Using Wearable GPS Technology to Quantify Occupation-Related Human Movement in a Remote Riverine Region of Hyperendemic Malaria Transmission 公开

Harless, Charles (2017)

Permanent URL: https://etd.library.emory.edu/concern/etds/8g84mn19c?locale=zh
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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

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