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  1. Co-infection with malaria and HIV in injecting drug users in Brazil : a new challenge to public health ?

    Article - En anglais

    Aims

    To describe AIDS and malaria geography in Brazil, highlighting the role of injecting drug users (IDUs) in malaria outbreaks occurring in malaria-free regions, and the potential clinical and public health implications of malaria/HIV co-infection.

    Design

    Review of the available literature and original analyses using geoprocessing and spatial analysis techniques.

    Findings

    Both HIV/AIDS and malaria distribution are currently undergoing profound changes in Brazil, with mutual expansion to intersecting geographical regions and social networks.

    Very recent reports describe the first clinical case of AIDS in a remote Amazonian ethnic group, as well as malaria cases in Rio de Janeiro state (hitherto a malaria-free area for 20 years) ; in addition, two outbreaks of both infections occurred at the beginning of the 1990s in the most industrialized Brazilian state (Sao Paulo), due to the sharing of needles and syringes by drug users.

    Spatial data point to 

    (a) the expansion of HIV/AIDS towards malarigenic areas located in the centre-west and north of Brazil, along the main cocaine trafficking routes, with IDU networks apparently playing a core role ; and (b) the possibility of new outbreaks of secondary malaria in urban settings where HIV/AIDS is still expanding, through the sharing of needles and syringes. (...)

    Mots-clés Pascal : Toxicomanie, Association morbide, SIDA, Virose, Infection, Asymptomatique, Paludisme, Protozoose, Parasitose, Variation géographique, Brésil, Amérique du Sud, Amérique, Santé mentale, Homme, Immunopathologie, Immunodéficit

    Mots-clés Pascal anglais : Drug addiction, Concomitant disease, AIDS, Viral disease, Infection, Asymptomatic, Malaria, Protozoal disease, Parasitosis, Geographical variation, Brazil, South America, America, Mental health, Human, Immunopathology, Immune deficiency

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0398437

    Code Inist : 002B18C05A. Création : 22/03/2000.