The Epidemiological Impact of STIs among General and Vulnerable Populations of the Amazon Region of Brazil: 30 years of Surveillance

Abstract

Sexually transmitted infections (STIs) represent a worldwide public health problem and, although many of them are curable, they continue to be neglected, especially in areas with a low human development index, such as in the northern region of Brazil. This review describes the results of 30 years of studies at the Virus Laboratory at the Federal University of Pará, including the prevalence and molecular epidemiology of HIV-1, HTLV-1/2, HPV, HBV, Treponema pallidum and Chlamydia trachomatis among urban and non-urban populations, and also in vulnerable groups in the Brazilian Amazon. Control strategies and challenges in preventing STIs are discussed considering this immense geographic region, where essential health services are unable to reach the entire population, especially the most vulnerable, such as female sex workers, people who use illicit drugs, remnants of quilombolos and indigenous communities.

Keywords: Amazon region; C. trachomatis; HBV; HIV-1; HPV; HTLV; STI; T. pallidum; epidemiology.

Figure 1

The Amazon rainforest extends over nine countries in South America (Brazil, Bolivia, Peru, Ecuador, Colombia, Venezuela, Guyana, French Guiana and Suriname). Around 60% of this tropical area is referred to as the Brazilian Amazon. Nine Brazilian states are part of this tropical region: Acre (AC), Amapá (AP), Amazonas (AM), Mato Grosso (MT), Maranhão (MA), Pará (PA), Rondônia (RO), Roraima (RR) and Tocantins (TO).