Malária e migração no Amapá: projeção espacial num contexto de crescimento populacional

Abstract

Malaria is still a serious public health problem, which continues to affect groups of the population living in the Amazon region. The main affected groups live in settlement areas and in artesanal gold mining camps (garimpos). This work aimed to analyze the relationship between the spread of the disease and the migratory process that leads people without any immunity against malaria to the areas of settlement and garimpos. This work also approached issues such as occupational activities, housing, and imported malaria cases from the international frontier with the Guyana. This study focused in the state of Amapa, specifically in the municiples of Ferreira Gomes, Porto Grande, Pedra Branca do Amapari, Serra do Navio, and Oiapoque where, from 1990 to 2003, the highest annual incidences of Plasmodium falciparum have been recorded for the urban sector, settlements, and garimpos. Both the exploratory/descriptive and ecological analysis systems were combined to describe the geographic areas. The data obtained by the Malaria Information System (SISMAL) and Epidemiological Watch System (SIVEP) supported the quantitative analysis and the qualitative approach of the malaria epidemics in the study area. Thematic maps were generated from geographic information system (GIS) data of the population under study and used the ArquiGiz system and the digital cartographic database of the Secretary for the Environment (SEMA). These maps allowed the spatial description, analysis, and discussion of the observed phenomena. The results lead to the conclusion that the occupational activity and housing have a direct relationship with the incidence of malaria. During the period under study, despite the policies used to control malaria, the studied areas remained as high-risk areas, and infection by P. falciparum increased, mainly in the geographic area of Oiapoque, an international frontier, where the imported cases presented the same tendency.