malaria grave realizados a nivel nacional y en la Región Loreto, utilizaron los criterios de gravedad de la OMS del año 200...

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This work was supported by the Consejo Nacional de Ciencia, Tecnologia e Innovacion Tecnologica (grant number 008-2014-FONDECYT); the Academie de Recherche et d'Enseignement Superieur-Commission de la Cooperation au Developpement of Belgium (grant number ARES-CCD, PRD-Peru 2014-2019 to N. S., A. L. C., and A. R. A.); World Health Organization Special Programme for Research and Training in Tropical Diseases (grant number 201460655 to D. G.); and National Institutes of Health, National Institute of Allergy and Infectious Diseases (grant numbers U19AI089681 to J. M. V. and R01AI110112 to J. E. C.). A. R. A. is a Postdoctoral Researcher of the Fonds de la Recherche Scientifique (FNRS, Belgium).