{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T09:06:14Z","timestamp":1785229574570,"version":"3.55.0"},"reference-count":31,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T00:00:00Z","timestamp":1620691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["424141\/2018-3"],"award-info":[{"award-number":["424141\/2018-3"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["309569\/2019-2"],"award-info":[{"award-number":["309569\/2019-2"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["PRINT-FIOCRUZ-CAPES"],"award-info":[{"award-number":["PRINT-FIOCRUZ-CAPES"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>In Brazil, malaria caused by Plasmodium vivax presents control challenges due to several reasons, among them the increasing possibility of failure of P. vivax treatment due to chloroquine-resistance (CQR). Despite limited reports of CQR, more extensive studies on the actual magnitude of resistance are still needed. Short-time recurrences of malaria cases were analyzed in different transmission scenarios over three years (2005, 2010, and 2015), selected according to malaria incidence. Multilevel models (binomial) were used to evaluate association of short-time recurrences with variables such as age. The zero-inflated Poisson scan model (scanZIP) was used to detect spatial clusters of recurrences up to 28 days. Recurrences compose less than 5% of overall infection, being more frequent in the age group under four years. Recurrences slightly increased incidence. No fixed clusters were detected throughout the period, although there are clustering sites, spatially varying over the years. This is the most extensive analysis of short-time recurrences worldwide which addresses the occurrence of P. vivax CQR. As an important step forward in malaria elimination, policymakers should focus their efforts on young children, with an eventual shift in the first line of malaria treatment to P. vivax.<\/jats:p>","DOI":"10.3390\/ijerph18105061","type":"journal-article","created":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T11:30:16Z","timestamp":1620732616000},"page":"5061","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Short-Time Recurrences of Plasmodium vivax Malaria as a Public Health Proxy for Chloroquine-Resistance Surveillance: A Spatio-Temporal Study in the Brazilian Amazon"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0358-3371","authenticated-orcid":false,"given":"Antonio A. S.","family":"Balieiro","sequence":"first","affiliation":[{"name":"Instituto Le\u00f4nidas &amp; Maria Deane, Funda\u00e7\u00e3o Oswaldo Cruz (ILMD\/Fiocruz), Amazonas 69057-070, Brazil"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia Parasitaria\u2014Instituto Oswaldo Cruz (IOC\/Fiocruz), Rio de Janeiro 21040-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre M.","family":"Siqueira","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Infectologia Evandro Chagas, Funda\u00e7\u00e3o Oswaldo Cruz (INI\/Fiocruz), Rio de Janeiro 21040-360, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gisely C.","family":"Melo","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o de Medicina Tropical Heitor Vieira Dourado (FMT-HVD), Amazonas 69040-000, Brazil"},{"name":"Programa de P\u00f3s Gradua\u00e7\u00e3o em Medicina Tropical\u2014Universidade do Estado do Amazonas (UEA), Amazonas 69040-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0848-1940","authenticated-orcid":false,"given":"Wuelton M.","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o de Medicina Tropical Heitor Vieira Dourado (FMT-HVD), Amazonas 69040-000, Brazil"},{"name":"Programa de P\u00f3s Gradua\u00e7\u00e3o em Medicina Tropical\u2014Universidade do Estado do Amazonas (UEA), Amazonas 69040-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7307-8851","authenticated-orcid":false,"given":"Vanderson S.","family":"Sampaio","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o de Medicina Tropical Heitor Vieira Dourado (FMT-HVD), Amazonas 69040-000, Brazil"},{"name":"Programa de P\u00f3s Gradua\u00e7\u00e3o em Medicina Tropical\u2014Universidade do Estado do Amazonas (UEA), Amazonas 69040-000, Brazil"},{"name":"Funda\u00e7\u00e3o de Vigil\u00e2ncia em Sa\u00fade (FVS), Amazonas 69093-018, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivo","family":"Mueller","sequence":"additional","affiliation":[{"name":"Walter &amp; Elisa Hall Institute, Melbourne 3052, Australia"},{"name":"Pasteur Institute, 75015 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus V. G.","family":"Lacerda","sequence":"additional","affiliation":[{"name":"Instituto Le\u00f4nidas &amp; Maria Deane, Funda\u00e7\u00e3o Oswaldo Cruz (ILMD\/Fiocruz), Amazonas 69057-070, Brazil"},{"name":"Funda\u00e7\u00e3o de Medicina Tropical Heitor Vieira Dourado (FMT-HVD), Amazonas 69040-000, Brazil"},{"name":"Programa de P\u00f3s Gradua\u00e7\u00e3o em Medicina Tropical\u2014Universidade do Estado do Amazonas (UEA), Amazonas 69040-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8371-2959","authenticated-orcid":false,"given":"Daniel A. M.","family":"Villela","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia Parasitaria\u2014Instituto Oswaldo Cruz (IOC\/Fiocruz), Rio de Janeiro 21040-900, Brazil"},{"name":"Programa de Computa\u00e7\u00e3o Cient\u00edfica, Funda\u00e7\u00e3o Oswaldo Cruz (PROCC\/Fiocruz), Rio de Janeiro 21040-360, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"90","DOI":"10.4269\/ajtmh.2001.65.90","article-title":"Plasmodium vivax clinically resistant to chloroquine in Colombia","volume":"65","author":"Soto","year":"2001","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"548","DOI":"10.4269\/ajtmh.2003.69.548","article-title":"Chloroquine-resistant Plasmodium vivax malaria in Peru","volume":"69","author":"Ruebush","year":"2003","journal-title":"Am. J. 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