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Yanomamis concentrated almost 10% of malaria cases in 2022 in Brazil


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Of the 123,151 cases of malaria registered in Brazil last year, 11,530 occurred in the Yanomami territory, which is experiencing a national health emergency decreed by the Ministry of Health last Friday (20).

The numbers, which are from the Sivep-Malaria (Malaria Epidemiological Surveillance Information System) and preliminary ones, indicate that diagnoses of the disease among the Yanomami represent 9.3% of the total observed in the country.

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Despite concentrating this volume of records of the disease, these indigenous people are a much smaller slice in Brazil: the Yanomamis are about 0.013% of the country’s population.

Malaria is caused by protozoa transmitted to humans through mosquito bites. After 30 minutes in the human organism, the parasites enter the liver and remain there for about 15 days. Afterwards, it invades the bloodstream and then the symptoms begin to appear. Fever, headache and chills are the main ones.

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It is also from the blood that a new transmission cycle can occur, since a mosquito can bite the infected person, sucking the protozoa present in that bloodstream. After a certain period, this mosquito can transmit the protozoan to other people, spreading the disease.

This cycle demonstrates the importance of early diagnosis, says Rodrigo de Souza, professor of postgraduate health sciences at the Federal University of Acre (UFAC). He explains that the more days someone spends with the disease without treatment, the greater the risk of spreading malaria through the mosquitoes that can bite it and, thus, take it to other people.

The point is worrying when one sees the reality of Brazilian indigenous villages, with problems such as malnutrition, which worsens the clinical condition of patients. Access to health services also tends to be more precarious in these locations. The picture delays the diagnosis, the treatment of the patient and, consequently, increases the chances of transmission of the infection.

Another problem is in relation to the vaccine.

In 2021, the WHO (World Health Organization) approved an immunizer against malaria with an effectiveness of about 50% to prevent serious forms of infection.

However, Souza says that the drug is recommended for the type of falciparum malaria, which is more prevalent in Africa, but not for the type of disease that circulates most in Brazil, called vivax.

The professor also draws attention to another aspect of the disease: the way it enters indigenous territories. According to him, not all communities live with the protozoan. “There are indigenous villages where […] a case rarely happens.”

One of the most common entry points for malaria for these peoples is through illegal mining. “When we talk about illegal mining, you can be sure that it is associated with malaria. It walks around in there”, says the professor.

He says that prospectors are constantly on the move: they go to regions to prospect and then move on to other locations. “They keep bringing malaria to these places.”

In this scenario, indigenous populations that have not had previous contact with the disease are at greater risk of suffering from malaria.

André Siqueira, a tropicalist physician and researcher at INI/Fiocruz (Evandro Chagas National Institute of Infectology), also mentions the fact that miners can have the disease and not receive adequate treatment. This leads to greater chances of parasite circulation in these communities.

The violence involved in illegal mining activities can also be associated with the interruption of health services, which results in difficulty in accessing proper diagnosis and treatment, providing an environment for new cases of the disease.

Among the Yanomami, the presence of prospectors was already reported by the indigenous people. The impact of their actions in the territory is now being investigated: an inquiry was launched to find out whether there was a crime of genocide against the Yanomami, focusing on the responsibility of prospectors, mining logistics operators, indigenous health coordinators and political agents.

But the circumstance is not seen only in this people. Data from Sivep-Malária show that indigenous areas concentrated around 28% of malaria cases in Brazil in 2022. Meanwhile, information from the 2010 census by the IBGE indicated that indigenous people represented only 0.26% of the Brazilian population.

“This illustrates the difficulty of controlling and managing malaria in indigenous areas”, says Siqueira.

For the researcher, the solution permeates policies in two equally necessary areas. “In addition to restructuring all assistance and surveillance actions, containing illegal activities is essential.”

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