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125-537: The Amazonas Sustainability Foundation (Fundação Amazonas Sustentável: FAS) is a private NGO based in Manaus , Amazonas, that promotes environmental conservation through sustainable development in state conservation units. It is a partnership between the government of the state of Amazonas and Banco Bradesco . The FAS was created in December 2007 to manage environmental products and services from State conservation units, and manage

250-657: A cathedral , opera house , zoological and botanical gardens , an eco-park, and regional and native peoples museums . The Solimões and Negro rivers meet just east of Manaus and join to form the Amazon River (using the Brazilian definition of the river; elsewhere, Solimões is considered the upper part of the Amazon ). Rubber made it the richest city in South America during the late 1800s. Rubber also helped Manaus earn its nickname,

375-419: A tropical rainforest climate , with the average annual compensated temperature of 27.4 °C (81.3 °F) and high air humidity , with a rainfall index around 2,300 mm (90.6 in) annually. The seasons are relatively well-defined concerning rain: July to September is relatively dry, and December to May is very rainy. Thunderstorms are frequent every day in the summer, but they can occur at any time of

500-575: A blood meal from a previously Plasmodium infected person or animal. Parasites are then typically introduced by the bite of an infected Anopheles mosquito. Some of these inoculated parasites, called " sporozoites ", probably remain in the skin, but others travel in the bloodstream to the liver , where they invade hepatocytes . They grow and divide in the liver for 2–10 days, with each infected hepatocyte eventually harboring up to 40,000 parasites. The infected hepatocytes break down, releasing these invasive Plasmodium cells, called " merozoites ", into

625-462: A child under five died of malaria in 2021, and "many of these deaths are preventable and treatable". Malaria is commonly associated with poverty and has a significant negative effect on economic development. In Africa, it is estimated to result in losses of US$ 12 billion a year due to increased healthcare costs, lost ability to work, and adverse effects on tourism. The term malaria originates from Medieval Italian : mala aria 'bad air',

750-414: A consistent supply of microscopy slides and stains. In places where microscopy is unavailable, malaria is diagnosed with RDTs, rapid antigen tests that detect parasite proteins in a fingerstick blood sample. A variety of RDTs are commercially available, targeting the parasite proteins histidine rich protein 2 (HRP2, detects P. falciparum only), lactate dehydrogenase , or aldolase . The HRP2 test

875-571: A drastic drop in cases of diarrhea. In 2018, it was replaced by a new program called "Programa Floresta em Pé" ("Standing Forests"). Manaus Manaus ( Portuguese: [mɐˈnaws, ma-] ) is the capital and largest city of the Brazilian state of Amazonas . It is the seventh-largest city in Brazil, with an estimated 2022 population of 2,063,689 distributed over a land area of about 11,401 km (4,402 sq mi). Located at

1000-472: A greater likelihood of complications and death. Malaria infection affects the immune responses following vaccination for various diseases. For example, malaria suppresses immune responses to polysaccharide vaccines. A potential solution is to give curative treatment before vaccination in areas where malaria is present. Due to the non-specific nature of malaria symptoms, diagnosis is typically suspected based on symptoms and travel history, then confirmed with

1125-453: A laboratory test showing hemoglobin levels below 8 grams per deciliter of blood. In areas of the world with little to no malaria, the WHO recommends only testing people with possible exposure to malaria (typically travel to a malaria-endemic area) and unexplained fever. In sub-Saharan Africa, testing is low, with only about one in four (28%) of children with a fever receiving medical advice or

1250-477: A laboratory test to detect the presence of the parasite in the blood (parasitological test). In areas where malaria is common, the World Health Organization (WHO) recommends clinicians suspect malaria in any person who reports having fevers, or who has a current temperature above 37.5 °C without any other obvious cause. Malaria should be suspected in children with signs of anemia : pale palms or

1375-534: A large amount of sweat on the surface of the skin. Due to the high levels of lactic acid released from the human body, it has been hypothesized to represent a specific human host-recognition cue for anthropophilic (attracted to humans) mosquitoes. Pungent foot odor Most studies use human odors as stimuli to attract host seeking mosquitoes and have reported a strong and significant attractive effect. The studies have found human odor samples very effective in attracting mosquitoes. Foot odors have been demonstrated to have

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1500-636: A less pronounced and almost continuous fever. Symptoms typically begin 10–15 days after the initial mosquito bite, but can occur as late as several months after infection with some P. vivax strains. Travellers taking preventative malaria medications may develop symptoms once they stop taking the drugs. Severe malaria is usually caused by P. falciparum (often referred to as falciparum malaria). Symptoms of falciparum malaria arise 9–30 days after infection. Individuals with cerebral malaria frequently exhibit neurological symptoms, including abnormal posturing , nystagmus , conjugate gaze palsy (failure of

1625-568: A major industrial center (the Free Economic Zone of Manaus). The mobile phone companies LG , Nokia , Samsung , Siemens , Sagem , Gradiente , and BenQ-Siemens operate mobile phone manufacturing plants in Manaus. Plastic lens manufacturer Essilor also has a plant here. The Brazilian sport utility vehicle manufacturer Amazon Veiculos is headquartered in Manaus. Two airlines, MAP Linhas Aéreas and Manaus Aerotáxi , have headquarters on

1750-435: A non-invasive way to detect malarial infections. In addition, these volatile compounds were heavily detected by mosquito antennae as an attractant, making the children more vulnerable to the bite of the mosquitos. Fatty acids Fatty acids have been identified as an attractive compound for mosquitoes, they are typically found in volatile emissions from the skin. These fatty acids that produce body odor profiles originate from

1875-559: A part of miasma theory ; the disease was formerly called ague or marsh fever due to its association with swamps and marshland. The term appeared in English at least as early as 1768. Malaria was once common in most of Europe and North America, where it is no longer endemic, though imported cases do occur. The scientific study of malaria is called malariology. Adults with malaria tend to experience chills and fever—classically in periodic intense bouts lasting around six hours, followed by

2000-530: A period of sweating and fever relief—as well as headache, fatigue, abdominal discomfort, and muscle pain . Children tend to have more general symptoms: fever, cough, vomiting, and diarrhea. Initial manifestations of the disease—common to all malaria species—are similar to flu-like symptoms , and can resemble other conditions such as sepsis , gastroenteritis , and viral diseases . The presentation may include headache , fever , shivering , joint pain , vomiting , hemolytic anemia , jaundice , hemoglobin in

2125-562: A postdoctoral scholar at the University of California, Berkeley studying the structural basis of membrane manipulation and cell-cell fusion by bacterial pathogens, discusses studies that determine how odor profiles can be used to diagnose the disease. Within the study, samples of volatile compounds from around 400 children within schools in Western Kenya were collected - to identify asymptomatic infections. These biomarkers have been established as

2250-626: A rapid diagnostic test in 2021. There was a 10-percentage point gap in testing between the richest and the poorest children (33% vs 23%). Additionally, a greater proportion of children in Eastern and Southern Africa (36%) were tested than in West and Central Africa (21%). According to UNICEF, 61% of children with a fever were taken for advice or treatment from a health facility or provider in 2021. Disparities are also observed by wealth, with an 18 percentage point difference in care-seeking behaviour between children in

2375-466: A short time, and a "thin film" of blood, allowing them to clearly see individual parasites and identify the infecting Plasmodium species. Under typical field laboratory conditions, a microscopist can detect parasites when there are at least 100 parasites per microliter of blood, which is around the lower range of symptomatic infection. Microscopic diagnosis is relatively resource intensive, requiring trained personnel, specific equipment, electricity, and

2500-458: A small monthly payment of R$ 50 (US$ 30) to each household in exchange for a commitment to preserve the forest. The stipend is paid to the mothers of families who live in conservation units as a reward for conserving the forest. The association component provides funds to associations of residents of the reserves, who may freely decide how they want to use the funds. The association component, which aims to strengthen community organisation and control of

2625-579: A small proportion of public expenditure on health. In contrast, a similar programme in Tanzania would cost an estimated one-fifth of the public health budget. In 2021, the World Health Organization confirmed that China has eliminated malaria. In 2023, the World Health Organization confirmed that Azerbaijan , Tajikistan , and Belize have eliminated malaria. In areas where malaria is common, children under five years old often have anaemia , which

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2750-510: A way past the net. Insecticide-treated nets (ITNs) are estimated to be twice as effective as untreated nets and offer greater than 70% protection compared with no net. Between 2000 and 2008, the use of ITNs saved the lives of an estimated 250,000 infants in Sub-Saharan Africa. According to UNICEF, only 36% of households had sufficient ITNs for all household members in 2019. In 2000, 1.7 million (1.8%) African children living in areas of

2875-479: Is a feature of blackwater fever , where haemoglobin from lysed red blood cells leaks into the urine. Infection with P. falciparum may result in cerebral malaria, a form of severe malaria that involves encephalopathy . It is associated with retinal whitening, which may be a useful clinical sign in distinguishing malaria from other causes of fever. An enlarged spleen , enlarged liver or both of these , severe headache, low blood sugar , and haemoglobin in

3000-425: Is a plan to restore the city centre to its former glory by removing beggars and irregular sellers from sidewalks and by doing that provide more safety for tourists and locals who are trying to walk in the historical areas of the city. All these plans were prompted by the 2014 World Cup. Manaus is the sixth-largest economy in Brazil. According to IBGE in 2014, its GDP was R$ 67,5 billion. The per capita income for

3125-436: Is a prison, Anisio Jobim Penitentiary Complex. Manaus has research centers, technology and public and private universities. Eduardo Gomes International Airport is the airport serving Manaus. The airport has two passenger terminals, one for scheduled flights and the other for regional aviation. It also has three cargo terminals . Eduardo Gomes International Airport is Brazil's third largest in freight movement, handling

3250-509: Is above the national average, and 10% above the average for the capital (Brasilia). Most of the population is located in the North and East regions of the city, and the New Town (northern area) the neighborhood is the most populous, with more than 260,000 residents. According to the results of the last census, the city's population increased from 343,038 inhabitants in 1960 to 622,733 in 1970. By 1990,

3375-518: Is associated with potentially life-threatening conditions about as often as with a diagnosis of P. falciparum infection. P. vivax proportionally is more common outside Africa. Some cases have been documented of human infections with several species of Plasmodium from higher apes , but except for P. knowlesi —a zoonotic species that causes malaria in macaques —these are mostly of limited public health importance. The Anopheles mosquitos initially get infected by Plasmodium by taking

3500-446: Is caused by six Plasmodium species: P. falciparum , P. malariae , P. ovale curtisi , P. ovale wallikeri , P. vivax and P. knowlesi . Among those infected, P. falciparum is the most common species identified (~75%) followed by P. vivax (~20%). Although P. falciparum traditionally accounts for the majority of deaths, recent evidence suggests that P. vivax malaria

3625-666: Is close to 100%. By the end of 2008, the program covered the Uatumã , Mamirauá , Piagaçu-Purus , Uacari and Cujubim sustainable development reserves and the Catuá-Ipixuna Extractive Reserve . There were plans to extend the program by 2010 to also include Maués State Forest , the Amanã , Juma , Rio Madeira , and Rio Amapá sustainable development reserves and the Rio Gregório Extractive Reserve . As of 2016

3750-465: Is deemed severe when any of the following criteria are present, otherwise it is considered uncomplicated. Cerebral malaria is defined as a severe P. falciparum -malaria presenting with neurological symptoms, including coma (with a Glasgow coma scale less than 11, or a Blantyre coma scale less than 3), or with a coma that lasts longer than 30 minutes after a seizure. Methods used to prevent malaria include medications, mosquito elimination and

3875-531: Is insufficient evidence that mosquito repellents can prevent malaria infection. Insecticide-treated nets (ITNs) and indoor residual spraying (IRS) are effective, have been commonly used to prevent malaria, and their use has contributed significantly to the decrease in malaria in the 21st century. ITNs and IRS may not be sufficient to eliminate the disease, as these interventions depend on how many people use nets, how many gaps in insecticide there are (low coverage areas), if people are not protected when outside of

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4000-597: Is located in the middle of the Amazon Rainforest . The Amazon represents over half of the planet's remaining rainforests and comprises the largest and most species-rich tract of tropical rainforest in the world. Wet tropical forests are the most species-rich biome , and tropical forests in the Americas are consistently more species-rich than the wet forests in Africa and Asia . As the largest tract of tropical rainforest in

4125-451: Is not available. In areas where the disease is common, malaria should be confirmed if possible before treatment is started due to concerns of increasing drug resistance . Resistance among the parasites has developed to several antimalarial medications; for example, chloroquine -resistant P. falciparum has spread to most malarial areas, and resistance to artemisinin has become a problem in some parts of Southeast Asia . The disease

4250-530: Is only paved for about another 100 kilometers (60 mi) to Castanho. After that, the highway is not paved, and cannot be used. Various governments have promised to recover this land-link with the rest of the country, but environmental issues, high costs and complicated logistics have impeded any progress so far. The two major state highways are the AM-010 and the AM-070. The AM-010 heads east, to Itacoatiara, Amazonas at

4375-553: Is operated by wide-body jets. Other freight routes include North America and Europe. The passenger terminal had been fully refurbished and expanded in time for the 2014 FIFA Football World Cup , which held 4 games in Manaus. The airport currently operates daily international flights to Miami and Orlando , United States, by American Airlines and LATAM Airlines Brasil ; to the city of Panama , by Copa Airlines ; and to Barcelona, Venezuela , by Avior Airlines . The airport has direct flights to all major airports in Brazil, operated by

4500-400: Is relatively invisible to immune surveillance. However, circulating infected blood cells are destroyed in the spleen . To avoid this fate, the P. falciparum parasite displays adhesive proteins on the surface of the infected blood cells, causing the blood cells to stick to the walls of small blood vessels, thereby sequestering the parasite from passage through the general circulation and

4625-449: Is sometimes due to malaria. Giving children with anaemia in these areas preventive antimalarial medication improves red blood cell levels slightly but does not affect the risk of death or need for hospitalisation. Vector control refers to methods used to decrease malaria by reducing the levels of transmission by mosquitoes. For individual protection, the most effective insect repellents are based on DEET or picaridin . However, there

4750-408: Is spread exclusively through bites of infected female Anopheles mosquitoes. The mosquito bite introduces the parasites from the mosquito's saliva into a person's blood. The parasites travel to the liver , where they mature and reproduce. Five species of Plasmodium commonly infect humans. The three species associated with more severe cases are P. falciparum (which is responsible for

4875-459: Is today Suriname . The fort was constructed in rock and clay, with four cannons guarding the curtains. It continued to function for more than 100 years. Next to the fort there were many indigenous mestizos , who helped in its construction and began to live in the vicinity. The population grew so much that, in 1695, the missionaries ( Carmelite , Jesuit , Franciscan ) built a nearby chapel dedicated to Nossa Senhora da Conceição (Our Lady of

5000-425: Is typical) to several years. After a period of dormancy, they reactivate and produce merozoites. Hypnozoites are responsible for long incubation and late relapses in P. vivax infections, although their existence in P. ovale is uncertain. The parasite is relatively protected from attack by the body's immune system because for most of its human life cycle it resides within the liver and blood cells and

5125-413: Is typically attributed to treatment failure. People may develop some immunity when exposed to frequent infections. Malaria infection develops via two phases: one that involves the liver (exoerythrocytic phase), and one that involves red blood cells, or erythrocytes (erythrocytic phase). When an infected mosquito pierces a person's skin to take a blood meal, sporozoites in the mosquito's saliva enter

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5250-757: Is widely used in Africa, where P. falciparum predominates. However, since HRP2 persists in the blood for up to five weeks after an infection is treated, an HRP2 test sometimes cannot distinguish whether someone currently has malaria or previously had it. Additionally, some P. falciparum parasites in the Amazon region lack the HRP2 gene, complicating detection. RDTs are fast and easily deployed to places without full diagnostic laboratories. However they give considerably less information than microscopy, and sometimes vary in quality from producer to producer and lot to lot. Serological tests to detect antibodies against Plasmodium from

5375-562: Is widespread in the tropical and subtropical regions that exist in a broad band around the equator . This includes much of sub-Saharan Africa , Asia , and Latin America . In 2022, some 249 million cases of malaria worldwide resulted in an estimated 608,000 deaths, with 80 percent being five years old or less. Around 95% of the cases and deaths occurred in sub-Saharan Africa. Rates of disease decreased from 2010 to 2014, but increased from 2015 to 2021. According to UNICEF, nearly every minute,

5500-767: The Anglican Episcopal Church , the Baptist Church , an Assembly of God Church, the Seventh-day Adventist Church , the Universal Church of the Kingdom of God , and the Jehovah's Witnesses among others. These churches are experiencing considerable growth, mainly in the outskirts of the city. The Church of Jesus Christ of Latter-day Saints also has a large presence, with a LDS temple having been built in

5625-448: The Lineage B.1.1.248 variant starting in early January 2021. The largest city in northern Brazil, Manaus occupies an area of 11,401 square kilometres (4,402 sq mi), with a density of 158.06 inhabitants per square kilometre (409.4/sq mi). It is the neighboring city of Presidente Figueiredo , Careiro , Iranduba , Rio Preto da Eva , Itacoatiara , and Novo Airão . Manaus

5750-789: The National Institute of Amazonian Research , being the most important center for scientific studies in the Amazon region and for international sustainability issues. It was known at the beginning of the century as Heart of the Amazon and City of the Forest. Currently, its main economic engine is the Industrial Park of Manaus, a Free Economic Zone. The city has a free port and an international airport . Its manufactures include electronics, chemical products , and soap; there are distilling and ship construction industries. Manaus also exports Brazil nuts , rubber , jute , and rosewood oil . It has

5875-626: The Teatro Amazonas , was effectively closed for most of the 20th Century. However it was used in scenes of the Werner Herzog film Fitzcarraldo (1982). After a gap of almost 90 years, it reopened to produce live opera in 1997 and is now attracting performers from all over the world. When the seeds of the rubber tree were smuggled out of the Amazon region to be cultivated on plantations in Southeast Asia, Brazil and Peru lost their monopoly on

6000-411: The bone marrow for 11 days, then return to the blood circulation to await uptake by the bite of another mosquito. Once inside a mosquito, the gametocytes undergo sexual reproduction, and eventually form daughter sporozoites that migrate to the mosquito's salivary glands to be injected into a new host when the mosquito bites. The liver infection causes no symptoms; all symptoms of malaria result from

6125-491: The polymerase chain reaction to detect the parasite's DNA have been developed, but they are not widely used in areas where malaria is common, due to their cost and complexity. The risk of disease can be reduced by preventing mosquito bites through the use of mosquito nets and insect repellents or with mosquito-control measures such as spraying insecticides and draining standing water . Several medications are available to prevent malaria for travellers in areas where

6250-589: The Americas, the Amazonian rainforests have unparalleled biodiversity . More than one-third of all species in the world live in the Amazon rainforest. Despite being located in the Amazon, Manaus is densely developed and has few green areas in the city. The largest green areas are: Manaus has a tropical monsoon climate ( Am ) according to the Köppen climate classification system, just dry enough in its driest month to not be

6375-567: The Bolsa Floresta participants. Malaria , diarrhea , influenza and helminthiasis (worm infection) together make up about 95% of diseases in Bolsa Floresta conservation units. The FAS is involved in training health care workers in ways of preventing these diseases, and in developing plans for each conservation unit. For example, distribution of sachets for purifying water in Rio Gregório Extractive Reserve in 2015 resulted in

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6500-472: The Bolsa Floresta program. It is funded by affiliated NGOs, government bodies and private individuals and enterprises. Most of the funding comes from private sources such as Coca-Cola , Samsung , Grupo Abril and Marriott International . The Bolsa Floresta Program (Programa Bolsa Floresta: PBF) has its origins in the Zona Franca Verde initiatives launched in 2003 by The Amazonas State Secretariat of

6625-586: The Conception), who, in time, became the patron saint of the city. A Royal Charter of March 3, 1755 created the captaincy of São José do Rio Negro, with capital in Mariuá (now Barcelos ), but with the governor, Lobo D'Almada, fearing a Spanish invasion, the seat went back to Lugar de Barra in 1791. Being located at the confluence of the Rio Negro and Amazon Rivers, it was a strategic point. On November 13, 1832, Lugar da Barra

6750-739: The Environment and Sustainable Development (SDS) to promote sustainable use of natural resources in order to increase the environmental benefits of the forests. The SDS initiated the program in September 2007 and assigned it to the FAS in March 2008. Bolsa Floresta is the main FAS program. The main funding comes from Bradesco and the Amazon Fund , which is supported by the Brazilian Development Bank (BNDES) and

6875-789: The Gods . The history of the European colonization of Manaus began in 1499 with the Spanish arrival at the mouth of the Amazon River. The Spanish then continued to colonize the region north of Brazil. Development continued in 1668–1669 with the building of the Fort of São José da Barra do Rio Negro by the Portuguese in order to ensure its predominance in the region, especially against the Dutch , at that time headquartered in what

7000-514: The Government of Norway. Deforestation is monitored annually by the FAS, SDS, and analysis of satellite images by partner organisations. The Bolsa Floresta program, which is voluntary, involves families living along the rivers within state-run conservation units in Amazonas. The initial focus on conservation units is due to the availability of an existing legal framework. It is planned is to later extend

7125-643: The Manaus Free Trade Zone Authority, SUBFRAME, was created. SUBFRAME is an independent body with its own legal status and assets and has financial and administrative autonomy. Tax incentives and the subsequent complementary legislation created comparative advantages in the region with respect to other parts of the country and as a result the Manaus Free Trade Zone attracted new investment to the area. These incentives constituted tax exemptions administered federally by SUBFRAME and SUDAM. There

7250-421: The Manaus Free Trade Zone in more concrete terms. The new Decree-Law stipulated that the Manaus Free Trade Zone would have a radius of 10 km (6.2 mi) with an industrial center as well as an agricultural center and that these would be given the economic means to allow for regional development in order to lift the Amazon out of the economic isolation that it had fallen into at that time. On August 28, 1967,

7375-504: The Paris of the Tropics . Many wealthy European families settled in Manaus and brought their love for sophisticated European art , architecture , and culture with them. Manaus was one of the twelve Brazilian host cities of the 2014 World Cup , as well as one of the five subsections of the 2016 Summer Olympics . The name Manaus comes from the native people called Manaós , which means Mother of

7500-405: The absence of Duffy antigens on red blood cells. The impact of sickle cell trait on malaria immunity illustrates some evolutionary trade-offs that have occurred because of endemic malaria. Sickle cell trait causes a change in the haemoglobin molecule in the blood. Normally, red blood cells have a very flexible, biconcave shape that allows them to move through narrow capillaries ; however, when

7625-455: The arrival of migrants from other regions of Brazil. Manaus has the largest neighborhood in Latin America, the neighborhood of Cidade Nova, which has 264,449 inhabitants, but it is estimated that the population exceeds 300,000 inhabitants. Cidade Nova is larger than all the cities inside the rest of Amazonas state. With the permanence and the strengthening of Free Economic Zone of Manaus ,

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7750-499: The banks of the Amazon River, which is the third largest city of the state. The AM-070 heads south, starting on the other side of the new Rio Negro Bridge at Manaus, and reaching Manacapuru , which lies at the banks of the Solimoes River , also known as the upper River Amazon, and which is the fourth largest city of the state. Both roads are paved and operate all year round. Ships dock at the main port in Manaus directly downtown on

7875-669: The banks of the Negro River. The terraced city is home to a network of bridged channels that divide it into several compartments. Several mobile phone companies have manufacturing plants in the port area, and other major electronics manufacturers also have plants there. Major exports going through the port include Brazil nuts, chemicals , petroleum , electrical equipment, and forest products. Regular Manaus taxis are white and can be stopped anywhere. They are organized into separate cooperatives, each with their own contact phone numbers. All taxis are metered, which does not necessarily mean

8000-418: The blood have been developed, but are not used for malaria diagnosis due to their relatively poor sensitivity and specificity. Highly sensitive nucleic acid amplification tests have been developed, but are not used clinically due to their relatively high cost, and poor specificity for active infections. Malaria is classified into either "severe" or "uncomplicated" by the World Health Organization (WHO). It

8125-430: The bloodstream and migrate to the liver where they infect hepatocytes, multiplying asexually and asymptomatically for a period of 8–30 days. After a potential dormant period in the liver, these organisms differentiate to yield thousands of merozoites, which, following rupture of their host cells, escape into the blood and infect red blood cells to begin the erythrocytic stage of the life cycle. The parasite escapes from

8250-540: The bloodstream. In the blood, the merozoites rapidly invade individual red blood cells , replicating over 24–72 hours to form 16–32 new merozoites. The infected red blood cell lyses, and the new merozoites infect new red blood cells, resulting in a cycle that continuously amplifies the number of parasites in an infected person. Over rounds of this infection cycle, a small portion of parasites do not replicate, but instead develop into early sexual stage parasites called male and female " gametocytes ". These gametocytes develop in

8375-408: The brain, they contribute to coma . In the placenta they contribute to low birthweight and preterm labor, and increase the risk of abortion and stillbirth. The destruction of red blood cells during infection often results in anemia, exacerbated by reduced production of new red blood cells during infection. Only female mosquitoes feed on blood; male mosquitoes feed on plant nectar and do not transmit

8500-544: The capital of the State of Roraima and to Venezuela. Strictly speaking, Manaus is connected by road to the rest of Brazil, as it is possible to drive continuously from Manaus into Venezuela, and then reenter Brazil through the BR-364 in Acre and its capital, Rio Branco , therefore passing through the countries of Colombia, Ecuador, and Peru. As such a route is impractical for most motorists,

8625-434: The cause, recurrence can be classified as either recrudescence , relapse , or reinfection. Recrudescence is when symptoms return after a symptom-free period due to failure to remove blood-stage parasites by adequate treatment. Relapse is when symptoms reappear after the parasites have been eliminated from the blood but have persisted as dormant hypnozoites in liver cells. Relapse commonly occurs between 8 and 24 weeks after

8750-584: The city began to receive investments and constant migration of people from many parts of the state and northern Brazil . The wealthiest neighborhood in Manaus is Adrianópolis, located in the Central-South Area of the city. Downtown Manaus is located in the Southern area of the city, next to Rio Negro River . After years of development, the historical center has been neglected by the authorities and it has become an area mostly for commerce and poor housing. There

8875-434: The city centre, simply known as the "Aeroclube" ( Portuguese : Flying club ). On Sundays, it is used for parachuting and where flying classes can be hired. Due to the fact that it is surrounded by residential areas, and has a recent history of crashes, it is under constant pressure to be moved. There are two federal highways that intersect Manaus. There is a paved road heading North (BR-174) connecting Manaus to Boa Vista ,

9000-463: The city has had the highest rate of population growth in recent years, and has the largest neighborhood of the city, the Nova Cidade neighborhood. The Center-South region has the highest per capita income . The Eastern Zone is known for having a large number of hills. The first neighborhood (bairro) established in Manaus was Educandos. From there, other areas of the city began to be occupied since

9125-426: The city was R$ 33,446. Although the main industry of Manaus through much of the 20th century was rubber , its importance has declined. Given its location, fish, wild fruits like Açaí and Cupuaçu, and Brazil nuts initiate important trades, as do petroleum refining, soap manufacturing, and chemical industries. Over the last decades, a system of federal investments and tax incentives has turned the surrounding region into

9250-411: The city, the sixth in Brazil. The Metropolitan Region of Manaus (RMM) is a metropolitan area that comprises eight cities of the Amazonas state, but without conurbation. Manaus is divided into seven regions: North, Southern, Central-South, East, West, Mid-West, and Rural area. The eastern region of the city is the most populated, with approximately 600,000 inhabitants (2007). The northern region of

9375-632: The city. Judaism , Candomblé , Islam , and spiritualism , among others, are also practised. There is a community of Amazonian Jews in Manaus. The city's Catedral Metropolitana Nossa Senhora da Conceição is the seat of the Roman Catholic Archdiocese of Manaus . The city has a very diverse presence of Protestant or Reformed faiths, such as the Presbyterian Church , Calvary Chapel , For Christ International Church of Grace of God, Pentecostal Church of God in Brazil, Methodist Church ,

9500-478: The climate, causing the temperature to drop to 18 °C (64.4 °F) or below. The proximity to the forest usually avoids extremes of heat and makes the city wet. According to the National Institute of Meteorology (INMET), the highest temperature registered in the city was 39 °C (102.2 °F), in 2015 and the lowest was 12 °C (53.6 °F) in 1989. On November 26, 2009, a case of acid rain

9625-521: The development of respiratory distress , which occurs in up to 25% of adults and 40% of children with severe P. falciparum malaria. Possible causes include respiratory compensation of metabolic acidosis , noncardiogenic pulmonary oedema , concomitant pneumonia , and severe anaemia . Although rare in young children with severe malaria, acute respiratory distress syndrome occurs in 5–25% of adults and up to 29% of pregnant women. Coinfection of HIV with malaria increases mortality. Kidney failure

9750-504: The disease in the long run, but the initial costs required are out of reach of many of the world's poorest people. There is a wide difference in the costs of control (i.e. maintenance of low endemicity) and elimination programs between countries. For example, in China—whose government in 2010 announced a strategy to pursue malaria elimination in the Chinese provinces —the required investment is

9875-578: The disease is common. Occasional doses of the combination medication sulfadoxine/pyrimethamine are recommended in infants and after the first trimester of pregnancy in areas with high rates of malaria. As of 2023, two malaria vaccines have been endorsed by the World Health Organization . The recommended treatment for malaria is a combination of antimalarial medications that includes artemisinin . The second medication may be either mefloquine , lumefantrine , or sulfadoxine/pyrimethamine. Quinine , along with doxycycline , may be used if artemisinin

10000-469: The disease months later. In those who have recently survived an infection, reinfection usually causes milder symptoms. This partial resistance disappears over months to years if the person has no continuing exposure to malaria. The mosquito vector is itself harmed by Plasmodium infections, causing reduced lifespan. Human malaria is caused by single-celled microorganisms of the Plasmodium group. It

10125-462: The disease. Females of the mosquito genus Anopheles prefer to feed at night. They usually start searching for a meal at dusk, and continue through the night until they succeed. However, in Africa, due to the extensive use of bed nets, they began to bite earlier, before bed-net time. Malaria parasites can also be transmitted by blood transfusions , although this is rare. Symptoms of malaria can recur after varying symptom-free periods. Depending upon

10250-622: The east boundary of the urban area in its lower section. According to the IBGE in 2019, there were 2,182,763 people residing in the city, and 2,676,936 people in the Metropolitan Region of Manaus . The population density was 191.45 inhabitants per square kilometre (495.9/sq mi). Manaus is the seventh largest city in Brazil , after São Paulo , Rio de Janeiro , Salvador , Brasília , Fortaleza and Belo Horizonte . The city's population growth

10375-593: The east centre of the state, the city is the centre of the Manaus metropolitan area and the largest metropolitan area in the North Region of Brazil by urban landmass. It is situated near the confluence of the Negro and Amazon rivers. It is one of the two cities in the Amazon Rainforest with a population of over 1 million people, alongside Belém . The city was founded in 1669 as the Fort of São José do Rio Negro. It

10500-494: The eyes to turn together in the same direction), opisthotonus , seizures , or coma . Diagnosis based on skin odor profiles Humans emanate a large range of smells. Studies have been conducted on how to detect human malaria infections through volatile compounds from the skin - suggesting that volatile biomarkers may be a reliable source for the detection of infection, including those asymptomatic. Using skin body odor profiles can be efficient in diagnosing global populations, and

10625-442: The frequency with which malaria parasites complete their life cycle in the cell. Individuals who are homozygous (with two copies of the abnormal haemoglobin beta allele ) have sickle-cell anaemia , while those who are heterozygous (with one abnormal allele and one normal allele) experience resistance to malaria without severe anaemia. Although the shorter life expectancy for those with the homozygous condition would tend to disfavour

10750-514: The grounds of Eduardo Gomes International Airport in Manaus. The initial idea of a Free Trade Port in Manaus came from Deputy Francisco Pereira da Silva and was subsequently formalized by Law No. 3.173 on June 6, 1957. The project was approved by the National Congress on October 23, 1951, under No. 1.310 and regulated by Decree No. 47.757 on February 2, 1960. It was then amended by rapporteur Maurício Jopper, an engineer, who by agreement with

10875-399: The highest attractiveness to anthropophilic mosquitoes. Some of these studies have included traps that had been baited with nylon socks previously worn by human participants and were deemed efficient in catching adult mosquitos. Foot odors have high numbers of volatile compounds, which in turn elicit an olfactory response from mosquitoes. Malaria has several serious complications , including

11000-429: The home, and an increase in mosquitoes that are resistant to insecticides. Modifications to people's houses to prevent mosquito exposure may be an important long term prevention measure. Mosquito nets help keep mosquitoes away from people and reduce infection rates and transmission of malaria. Nets are not a perfect barrier and are often treated with an insecticide designed to kill the mosquito before it has time to find

11125-492: The import and export demand from the Manaus Industrial Complex . For this reason, Infraero invested in the construction of the third cargo terminal, opened on December 14, 2004. TAM Airlines also inaugurated its own cargo terminal near the airport in 2008, which claims to be the largest cargo terminal in Brazil. The country's major dedicated freight route is between Manaus and Viracopos International Airport , which

11250-423: The infection of red blood cells. Symptoms develop once there are more than around 100,000 parasites per milliliter of blood. Many of the symptoms associated with severe malaria are caused by the tendency of P. falciparum to bind to blood vessel walls, resulting in damage to the affected vessels and surrounding tissue. Parasites sequestered in the blood vessels of the lung contribute to respiratory failure . In

11375-502: The initial symptoms and is often seen in P. vivax and P. ovale infections. P. vivax malaria cases in temperate areas often involve overwintering by hypnozoites, with relapses beginning the year after the mosquito bite. Reinfection means that parasites were eliminated from the entire body but new parasites were then introduced. Reinfection cannot readily be distinguished from relapse and recrudescence, although recurrence of infection within two weeks of treatment ending

11500-634: The liver undetected by wrapping itself in the cell membrane of the infected host liver cell. Within the red blood cells, the parasites multiply further, again asexually, periodically breaking out of their host cells to invade fresh red blood cells. Several such amplification cycles occur. Thus, classical descriptions of waves of fever arise from simultaneous waves of merozoites escaping and infecting red blood cells. Some P. vivax sporozoites do not immediately develop into exoerythrocytic-phase merozoites, but instead, produce hypnozoites that remain dormant for periods ranging from several months (7–10 months

11625-431: The metabolism of glycerol, lactic acid, amino acids, and lipids - through the action of bacteria found within the skin. They create a “chemical signature” for the mosquitoes to locate a potential host, humans in particular. Lactic acid Lactic acid, a naturally produced levorotatory isomer, has been titled an attractant of mosquitoes for a long time. Lactic acid is predominantly produced by eccrine-sweat glands, creating

11750-489: The meter will be used. Malaria Malaria is a mosquito-borne infectious disease that affects vertebrates and Anopheles mosquitoes. Human malaria causes symptoms that typically include fever , fatigue , vomiting , and headaches . In severe cases, it can cause jaundice , seizures , coma , or death . Symptoms usually begin 10 to 15 days after being bitten by an infected Anopheles mosquito . If not properly treated, people may have recurrences of

11875-456: The military dictatorship in Brazil, the newly installed government concerned about the "demographic gap in Brazil", began to introduce numerous projects in the interior of the country, especially in the Amazon region, with the introduction of the Manaus free trade zone in 1967, and with the opening of new roads within the region, the city had a wide period of investments in financial and economic capital, both national and international, attracted by

12000-504: The modified haemoglobin S molecules are exposed to low amounts of oxygen, or crowd together due to dehydration, they can stick together forming strands that cause the cell to distort into a curved sickle shape. In these strands, the molecule is not as effective in taking or releasing oxygen, and the cell is not flexible enough to circulate freely. In the early stages of malaria, the parasite can cause infected red cells to sickle, and so they are removed from circulation sooner. This reduces

12125-549: The original author, justified the creation of a Free Trade Zone instead of a Free Trade Port. For the first ten years, the ZFM (Manaus Free Trade Zone) was located in a warehouse rented from Manaus Harbour, in the Port of Manaus, and relied on federal funds. It was perhaps due to this lack of its own resources that there was little credibility in the project. On February 28, 1967, President Castelo Branco signed Decree-Law No. 288, which redefined

12250-556: The other host cities. A massive prison riot occurred in January 2017 , having begun in Manaus and later spreading to two additional cities in Brazil, thus unleashing security problems within the country. During the COVID-19 pandemic in Brazil , an estimated 76% of the population of Manaus was infected with coronavirus, and the possibility of herd immunity was discussed. However, a second outbreak infected people in Manaus, this time with

12375-624: The parasite eventually disappears from that area, as happened in North America, Europe, and parts of the Middle East. However, unless the parasite is eliminated from the whole world, it could re-establish if conditions revert to a combination that favors the parasite's reproduction. Furthermore, the cost per person of eliminating anopheles mosquitoes rises with decreasing population density, making it economically unfeasible in some areas. Prevention of malaria may be more cost-effective than treatment of

12500-471: The population grew to 1,025,979 inhabitants, increasing its density to 90 inhabitants per square kilometre (230/sq mi). According to a 2013 genetic study, the ancestry of the inhabitants of Manaus is 45.9% European, 37.8% Native American, and 16.3% African. The city has been influenced by Catholicism since the time of European colonialism, and the majority of Manauenses are Catholic —there are nevertheless dozens of different Protestant denominations in

12625-589: The population of the then state of Grão-Pará from about 100,000 to 60,000. The involvement of rebels from the Upper Amazon (Manaus today) in what was originally a movement based in Belém was crucial for the birth of the current state of the Amazon. During the brief period of revolution, the Cabanos of the Upper Amazon, bands of rebels, roamed throughout the region, occupying Manaus twice, and, in most settlements, their arrival

12750-451: The prevention of bites. As of 2023, there are two malaria vaccines , approved for use in children by the WHO: RTS,S and R21 . The presence of malaria in an area requires a combination of high human population density, high Anopheles mosquito population density and high rates of transmission from humans to mosquitoes and from mosquitoes to humans. If any of these is lowered sufficiently,

12875-528: The primary forest, and permanent enrolment of children in school. The basic goal is to improve the quality of life by valuing the standing forest. Bolsa Floresta imposes slightly more stringent rules than those set out in the conservation unit management plans. The family must join the reserve association and pay the association fee, must send their children to school, cannot increase the area under cultivation and can only clear secondary growth for crop rotation. However, enrolment in Bolsa Floresta by eligible families

13000-400: The product. The rubber boom ended abruptly, many people left its major cities, and Manaus fell into poverty. The rubber boom had made possible electrification of the city before it was installed in many European cities, but the end of the rubber boom made the generators too expensive to run. The city was not able to generate electricity again for years. In the 1960s during the establishment of

13125-486: The program to other areas. The formal income of most of the eligible families would place them at the extreme poverty level. However, this is raised considerably after accounting for the value of slash-and-burn cultivation of cassava, hunting, fishing and collection of forest products. The program provides social benefits and support for community associations in return for participation in workshops on environmental services, commitment not to open new areas of cultivation in

13250-732: The program was operating in fifteen conservation units covering a total of more than 100,000 square kilometres (39,000 sq mi). Of these the Juma Sustainable Development Reserve was a certified REDD+ initiative and the other fourteen were in the REDD+ readiness phase. The program has four components: income, family, association and social. The income component of the program supports sustainable income-generation activities including local processing of products to add value, ecotourism, fish farming, natural honey production and breeding of small livestock. The family component gives

13375-431: The program, is equal to about 10% of the family component. The social component, coordinated with government institutions, improves education, sanitation, health, communications and transport infrastructure. Health is seen as an essential part of the program, since the other benefits have limited value if not accompanied by improved health. The program works with other state and private organisations to improve health among

13500-411: The richest (71%) and the poorest (53%) households. Malaria is usually confirmed by the microscopic examination of blood films or by antigen -based rapid diagnostic tests (RDT). Microscopy—i.e. examining Giemsa -stained blood with a light microscope —is the gold standard for malaria diagnosis. Microscopists typically examine both a "thick film" of blood, allowing them to scan many blood cells in

13625-458: The rubber barons. "If one rubber baron bought a vast yacht, another would install a tame lion in his villa, and a third would water his horse on champagne." The city built a grand opera house, with vast domes and gilded balconies, and using marble, glass, and crystal, from around Europe. The opera house cost ten million (public-funded) dollars. In one season, half the members of one visiting opera troupe died of yellow fever . The opera house, called

13750-437: The screening and monitoring of infection to officially eradicate malaria. Research findings have predominantly relied on chemical explanations to explain the differences in attractiveness among humans based on distinct odor profiles. The existence of volatile compounds, like fatty acids, and lactic acid is an essential reason on why some individuals are more appealing to mosquitos than others. Volatile compounds Kanika Khanna,

13875-475: The smoke from forest fires. The urban area covers all or part of four river basins, all tributaries of the Rio Negro. The São Raimundo and Educandos streams are completely contained in the city. The Tarumã Açu forms the western boundary of the city in its lower reaches, and is fed by several tributaries that originate in the Ducke Reserve and run through the north and west of the city. The Puraquequara forms

14000-563: The spleen. The blockage of the microvasculature causes symptoms such as those in placental malaria. Sequestered red blood cells can breach the blood–brain barrier and cause cerebral malaria. Due to the high levels of mortality and morbidity caused by malaria—especially the P. falciparum species—it has placed the greatest selective pressure on the human genome in recent history. Several genetic factors provide some resistance to it including sickle cell trait , thalassaemia traits, glucose-6-phosphate dehydrogenase deficiency , and

14125-401: The tax incentives granted by the free zone, in this period, Manaus had enormous demographic growth becoming one of the most populous cities in Brazil. Manaus was one of the host cities of the 2014 FIFA World Cup and one of the seats of some Olympic football games. It was the only host city in the Amazon rainforest and the most geographically isolated, being further north and west than any of

14250-635: The three major carriers: Gol Transportes Aéreos , TAM Airlines , and Azul Brazilian Airlines . The airport's IATA code is MAO. Manaus Air Force Base - ALA8 , one of the most important bases of the Brazilian Air Force , is located in Manaus at the former Ponta Pelada Airport . Apart from the Eduardo Gomes International Airport and Ponta Pelada Airport, Manaus is also served by Flores Airport , used by small propeller aircraft and helicopters about 6 kilometres (4 miles) north of

14375-548: The trait's survival, the trait is preserved in malaria-prone regions because of the benefits provided by the heterozygous form. Liver dysfunction as a result of malaria is uncommon and usually only occurs in those with another liver condition such as viral hepatitis or chronic liver disease . The syndrome is sometimes called malarial hepatitis . While it has been considered a rare occurrence, malarial hepatopathy has seen an increase, particularly in Southeast Asia and India. Liver compromise in people with malaria correlates with

14500-415: The urine with kidney failure may occur. Complications may include spontaneous bleeding, coagulopathy , and shock . Malaria during pregnancy can cause stillbirths , infant mortality , miscarriage , and low birth weight , particularly in P. falciparum infection, but also with P. vivax . Malaria is caused by infection with parasites in the genus Plasmodium . In humans, malaria

14625-424: The urine , retinal damage , and convulsions . The classic symptom of malaria is paroxysm —a cyclical occurrence of sudden coldness followed by shivering and then fever and sweating, occurring every two days ( tertian fever ) in P. vivax and P. ovale infections, and every three days ( quartan fever ) for P. malariae . P. falciparum infection can cause recurrent fever every 36–48 hours, or

14750-401: The vast majority of malaria deaths), P. vivax , and P. knowlesi (a simian malaria that spills over into thousands of people a year). P. ovale and P. malariae generally cause a milder form of malaria. Malaria is typically diagnosed by the microscopic examination of blood using blood films , or with antigen-based rapid diagnostic tests . Methods that use

14875-509: The vast majority of transportation to and from Manaus is by boat or plane, except for journeys to Roraima . The Independent noted that "there are still no roads to Manaus" from the rest of the country. The BR-319 heads South connecting Manaus to Porto Velho , the state capital of Rondônia . However, access to this highway requires a ferry crossing to Careiro , across the Rio Negro and Amazon River , which takes about 40 minutes, and then

15000-427: The world where malaria is common were protected by an ITN. That number increased to 20.3 million (18.5%) African children using ITNs in 2007, leaving 89.6 million children unprotected and to 68% African children using mosquito nets in 2015. The percentage of children sleeping under ITNs in sub-Saharan Africa increased from less than 40% in 2011 to over 50% in 2021. Most nets are impregnated with pyrethroids ,

15125-568: The year. There have been occasional occurrences of hail in the city. Due to the city's proximity to the equator , the heat is constant in the local climate. There are no cold days in winter, and rarely very intense polar air masses in the South-Central part of Brazil and in the southwest of the Amazon have some effect on the city, as occurred in August 1955. But although they are rare, they influence

15250-541: Was elevated to town status and named Manaus. On October 24, 1848, under Law 145 of the Provincial Assembly of Para, it was renamed the City of Barra do Rio Negro. On September 4, 1856, the governor, Herculano Ferreira Pena, finally gave it the name "Manaus". The Cabanagem was the revolt in which blacks, Native Americans, and mestizos fought against the white political elite and took power in 1835. The Cabanagem reduced

15375-519: Was elevated to a town in 1832 with the name of "Manaus", an altered spelling of the indigenous Manaós peoples, and legally transformed into a city on October 24, 1848, with the name of Cidade da Barra do Rio Negro , Portuguese for "The City of the Margins of the Black River". On September 4, 1856, it returned to its original name. Manaus is located in the center of the Amazon rainforest , and home to

15500-515: Was greeted by the non-white population spontaneously joining their ranks, leading to a greater number of adherents to the movement. With that there was an integration of people in the region thus forming the state. Manaus was at the center of the Amazon region's rubber boom during the late 19th century. For a time, it was "one of the gaudiest cities of the world". Historian Robin Furneaux wrote of this period, "No extravagance, however absurd, deterred"

15625-472: Was recorded in Manaus. Air pollution, caused in large part by the accumulation of smoke from burning, associated with the sulfur dioxide emitted by cars, was the cause of this phenomenon. Although the incidence of acid rain is common in some Brazilian capitals where there is a great concentration of cars, in Manaus and other cities of the Amazonas the situation is aggravated by the prolonged period of drought with

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