Objectives: High-quality clinical research is dependent on adequate design, methodology, and data collection. The utilization of electronic data capture (EDC) systems is recommended to optimize research data through proper management. This paper’s objective is to present the procedures of REDCap (Research Electronic Data Capture), which supports research development, and to promote the utilization of this software among the scientific community.Methods: REDCap’s web application version 10.4.1 released on 2021 (Vanderbilt University) is an EDC system suitable for clinical research development. This paper describes how to join the REDCap consortium and presents how to develop survey instruments and use them to collect and analyze data.Results: Since REDCap is a web application that stimulates knowledge-sharing among the scientific community, its development is not finished and it is constantly receiving updates to improve the system. REDCap’s tools provide access control, audit trails, and data security to the research team.Conclusions: REDCap is a web application that can facilitate clinical research development, mainly in health fields, and reduce the costs of conducting research. Its tools allow researchers to make the best use of EDC components, such as data storage.

Background: In Brazil, malaria is caused mainly by the Plasmodium vivax and Plasmodium falciparum species. Its transmission occurs in endemic and non-endemic areas. Malaria geography in Brazil has retracted and is now concentrated in the North region. The Brazilian Amazon region accounts for 99% of Brazil's cases. Brazil’s extra-Amazon region has a high frequency of imported cases and in 2019 presented a mortality rate 123 times higher than the Amazon region. Extra-Amazon cases present risks of reintroduction. This study aims to characterize the epidemiological scenario for malaria in the extra-Amazon region of Brazil from 2011 to 2020 with a two-year forecast. Methods: Time-series study with description of malaria cases and deaths registered in Brazilian extra-Amazon region from 2011 to 2020. Public data from the Notifiable Diseases Information System (Sinan) and the Mortality Information System (SIM) were used. Descriptive analysis, incidence, and notification rates were calculated. Flow charts analysed the flux between Places of Probable Infection (PI) and places of notification. The prediction model utilized a multiplicative Holt-winters model for trend and seasonality components. Results: A total of 6849 cases were registered. Cases were predominantly white males with 9 to 11 years of education, mostly between 30 and 39 years old. Imported cases accounted for 78.9% of cases. Most frequent occupations for imported cases are related to travelling and tourism activities. Among autochthonous cases, there is a higher frequency of agriculture and domestic economic activities. In the period there were 118 deaths due to malaria, of which 34.7% were caused by P. falciparum infections and 48.3% were not specified. The most intense flows of imported cases are from Amazonas and Rondônia to São Paulo, Rio de Janeiro, and Paraná. The prediction estimates around 611 cases for each of the following two years. Conclusion: The time series allows a vast epidemiological visualization with a short-term prediction analysis that supports public health planning. Government actions need to be better directed in the extra-Amazon region so the objective of eliminating malaria in Brazil is achieved. Carrying out quality assessments for information systems and qualifying personnel is advisable. Malaria outside the Amazon region is mainly due to imported cases and delay in diagnosis is associated with a higher fatality rate. Better strategies to diagnose and treat suspected cases can lead to lower risk of deaths and local outbreaks that will be important for achieving malaria elimination in Brazil.

Background: Aedes aegypti and Culex quinquefasciatus are the main urban vectors of arthropod-borne viruses causing human disease, including dengue, Zika, or West Nile. Although key to disease prevention, urban-mosquito control has met only limited success. Alternative vector-control tactics are therefore being developed and tested, often using entomological endpoints to measure impact. Here, we test one promising alternative and assess how three such endpoints perform at measuring its effects. Methods: We conducted a 16-month, two-arm, cluster-randomized controlled trial (CRCT) of mosquito-disseminated pyriproxyfen (MD-PPF) in central-western Brazil. We used three entomological endpoints: adult-mosquito density as directly measured by active aspiration of adult mosquitoes, and egg-trap-based indices of female Aedes presence (proportion of positive egg-traps) and possibly abundance (number of eggs per egg-trap). Using generalized linear mixed models, we estimated MD-PPF effects on these endpoints while accounting for the non-independence of repeated observations and for intervention-unrelated sources of spatial-temporal variation. Results: On average, MD-PPF reduced adult-mosquito density by 66.3% (95% confidence interval, 95% CI: 47.3–78.4%); Cx. quinquefasciatus density fell by 55.5% (95% CI: 21.1–74.8%), and Ae. aegypti density by 60.0% (95% CI: 28.7–77.5%). In contrast, MD-PPF had no measurable effect on either Aedes egg counts or egg-trap positivity, both of which decreased somewhat in the intervention cluster but also in the control cluster. Egg-trap data, therefore, failed to reflect the 60.0% mean reduction of adult Aedes density associated with MD-PPF deployment. Conclusions: Our results suggest that the widely used egg-trap-based monitoring may poorly measure the impact of Aedes control; even if more costly, direct monitoring of the adult mosquito population is likely to provide a much more realistic and informative picture of intervention effects. In our CRCT, MD-PPF reduced adult-mosquito density by 66.3% in a medium-sized, spatially non-isolated, tropical urban neighborhood. Broader-scale trials will be necessary to measure MD-PPF impact on arboviral-disease transmission.

Deforestation and high human mobility due to mining activities have been key to the increase in malaria cases in the Americas. Here, we review the epidemiological and control aspects of malaria in the Amazon mining areas. Epidemiological evidence shows: 1) a positive correlation between illegal mining activity and malaria incidence, mostly in the Amazon region; 2) most Brazilian miners are males aged 15-29 years who move between states and even countries; 3) miners do not fear the disease and rely on medical care, diagnosis, and medication when they become ill; 4) illegal mining has emerged as the most reported anthropogenic activity within indigenous lands and is identified as a major cause of malaria outbreaks among indigenous people in the Amazon; and 5) because mining is largely illegal, most areas are not covered by any healthcare facilities or activities, leading to little assistance in the diagnosis and treatment of malaria. Our review identified five strategies for reducing the malaria incidence in areas with mining activities: 1) reviewing legislation to control deforestation and mining expansion, particularly in indigenous lands; 2) strengthening malaria surveillance by expanding the network of community health agents to support rapid diagnosis and treatment; 3) reinforcing vector control strategies, such as the use of insecticide-treated nets; 4) integrating deforestation alerts into the national malaria control program; and 5) implementing multi-sectoral activities and providing prompt assistance to indigenous populations. With this roadmap, we can expect a decrease in malaria incidence in the Amazonian mining areas in the future.

Resumo Objetivo: Apresentar metodologia padronizada para vinculação de diferentes bancos de dados em saúde pública. Métodos: Artigo de revisão metodológica, com descrição específica de processos de tratamento de dados para vinculação (linkage) determinística entre bancos de dados estruturados. Instruiu-se como tratar os dados, selecionar chaves de vinculação e vincular os bancos, utilizando-se dois bancos de dados simulados no software R. Resultados: Foram apresentados os comandos utilizados para a vinculação determinística, do tipo inner_join. O processo de vinculação resultou em um banco de dados com 40.108 pares ao se utilizar apenas a chave “Nome”. Com a adição da segunda chave, “Nome da mãe”, o resultado caiu para 112 pares. Ao adicionar a terceira chave, “Data de nascimento”, apenas dois pares foram identificados. Conclusão: A vinculação de bancos de dados e suas análises são ferramentas válidas e úteis para os serviços de saúde, no apoio a ações de vigilância em saúde.

Malaria is a global health challenge, and international efforts are underway to alleviate its impact by 2035. Within the 249 million global cases, 0.6 million occur in the Americas, mainly in Venezuela, Brazil, and Colombia. Considering Brazil’s geographical proximity to malaria-endemic countries in South America, this study objective is to analyze the epidemiological characteristics and time trends of imported malaria cases in Brazil from 2007 to 2022, discussing their influence on the elimination process. This is an ecological time-series study that analyses malaria imported cases (infected in other countries) notified in Brazil, from 2007 to 2022. Brazil’s Ministry of Health data were used. Descriptive statistics were employed to analyze sociodemographic and spatial patterns, while the impact of the Covid-19 pandemic on imported malaria trends was assessed using Prais-Winsten regression methods. In the study period there was a total of 109,914 imported cases (2.6% of Brazil’s total malaria burden). There was an annual reduction of 515.3 cases (p = 0.001) prior to the Covid-19 pandemic. During the pandemics there was an overall reduction of -3,301.8 cases (p = 0.001). In the Amazon regionP.vivaximported infections predominated, whereas in the extra-Amazon regionP.falciparumimported infections were more prevalent. Most imported cases were males (67.8%), of Black ethnicity (47.5%), with incomplete primary education (45.1%), aged 20–39 (61.1%), and primarily gold miners (54.0%). Most cases are from French Guiana (31.7%), Venezuela (30.0%), and Guyana (17.9%). African nations, notably Angola and Nigeria, were primary sources of imported cases to the extra-Amazon region. The imported cases flux, predominantly from Latin America, threatens Brazil’s elimination goals by potentially reintroducing the disease into previously cleared areas and sustaining the transmission in endemic areas. Strengthening epidemiological surveillance at the borders and fostering international cooperation are imperative steps in addressing this challenge.