{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T15:24:55Z","timestamp":1772465095910,"version":"3.50.1"},"reference-count":14,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Mem. Inst. Oswaldo Cruz"],"abstract":"<jats:p>BACKGROUND Malaria remains a major public health concern in Brazil, with the Amazon region accounting for 99.9% of the country\u2019s cases. Indoor residual spraying (IRS) using Etofenprox 20% PM is a core vector control strategy. However, inefficiencies in the insecticide custody chain, including planning, storage, and distribution, may compromise intervention effectiveness.  OBJECTIVES This study aimed to evaluate the insecticide custody chain from a process perspective, identifying logistical bottlenecks, while also exploring potential impact by examining associations between insecticide allocation and malaria burden in Brazil and in three high-incidence municipalities in the state of Amazonas (Barcelos, Tef\u00e9, and S\u00e3o Gabriel da Cachoeira) from 2019 to 2023. The underlying hypothesis is that in a well-functioning system, insecticide distribution should be correlated with malaria risk determinants, such as epidemiological and environmental variables, rather than merely responding to reported case counts.  METHODS A mixed-methods approach was used. Quantitative analysis applied Pearson correlation, simple and multiple linear regressions (with time-lag), and ARIMA models to evaluate associations between insecticide volume and malaria cases, incorporating environmental and demographic covariates. A complementary qualitative assessment, based on a structured risk matrix, examined failures across four stages of the custody chain: planning, storage, application, and monitoring.  FINDINGS At the national level, insecticide volume was significantly associated with malaria cases (\u03b2 = 0.161; p = 0.038; R\u00b2 = 0.74) and deforestation (\u03b2 = 0.626; p = 0.034). Time-series analysis revealed a reactive pattern, with insecticide allocation often lagging behind malaria incidence peaks. In the municipalities studied, models lacked statistical significance, but trends suggested weak local planning and disconnects from risk-based forecasting. The risk matrix revealed systemic weaknesses, including limited data interoperability, insufficient integration of environmental indicators, and poor federal coordination.  MAIN CONCLUSIONS The current custody chain functions reactively and lacks integration with surveillance and predictive environmental data, contradicting World Health Organization (WHO) recommendations. Structural reforms are urgently needed. These include: (i) risk-based planning incorporating environmental variables, (ii) interoperable information systems, (iii) improved surveillance of vector resistance, and (iv) intergovernmental agreements for equitable and efficient resource allocation. Findings highlight the need for strategic reorientation of IRS logistics toward anticipatory and data-driven planning. Strengthening the custody chain through intersectoral coordination and environmental intelligence is essential not only to improve operational efficiency but also to increase the cost-effectiveness and epidemiological impact of malaria control interventions in the Amazon. Lessons learned may inform broader efforts in other endemic regions aiming for malaria elimination.<\/jats:p>","DOI":"10.1590\/0074-02760250152","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T14:13:19Z","timestamp":1772460799000},"source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of the insecticide custody chain and its relationship with malaria burden in the Brazilian Amazon: a process and exploratory impact assessment (2019-2023)"],"prefix":"10.1590","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1193-0122","authenticated-orcid":false,"given":"Marcela Lima","family":"Dourado","sequence":"first","affiliation":[{"name":"Funda\u00e7\u00e3o Oswaldo Cruz-Fiocruz,  Brasil; Minist\u00e9rio da Sa\u00fade,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafaella Albuquerque e","family":"Silva","sequence":"additional","affiliation":[{"name":"Minist\u00e9rio da Sa\u00fade,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00e1rcia Caldas de","family":"Castro","sequence":"additional","affiliation":[{"name":"Harvard University,  Estados Unidos da Am\u00e9rica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e1ssio Roberto Leonel","family":"Peterka","sequence":"additional","affiliation":[{"name":"Minist\u00e9rio da Sa\u00fade,  Brasil; Secretaria de Sa\u00fade do Estado do Amap\u00e1,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina Ribas","family":"Kluge","sequence":"additional","affiliation":[{"name":"Minist\u00e9rio da Sa\u00fade,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"Castro","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Oswaldo Cruz-Fiocruz,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Bento Pereira","family":"Lima","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Oswaldo Cruz-Fiocruz,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"key":"ref1","series-title":"Elimina mal\u00e1ria Brasil: plano nacional de elimina\u00e7\u00e3o da mal\u00e1ria","first-page":"1","year":"2022"},{"key":"ref2","series-title":"Guia para gest\u00e3o local do controle da mal\u00e1ria: controle vetorial","first-page":"1","year":"2009"},{"key":"ref3","series-title":"Guidelines for malaria vector control","year":"2021"},{"key":"ref4","series-title":"Guidelines for risk management in health supply chains","year":"2018"},{"issue":"Suppl. 2","key":"ref5","doi-asserted-by":"crossref","first-page":"103","DOI":"10.4269\/ajtmh.2004.71.103","article-title":"Integrated urban malaria control: a case study in Dar es Salaam, Tanzania","volume":"71","author":"Caldas de Castro M","year":"2004","journal-title":"Am J Trop Med Hyg"},{"issue":"2","key":"ref6","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1590\/S0102-30982007000200005","article-title":"Meio ambiente e sa\u00fade: metodologia para an\u00e1lise espacial da ocorr\u00eancia de mal\u00e1ria em projetos de assentamento","volume":"24","author":"Castro MC","year":"2007","journal-title":"Rev Bras Estud Popul"},{"issue":"3","key":"ref7","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1590\/S0104-530X2013000300014","article-title":"Modelos para gest\u00e3o de riscos em cadeias de suprimentos: revis\u00e3o, an\u00e1lise e diretrizes para futuras pesquisas","volume":"20","author":"Tomas RN","year":"2013","journal-title":"Gest\u00e3o & Produ\u00e7\u00e3o"},{"issue":"30","key":"ref8","first-page":"1","article-title":"Monitoramento dos casos de arboviroses at\u00e9 a semana epidemiol\u00f3gica 52 de 2022 e Mal\u00e1ria na regi\u00e3o extra-amaz\u00f4nica do Brasil: s\u00e9rie hist\u00f3rica de 2010 a 2021","volume":"53","year":"2022","journal-title":"Boletim Epidemiol\u00f3gico"},{"issue":"15","key":"ref9","first-page":"1","article-title":"Dia mundial de luta contra a mal\u00e1ria","volume":"52","year":"2021","journal-title":"Boletim Epidemiol\u00f3gico"},{"issue":"1","key":"ref10","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1186\/s12936-016-1335-1","article-title":"Challenges for malaria elimination in Brazil","volume":"15","author":"Ferreira MU","year":"2016","journal-title":"Malar J"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1111\/j.1749-6632.2001.tb02753.x","article-title":"Agricultural colonization and malaria on the Amazon frontier","volume":"954","author":"Singer BH","year":"2001","journal-title":"Ann N Y Acad Sci"},{"key":"ref12","series-title":"Dados de desmatamento na Amaz\u00f4nia","year":"2024"},{"issue":"44","key":"ref13","doi-asserted-by":"crossref","DOI":"10.1073\/pnas.2409583121","article-title":"Ecological change increases malaria risk in the Brazilian Amazon","volume":"121","author":"Arisco NJ","year":"2024","journal-title":"Proc Natl Acad Sci USA"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1057\/s41599-024-03180-5","article-title":"Beyond probability-impact matrices in project risk management: a quantitative methodology for risk prioritisation","volume":"11","author":"Acebes F","year":"2024","journal-title":"Humanit Soc Sci Commun"}],"container-title":["Mem\u00f3rias do Instituto Oswaldo Cruz"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0074-02762026000105011&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T14:13:21Z","timestamp":1772460801000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0074-02762026000105011&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":14,"alternative-id":["S0074-02762026000105011"],"URL":"https:\/\/doi.org\/10.1590\/0074-02760250152","relation":{},"ISSN":["1678-8060","0074-0276"],"issn-type":[{"value":"1678-8060","type":"electronic"},{"value":"0074-0276","type":"print"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e250152"}}