Abstract
This study addresses the co-occurrence of malaria and Chagas disease in municipalities in the Amazon, a region characterized by geographic and climatic diversity and by socioeconomic and environmental transformations. This study aimed to identify the factors related to the co-occurrence of malaria and Chagas disease in the Brazilian Amazon from 2015 to 2019. The analysis explored 19 environmental indicators and two socioeconomic indicators related to habitat loss, land use and cover, climate anomalies, and the multidimensional poverty index. Modeling was performed by Conditional Inference Trees, adjusting models with and without contextual variables, to map areas of probable co-occurrence of the diseases. The incidence of malaria is predominant in the western Amazon, while Chagas disease is more frequent in areas of Pará and parts of Amazonas and Acre. Municipalities with high coverage of native vegetation showed higher incidences of malaria, but not necessarily of Chagas disease. Municipalities with native vegetation cover and pasture areas showed heterogeneous incidence of diseases, with some presenting a high incidence of both diseases. The predictive analysis showed an increase in the number of municipalities with a high expected incidence of malaria (moderate) and disease Chagas (high) from 1 to 7, when compared to observed data. The study showed areas with a risk of moderate and high incidence of both diseases, covering a larger region than that observed in the period. Alternatives of shared surveillance and the integration of programs for the identification of cases and treatment can be a measure to optimize resources and help eradicate these diseases in the region.