RESILIÊNCIA DO PARAGUAI NA ELIMINAÇÃO DA MALÁRIA: 24 ANOS DE INDICADORES

Paulo Sérgio Siberti da Silva; Andre Luis Rocco Gomes Lima; Lara Kathilyn  Meira Costa; Lídia Cordeiro dos Reis Ricaneli; Francisco de Assis Muniz de Oliveira

doi:10.1590/SciELOPreprints.14658

##article.authors##

Paulo Sérgio Siberti da Silva Leonardo Da Vinci University https://orcid.org/0000-0001-8763-6877
- Conceptualization
- Data Curation
- Formal Analysis
- Investigation
- Methodology
- Project Administration
- Supervision
- Validation
- Visualization
- Writing – Original Draft Preparation
- Writing – Review & Editing
Andre Luis Rocco Gomes Lima Leonardo Da Vinci University https://orcid.org/0009-0000-7067-5765
- Investigation
- Writing – Original Draft Preparation
- Writing – Review & Editing
- Formal Analysis
- Data Curation
Lara Kathilyn Meira Costa Leonardo Da Vinci University https://orcid.org/0009-0006-0483-6149
- Investigation
- Methodology
- Writing – Original Draft Preparation
- Writing – Review & Editing
- Formal Analysis
Lídia Cordeiro dos Reis Ricaneli Leonardo Da Vinci University https://orcid.org/0009-0008-8811-0752
- Conceptualization
- Data Curation
- Formal Analysis
- Methodology
- Investigation
- Writing – Original Draft Preparation
- Writing – Review & Editing
Francisco de Assis Muniz de Oliveira Leonardo Da Vinci University https://orcid.org/0009-0006-4183-0870
- Investigation
- Methodology
- Formal Analysis
- Writing – Original Draft Preparation
- Writing – Review & Editing

DOI:

https://doi.org/10.1590/SciELOPreprints.14658

Keywords:

malaria, Paraguay, epidemiological surveillance, malaria indicators, public health

Abstract

This study aimed to analyze the evolution of malaria epidemiological indicators in Paraguay (2000-2024), focusing on the elimination of autochthonous transmission and the monitoring of imported cases. The methodology employed an observational, descriptive, retrospective, ecological, and longitudinal study design, utilizing secondary data from scientific literature and SENEPA official records. Malariometric indicators such as annual parasitic incidence (API), autochthonous and imported cases, and blood examinations were analyzed. Results revealed a three-phase epidemiological transition: a drastic reduction in autochthonous cases (2000-2011), culminating in the last recorded case in 2011; and a consolidation phase (2012-2024) without local transmission, but with persistent imported cases. Success was attributed to comprehensive vector control, active surveillance, and sustained financial commitment. The initial increase in imported cases was interpreted as an indicator of effective surveillance. However, the decline in the Annual Blood Examination Index (% IEA) highlights the dilemma between efficiency and sensitivity in post-elimination surveillance, making active case finding for asymptomatic infections crucial for validation. In conclusion, Paraguay's experience demonstrates that malaria elimination is achievable through political commitment, continuous funding, adaptive surveillance, and integrated strategies, serving as a replicable model for other regions. Maintaining malaria-free status will depend on continuous surveillance of imported cases and rapid response capabilities to any reintroduction.