Using Wearable GPS Technology to Quantify Occupation-Related Human Movement in a Remote Riverine Region of Hyperendemic Malaria Transmission Pubblico
Harless, Charles (2017)
Abstract
Background: Though most of Amazonian Peru remains seasonally endemic for malaria, a number of high-risk remote hotspots have been identified in the primarily riverine region. It has been hypothesized that asymptomatic riverboat workers from these hotspots may be responsible for the occurrence of seasonal transmission and regional reintroduction. Goal: Therefore, the primary goal of this study was to characterize the normal regional movement of residents of a remote rural hotspot village in order to assess the plausibility of this hypothesis. Methods: Wearable GPS technology was used in this setting to accurately record this regional and fine-scale movement. Local spatial statistics were then used to determine areas of significant clustering; results were further analyzed using time and profession as differentiating variables. Results: Local spatial statistics revealed a highly heterogeneous spatial distribution around neighboring remote villages, within the regional urban centers of Nauta and Iquitos, and along the riverine networks which connect these features. Diurnal and nocturnal sub-analyses revealed further heterogeneity within the data, which interpreted with knowledge of vector behavior, assess differences in potential for disease transmission as mediated by either Anopheles or Aedes mosquitos. Conclusion: Given that Santa Emilia is an identified malaria hotspot in remote Amazonian Peru, the results of this human movement study suggest that local riverboat transporters and remote-based government school teachers are most likely involved in the ongoing regional transmission and reintroduction of malaria which is annually reported throughout the region. Implications: These findings suggest that less regional transmission and reintroduction of malaria might occur, on an annual basis in the Peruvian Amazon, if riverboat transporters and remote-based government teachers throughout the Loreto Department were more actively screened and treated for malaria.
Table of Contents
CHAPTER 1 - Literature Review
Global Topic:
1) Disease & Burden
9
Vectors: Anopheles mosquito vs Aedes mosquito
2) Transmission
11
Human Movement vs Vector Movement
3) Control Efforts
13
Issues of Spread and Reintroduction
4) Use of GPS and GIS Technologies
16
Malaria in Peru:
5) Amazon Region
18
Regional Vectors
6) Regional Disease and Burden
21
7) Riverine Communities and River-Boat Workers
22
Vector Migration
8) Uses of GPS and GIS Technologies
25
Arbovirus and Iquitos-centric
Conclusion: Needs, Goals, Aims, and Significance Statements
28
CHAPTER 2 - Methods
1) Introduction
29
2) Population and Sample
30
3) Research Design
33
4) Instruments
34
5) Ethical Considerations
34
6) Procedures
35
7) Data Analysis
36
8) Limitations and Delimitations
40
CHAPTER 3 - Results
1) Introduction
41
2) Findings
41
Study Area
Remote Zone
Urban Centers Zone
3) Other Findings
70
Santa Emilia Subzone
4) Summary
73
CHAPTER 4 - Discussion
1) Introduction
74
2) Context
74
3) Discussion
75
4) Strengths and Limitations
78
CHAPTER 5 - Recommendations and Implications
1) Recommendations
80
2) Implications
81
3) Conclusions
81
References
82
Appendices
85
About this Master's Thesis
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