Evidence map›Paper›PMID 40990168›Full record

ArticleTropical medicine & international health : TM & IH2025

Towards Malaria Elimination: A Nationwide Case-Control Study to Assess Risk Factors for Severe Malaria-Related Deaths in Brazil.

Klauss K S Garcia, Gabriel Z Laporta, Elisabeth Carmen Duarte, Seyi Soremekun, Amanda Amaral Abrahão, Anderson Coutinho da Silva, Anielle de Pina Costa, Marcus Vinícius Guimarães Lacerda, Chris Drakeley, Walter Massa Ramalho and 1 more

Abstract read
In one paragraph

Article in Tropical medicine & international health : TM & IH, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Klauss K S GarciaCentre for Tropical Medicine, University of Brasilia, Brasilia, Brazil.ORCID https://orcid.org/0000-0003-2268-8742
Gabriel Z LaportaGraduate Program in Health Sciences, FMABC Medical School University Centre, Santo André, São Paulo, Brazil.ORCID https://orcid.org/0000-0001-7412-9390
Elisabeth Carmen DuarteCentre for Tropical Medicine, University of Brasilia, Brasilia, Brazil.ORCID https://orcid.org/0000-0001-9148-5063
Seyi SoremekunDepartment of Infection Biology, The London School of Hygiene & Tropical Medicine, London, UK.ORCID https://orcid.org/0000-0002-5531-0220
Amanda Amaral AbrahãoFaculty of Health Sciences, University of Brasilia, Brasilia, Brazil.ORCID https://orcid.org/0000-0002-7537-7561
Anderson Coutinho da SilvaCentre for Tropical Medicine, University of Brasilia, Brasilia, Brazil.ORCID https://orcid.org/0009-0007-4960-6782
Anielle de Pina CostaFluminense Federal University, Niterói, Rio de Janeiro, Brazil.
Marcus Vinícius Guimarães LacerdaFundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil.ORCID https://orcid.org/0000-0003-3374-9985
Chris DrakeleyDepartment of Infection Biology, The London School of Hygiene & Tropical Medicine, London, UK.ORCID https://orcid.org/0000-0003-4863-075X
Walter Massa RamalhoCentre for Tropical Medicine, University of Brasilia, Brasilia, Brazil.ORCID https://orcid.org/0000-0001-5085-5670
André M SiqueiraEvandro Chagas National Institute of Infectious Diseases, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Rio de Janeiro, Brazil.

Funding

Coordination for the Improvement of Higher Education Personnel 10/2022 CAPES-#88881.690401/2022-01Gates Foundation INV-003970Ministry of Health BMoH/DECIT/CNPq-#443148/2019-8
6 · The paper itself

Abstract

objectiveThe objective of this study is to describe malaria-related deaths and assess their risk factors.

methodsThis is a case-control study using data from Brazil's Ministry of Health (2011-2020) on malaria-related deaths (ICD-10: B50-B54). A probabilistic record linkage was performed to match epidemiological data (Sivep-Malaria and Sinan) with death records from the Mortality Information System (SIM). Cases were defined as individuals who died of malaria, and controls were malaria cases that did not result in death. Logistic regression models were used to identify the factors associated with malaria mortality.

resultsA total of 632 malaria-related deaths were recorded, with 454 (71.8%) occurring in the Amazon region and 178 (28.1%) outside it. Risk factors in the Amazon included age (< 6 months or > 60 years; p ≤ 0.01), delayed treatment (> 48 h; p < 0.001), illiteracy (p = 0.01), and living in indigenous population villages (p < 0.001), while active case detection was protective (p = 0.01). In the Extra-Amazon, risk factors included delayed treatment (p = 0.049), P. falciparum or mixed infections (p < 0.049), foreign-acquired infections (p = 0.01), and higher education level (p = 0.03)-which is a proxy for increased income and travel frequency, which may increase the likelihood of exposure in endemic areas and delayed diagnosis upon return.

conclusionThis nationwide record-linkage study shows that malaria deaths remain concentrated in socially vulnerable groups: infants, older adults, and especially indigenous populations living in the Amazon. Delayed treatment is also a determinant for deaths, in both endemic and non-endemic regions, while active case detection markedly reduces the odds of death. To reach Brazil's zero-malaria-death target by 2030, it is needed to improve timely diagnosis and treatment, to enhance epidemiological information systems along with active surveillance amplification in remote communities. Finally, integrating national health-information systems allows real-time monitoring, and with coordinated action, eliminating malaria deaths remains achievable.

Indexed as

Disease EradicationMalariaAdolescentAdultAgedBrazilCase-Control StudiesChildChild, PreschoolFemaleHumansInfantInfant, NewbornLogistic ModelsMalaria, FalciparumMaledeathsepidemiological surveillancemalariapublic healthrecord linkagerisk factors

Identifiers

PMID40990168
PMCPMC12588806

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.