Migração interna e a distribuição da mortalidade por doença de Chagas, Brasil, 1981/1998

Migration among individuals with leprosy: a population-based study in Central Brazil

“…We also found that after diagnosis migration was significantly associated with prior migration, consistent with findings in other studies 30 . Migration can additionally place resident populations at risk, and in Brazil migration has been considered as a possible explanation for diseases, such as leishmaniasis, schistosomiasis and Chagas disease, that have moved into previously non-endemic areas 5,7,8,9,10 . We found that much of the migration in the five years prior to diagnosis was within the endemic cluster in Tocantins and also other states, primarily neighboring Maranhão and Pará.…”

“…Migration has been identified as one of the social determinants that can influence health and risk for neglected tropical diseases (NTDs) 1,2 , and is considered a possible factor in leprosy susceptibility and distribution in Brazil 3,4 . Other neglected diseases have also been associated with population movement, including leishmaniasis 5,6 schistosomiasis 7,8,9 , and Chagas disease 10 . Migration can increase the risk of NTD transmission and susceptibility, as non-immune migrants move into areas of NTD endemicity, and infected migrants may return to non-endemic areas through circular migration or permanent movement 5,7 .…”

Tendência da mortalidade relacionada à doença de Chagas, Estado de São Paulo, Brasil, 1985 a 2006: estudo usando causas múltiplas de morte

“…Essa queda foi maior que a de 47,83% observada entre os triênios de 1981 a 1983 e 1996 a 1998 para a Região Sudeste (39), cujo valor é ponderado, em grande parte, pelos coeficientes do Estado de São Paulo. Do mesmo modo, a tendência de queda confirma-se na comparação entre a mortalidade proporcional de 0,72% nos 22 anos estudados e a de 1,04% encontrada de 1981 a 1998 (39). Ressalve-se a influência sobre essa tendência da reduzida proporção de 12,71% de mortes em que a doença de Chagas ocorreu como causa associada, apesar do aumento de seu número e da mortalidade proporcional correspondente no período.…”

Chagas disease in the State of Pernambuco, Brazil: analysis of admissions and mortality time series

“…Neither will it exclude deaths from Chagas disease of patients who came to reside in that state during the period studied. While investigating mortality rates for the disease from 1981 to 1998 in Brazil, Drumond & Marcopilo 16 verified that 32% of those who died were born in states other than their state of residence, which reflects the extensive internal migration that occurred during the period. Data analysis by place of infection may allow this bias to be corrected; however, many carriers only discover that they have the disease long after they initially acquired the parasite and vast majority does not have precise information concerning the circumstances of their contact with T. cruzi.…”