Article
Successes and failures in the control of infectious diseases in Brazil: social and environmental context, policies, interventions, and research needs
Registration in:
BARRETO, Mauricio L. et al. Successes and failures in the control of infectious diseases in Brazil: social and environmental context, policies, interventions, and research needs. Lancet, London, v. 377, p. 1877–89, 2011.
0140-6736
DOI:10.1016/S0140- 6736(11)60202-X
Author
Barreto, Maurício Lima
Teixeira, M. Gloria
Bastos, Francisco Inácio Pinkusfeld Monteiro
Ximenes, Ricardo Arraes de Alencar
Barata, Rita de Cássia Barradas
Rodrigues, Laura C.
Abstract
Despite pronounced reductions in the number of deaths due to infectious diseases over the past six decades, infectious
diseases are still a public health problem in Brazil. In this report, we discuss the major successes and failures in the
control of infectious diseases in Brazil, and identify research needs and policies to further improve control or interrupt
transmission. Control of diseases such as cholera, Chagas disease, and those preventable by vaccination has been
successful through effi cient public policies and concerted eff orts from diff erent levels of government and civil society. For
these diseases, policies dealt with key determinants (eg, the quality of water and basic sanitation, vector control), provided
access to preventive resources (such as vaccines), and successfully integrated health policies with broader social policies.
Diseases for which control has failed (such as dengue fever and visceral leishmaniasis) are vector-borne diseases with
changing epidemiological profi les and major diffi culties in treatment (in the case of dengue fever, no treatment is
available). Diseases for which control has been partly successful have complex transmission patterns related to adverse
environmental, social, economic, or unknown determinants; are sometimes transmitted by insect vectors that are diffi cult
to control; and are mostly chronic diseases with long infectious periods that require lengthy periods of treatment.
Subjects
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