Dengue and TB: A Two-Front Battle in Brazil

    Brazil government’s actions to control dengue resulted in a 73.3% reduction in the incidence of the disease in the first half of 2004, in comparison with the same period last year.

    Data from the Ministry of Health’s Secretariat of Health Surveillance show that 84.535 people contracted dengue in the first six months of this year, as against the 299,764 cases reported in the first half of 2003.


    The only Brazilian state in which the number of reported cases of dengue increased (by 31.4%) was Amapá, where 2,276 people were infected.


    The Ministry of Health provided guidance to the state and redirected equipment for the application of insecticides, as well as other measures to keep the disease from spreading.


    In the South, which reported 303 cases, the reduction amounted to 96.9%.


    The Northeast, with 25,110 cases, showed a 83.3% decrease.


    The decline in the Southeast was 64.8%, with 29,084 cases reported in the first half of 2004.


    In the Center-West, with 12,595 victims, there was a 57.7% drop.


    In the North, with 12,928 cases, the reduction came to 50.5%.


    Tuberculosis Still Serious


    With an estimated 50 million people (out of a population of 170 million) infected with the Koch bacillus, the bacteria that causes tuberculosis, Brazil still has a long way to go to win the fight against the disease.


    The disease will not develop in all of those people, but Brazil gets around 119,000 new tuberculosis cases annually.


    And although the disease is curable, 6,000 people die of tuberculosis in Brazil each year.


    All of which is why Brazil is in 15th place on a World Health Organization list of countries that need to do more in diagnosing and treating tuberculosis.


    Minister of Health, Humberto Costa, calls Brazil’s position on the list “uncomfortable, especially because the country has high levels of development in so many other areas.”


    The government’s goal is to reverse the situation by investing some US$ 40 million (120 million reais) between now and the year 2007 to improve data on the disease, along with its diagnosis and treatment.


    Meanwhile the country’s best laboratories are trying to do something about the problem.


    A Better Vaccine


    Two of Brazil’s most prestigious biology research centers, the Fundação Oswaldo Cruz (Fiocruz) and Fundação Ataulpho de Paiva (FAP) have just announced that they will seek to map the genetic sequence of the tuberculosis bacillus used in the vaccine known as BCG Moreau.


    According to an explanation by Fiocruz, the mapping will make it possible to develop more efficient vaccines with fewer collateral effects.


    Luiz Roberto Castello Branco, scientific director at FAP, says that the Brazilian vaccine now used was developed in 1930 and is no longer efficient against some more resistant strains.


    “But even so, our vaccine is considered the best in the world in terms of immunization efficiency and lack of collateral effects,” he explains.


    The Fiocruz-FAP genetic sequencing project will cost an estimated US$ 170,000 (500,000 reais) and should be completed in early 2005.


    Attempts will be made during the process to develop other so-called modified vaccines, which can be used for protection against other diseases.


    The scientists will also be trying to discover why BCG (which stands for an attenuated tubercle bacilli strain named Bacillus Calmette-Guerin) can provide partial immunity against leprosy and is efficient in treating asthma and superficial bladder cancer.


    Protecting Brazil


    Brazil needs an efficient tuberculosis vaccine. This year FAP will produce 17 million vaccines. According to Ministry of Health data, every year Brazil has 100,000 new cases. And with the appearance of drug resistant strains the need becomes urgent.


    The World Health Organization (WHO) reports that a new resistant strain is on the move after appearing in China and other parts of eastern Asia.


    WHO considers drug resistant tuberculosis to be a major threat to public health worldwide and has called on governments to implement special measures to monitor and treat the disease.


    Agência Brasil

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