GEO Brasil - UNEP

123 Infectious and parasitic diseases
The widely accepted model for infectious diseases in the
1970s and 1980s – called epidemiological transition –
presupposed that these diseases would soon cease to be
relevant and be replaced as health problems for diseases
caused by lifestyles and change in habits, specially those
related to the consumption of industrialised products, which
promote the development of non-communicable chronic
diseases This model was reconsidered during the past
decade, specially in developing countries, where infectious/
parasitic and chronic diseases both occur, overlapping
throughout time While analysing the magnitude of
infectious and parasitic diseases, its expression at the
regional and local level should be considered, in view of the
complexity of its social and biological determinants and
the environmental factors conditioning their occurrence
few years were characterised by a gradual increase of these
diseases, both recently originated (emergent), and those of
an older nature (re-emergent)
According to data published by the Ministry of Health/
FUNASA in 2002, since the beginning of the 1980s and
specially in recent years, there has been an increase of
various endemic diseases in the country, such as: malaria,
tuberculosis and Hansen’s disease, several outbreaks or
epidemics, such as meningococcal meningitis, cholera,
dengue, leptospirosis, leishmaniasis, yellow fever, in addition
to the dissemination of AIDS, and other diseases not very
well known up to that moment, such as hantavirus The
increased occurrence of these endemic diseases
contributed towards consolidating society’s impression –
and among health professionals – that public health
services, such as they are currently organised, can no longer
contain the advance of these problems (Tables 2, 3 and 4)
the state of the environment in Brazil
Today, it is acknowledged that the life conditions no longer
offer guarantees against the dissemination of infectious
agents, even in developed countries Acceptance of this
presupposition leads to a rather pessimistic perspective as
for the behaviour of endemic communicable diseases in
peripheral countries, where basic issues such as
malnutrition, environmental sanitation, adequate housing
conditions, vector control and access to basic health care,
have not been satisfactorily addressed yet Thus, the past
The increased incidence of these diseases did not happen
uniformly throughout the entire country As for dengue and
malaria, Tables 3 and 4 show, respectively, the geographic
differences in their transmissions during that period For
dengue, the incidence rate predominates in the Northeast
and Central West, and it is also high in the Southeast Malaria
has high incidence rates in the Amazon and in the Central
West, specially in the 1990s The significant increase in
malaria rates, specially in the Central West, is linked to the
expansion of gold exploration in that region during that
Table2-Timeevolution of the main infectious and parasitic diseases registered in Brazil during the 1980s and
1990s.
Disease
AIDS
Cholera
Dengue
Meningococcal Disease
Yellow Fever
Hansen’s Disease
Hantavirus Infections
American tegumentary leishmaniasis
Visceral leishmaniasis
Leptospirosis
Malaria (all forms)
Tuberculosis
1980/84 1985/89 subtotal 1990/94 1995/99 subtotal
191 15,630 15,821 71,443 107,493 178,936
0 0 0 151,339 16,380 167,719
11,000 141,663 152,663 211,448 1,346,469 1,557,917
6,771 12,743 19,514 26,631 30,109 56,740
122 67 189 131 132 263
86,294 111,841 198,135 158,800 203,963 362,763
0 0 0 3 41 44
26,802 101,784 128,586 140,428 151,321 291,749
4,991 8,003 12,994 11,031 15,772 26,803
0 7,179 7,179 12,138 20,072 32,210
1,264,903 2,489,008 3,753,911 2,713,818 2,518,373 5,232,191
422,024 412,637 834,461 396,127 421,883 818,010
Fonte: MS/FUNASA - 2001
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