{"doi":"10.1093/infdis/jiaf457","title":"The Source-Sink Dynamics of <i>Plasmodium vivax</i> May Undermine Malaria Elimination Efforts in the Amazon: An Epidemiological and Population Genomic Study","abstract":"BACKGROUND: Brazil's progress toward malaria elimination has stalled and 163 000 new cases (more than 80% caused by Plasmodium vivax) were recorded in the Brazilian Amazon in 2023. We hypothesize that human mobility continues to disperse parasites from hotspots to areas with decreasing endemicity. METHODS: We analyzed 5.5 million malaria case notifications between 2003 and 2023 to describe malaria case mobility and identify sources and sinks of P. vivax in the Brazilian Amazon. We leveraged whole-genome sequence data from 408 P. vivax isolates sampled from across South America to characterize parasite gene flow and infer likely regional routes of parasite dispersal. RESULTS: We found that nearly one-third of the P. vivax infections diagnosed in residents in the Brazilian Amazon over 21 years were acquired outside the locality or municipality of residence, but only 1.7% were imported from other countries in South America, mostly from the Guiana Shield. We show that large cities with residual malaria transmission-such as Manaus and Porto Velho-are receptive parasite sinks surrounded by high-risk source rural localities. Although the genetic relatedness of parasites tended to decrease with geographic distance, parasites from sites more than 1000 km apart often remained genetically connected. CONCLUSIONS: Understanding parasite source-sink dynamics on different geographic scales is crucial to target high-risk mobile populations and source localities along with receptive sinks within low-transmission municipalities, with the goal of eliminating malaria transmission and preventing its reintroduction into malaria-free areas.","journal":"The Journal of Infectious Diseases","year":2025,"id":526773,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9424,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":438085,"name":"Rodrigo M. Corder","orcid":"0000-0002-8929-2200","position":1,"is_corresponding":false},{"id":438086,"name":"Igor Cavallini Johansen","orcid":"0000-0002-5360-3740","position":2,"is_corresponding":false},{"id":1085058,"name":"Winni Alves Ladeia","orcid":"0000-0002-8815-5773","position":3,"is_corresponding":false},{"id":290862,"name":"Priscila T. Rodrigues","orcid":"0000-0001-5352-6071","position":4,"is_corresponding":false},{"id":316976,"name":"Simone Ladeia-Andrade","orcid":"0000-0003-0912-5937","position":5,"is_corresponding":false},{"id":290876,"name":"Joana C. Silva","orcid":"0000-0001-6502-7026","position":6,"is_corresponding":false},{"id":290870,"name":"Marcelo U. Ferreira","orcid":"0000-0002-5293-9090","position":7,"is_corresponding":false},{"id":1402886,"name":"Nathalia Rammé Medeiros de Albuquerque","orcid":"0000-0001-7198-8026","position":0,"is_corresponding":true}],"reference_count":24,"raw_metadata":null,"created_at":"2026-07-19T02:50:34.851930Z","pmid":"40903008","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}