SPATIO-TEMPORAL DYNAMICS OF VISCERAL LEISHMANIASIS TRANSMISSION IN A HIGHLY ENDEMIC REGION OF BRAZIL
DOI:
https://doi.org/10.26694/repis.v10i1.5747Keywords:
Geographic information system, Spatial analysis, Time series studies, Visceral leishmaniasisAbstract
Background: Brazil concentrates 96% of visceral leishmaniasis cases occurred in Americas, and Maranhão is the Brazilian state with the highest number of registered cases. We aimed to analyze the spatio-temporal dynamics of visceral leishmaniasis transmission in a Brazilian region with high endemicity between 2009 to 2017.
Methods: We carried out an ecological and time series study using spatio-temporal analysis techniques. A time-trend analysis was performed by the segmented linear regression. High-risk clusters were identified through spatial autocorrelation (Moran’s global and local indexes) and space-time scan statistics.
Results: There were 5,128 visceral leishmaniasis cases, and it was observed increasing trends of new cases in the general population, among men, adults ≥20 years old, especially ≥60 years old. VL-HIV coinfection, mortality and lethality were crescent. Spatial analysis revealed intense visceral leishmaniasis transmission in almost the entire state and high-risk priority areas.
Implications: Visceral leishmaniasis is in a substantial geographical expansion, demonstrating that the surveillance policies need to be reformulated.
References
Oryan A, Akbari M. Worldwide risk factors in leishmaniasis. Asian Pac J Trop Med [Internet]. 2016 [cited 2024 Jun 06]; 9(10): 925–932. Available from: https://doi.org/10.1016/j.apjtm.2016.06.021
Bulstra CA, Le Rutte EA, Malaviya P, Hasker EC, Cofferng LE, Singh OP, et al. Visceral leishmaniasis: Spatiotemporal heterogeneity and drivers underlying the hotspots in Muzaffarpur, Bihar, India. PLoS Negl Trop Dis [Internet]. 2018 [cited 2024 Jun 06]; 12(12): 1-10. Available from: https://doi.org/10.1371/journal.pntd.0006888
Belo VS, Werneck GL, Barbosa DS, Simões TC, Nascimento BWL, Silva ES, et al. Factors Associated with Visceral Leishmaniasis in the Americas: A Systematic Review and Meta-Analysis. PLoS Negl Trop Dis [Internet]. 2013 [cited 2024 Jun 06]; 7(4):1-12. Available from: https://doi.org/10.1371/journal.pntd.0002182
Conti RV, Lane VFM, Montebello L, Pinto VL Jr. Visceral leishmaniasis epidemiologic evolution in timeframes, based on demographic changes and scientific achievements in Brazil. J Vector Borne Dis [Internet]. 2016 [cited 2024 Jun 06]; 53(2): 99–104. Available from: https://pubmed.ncbi.nlm.nih.gov/27353578/
Word Health Organization [Internet]. Leishmaniasis. Genebra: WHO; 2019 [cited 2024 Jun 06]. Available from: https://www.who.int/news-room/fact-sheets/detail/leishmaniasis
Organização Pan-Americana de Saúde [Internet]. Leishmanioses. Informe Epidemiológico das Américas. Brasília: OPAS; 2019 [cited 2024 Jun 06]. Organização Pan-Americana de Saúde. Available from: http://iris.paho.org/xmlui/bitstream/handle/123456789/50505/2019-cde-leish-informe-epi-das-americas.pdf?ua=1
Maia-Elkhoury ANS, Alves WA, Sousa-Gomes ML, Sena JM, Luna EA. Visceral leishmaniasis in Brazil: trends and challenges. Cad Saude Publica [Internet]. 2008 [cited 2024 Jun 06]; 24(12): 2941–2947. Available from: https://doi.org/10.1590/S0102-311X2008001200024
Sales DP, Chaves DP, Martins NS, Silva MIS. Aspectos Epidemiológicos da Leishmaniose Visceral Canina e Humana no Estado do Maranhão, Brasil (2009-2012). R Bras. Ci. Vet [Internet]. 2017 [cited 2024 Jun 06]; 24(3): 144–150. Available from: doi.org/10.4322/rbcv.2017.028
Marcondes M, Rossi CN. Leishmaniose visceral no Brasil. Braz J Vet Res Anim Sci [Internet]. 2013 [cited 2024 Jun 06]; 50(5): 341-352. Available from: https://doi.org/10.11606/issn.2318-3659.v50i5p341-352
Brasil. Ministério da Saúde. Manual de Vigilância e Controle da leishmaniose visceral. Secretaria de Vigilância em Saúde. Departamento de Vigilância Epidemiológica. Brasília: Ministério da Saúde; 2014. 3rd ed. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/manual_vigilancia_controle_leishmaniose_visceral_1edicao.pdf
Costa JML, Viana GMC, Saldanha ACR, Nascimento MDSB, Alvim AC, Burattini MN, et al. Leishmaniose visceral no estado do Maranhão, Brasil: a evolução de uma epidemia. Cad Saúde Publica [Internet]. 1995 [cited 2024 Jun 06]; 11(2): 321–324. Available from: https://doi.org/10.1590/S0102-311X1995000200016
Freitas LCS, Feitosa AC. Espaço e saúde: condições socioambientais favoráveis à leishmaniose visceral (LV) na bacia do rio Anajá em Paço do Lumiar - MA. Hygeia - Rev Bras Geogr Médica e da Saúde [Internet]. 2014 [cited 2024 Jun 06]; 10(18): 33–45. Available from: https://doi.org/10.14393/Hygeia1022802
Garcês AR Jr, Brasil GVS, Ferreira LC, Rodrigues ZMR, Aquino J Jr. Análise de casos de leishmaniose visceral utilizando técnicas de geoprocessamento [anais on the internet]. Goiânia - Brasil: Anais do XV Congresso Brasileiro de Informática em Saúde; 2016 [cited 2024 Jun 06), pp. 929–938. Available from: https://docs.bvsalud.org/biblioref/2018/07/906706/anais_cbis_2016_artigos_completos-929-938.pdf
Sunyoto T, Boelaert M, Meheus F. Understanding the economic impact of leishmaniasis on households in endemic countries: a systematic review. Expert Rev Anti Infect Ther [Internet]. 2019 [cited 2024 Jun 06]; 17(1): 57–69. Available from: 10.1080/14787210.2019.1555471
Paradella R. Número de idosos cresce 18% em 5 anos e ultrapassa 30 milhões em 2017 [Internet]. IBGE. 2018 [cited 2024 Jun 06]; [about 4 screens]. Available from: https://agenciadenoticias.ibge.gov.br/agencia-noticias/2012-agencia-de-noticias/noticias/20980-numero-de-idosos-cresce-18-em-5-anos-e-ultrapassa-30-milhoes-em-2017
PNUD. Programa das Nações Unidas para o Desenvolvimento. Atlas of human development in Brazil. Brasília: PNUD 2013 [cited 2024 Jun 06]. Available from: http://www.atlasbrasil.org.br/
IBGE. Instituto Brasileiro de Geografia e Estatística. Rio de Janeiro: IBGE; 2019 [cited 2024 Jun 06]. Available from: https://www.ibge.gov.br/
Brasil. Secretaria de Vigilância em Saúde. Guia de vigilância em saúde [Internet]. 2019 [cited 2024 Jun 06]; 3rd ed.: 1–74. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/guia_vigilancia_saude_3ed.pdf
Antunes JLF, Cardoso MRA. Uso da análise de séries temporais em estudos epidemiológicos. Epidemiologia e Serviços de Saúde [Internet]. 2015 [cited 2024 Jun 06]; 24(3): 565–576. Available from: https://doi.org/10.5123/S1679-49742015000300024
Anselin L. Local Indicators of Spatial Association—LISA. Geogr Anal. [Internet]. 1995; 27(2): 93–115. Available from: https://doi.org/10.1111/j.1538-4632.1995.tb00338.x
Kulldorff M. A spatial scan statistic. Commun Stat Theory Methods [Internet].1997 [cited 2024 Jun 06]; 26(6): 1481–1496. Available from: https://doi.org/10.1080/03610929708831995
Ministério da Saúde. [Leishmaniose visceral] [Ilustration on the internet], 2017 [cited 2024 Jun 06]. Available from: http://portalarquivos2.saude.gov.br/images/pdf/2019/janeiro/28/leishvisceral-17-novo-layout.pdf%0Afile:///D:/IC/Pibic/leishvisceral-17-novo-layout.pdf
Coimbra VCS, Lima MS, Oliveira FM, Abreu WM, Ferreira JMT, Bezerra NPC. Visceral leishmaniasis: epidemiological profile of cases reported in São Luis-MA, Brazil, from 2014 to 2017. Rev Bra Edu Saúd [Internet]. 2019 [cited 2024 Jun 06]; 9(3): 87–93. Available from: https://doi.org/10.18378/rebes.v9i3.6470
Farias HMT, Gusmão JD, De Aguilar RV, Barbosa SFAB. Perfil epidemiológico da leishmaniose visceral humana nas regiões de saúde do norte de minas gerais. Enfer Foco [Internet]. 2019 [cited 2024 Jun 06]; 10(2): 90-96. Available from: doi.org/10.21675/2357-707X.2019.v10.n2.1887.
Góes MAO, Melo CM, Jeraldo VLS. Série temporal da leishmaniose visceral em Aracaju, estado de Sergipe, Brasil (1999 a 2008): aspectos humanos e caninos. Rev Bras Epidemiol [Internet]. 2012 [cited 2024 Jun 06]; 15(2): 298–307. Available from: https://doi.org/10.1590/S1415-790X2012000200007
Gusmão JD, Brito PA, Leite MTS. Perfil epidemiológico da leishmaniose visceral no norte de Minas Gerais, Brasil, no período de 2007 a 2011. Rev Baiana Saúde Pública [Internet]. 2014 [cited 2024 Jun 06]; 38(3): 615–624. Available from: https://doi.org/10.22278/2318-2660.2014.v38.n3.a505
Rocha MAN, Matos-Rocha TJ, Ribeiro CMB, Ribeiro CMB, Abreu SRO. Epidemiological aspects of human and canine visceral leishmaniasis in State of Alagoas, Northeast, Brazil. Braz J Biol [Internet]. 2018 [cited 2024 Jun 06]; 78(4): 609–614. Available from: https://doi.org/10.1590/1519-6984.166622
Santos G, Barreto M, Monteiro M, Silva R. Aspectos epidemiológicos e clínicos da leishmaniose visceral no estado do Piauí, Brasil. Rev Ciênc Desenv [Internet]. 2017 [cited 2024 Jun 06); 10(2):142-153. Available from: doi.org/10.11602/1984-4271.2017.10.2.12
Romero GAS, Boelaert M. Control of Visceral Leishmaniasis in Latin America—A Systematic Review. PLoS Negl Trop Dis [Internet]. 2010 [cited 2024 Jun 06]; 4(1): 1-12. Available from: https://doi.org/10.1371/journal.pntd.0000584
Lima ID, Lima ALM, Mendes-Aguiar CO, Coutinho JFV, Wilson ME, Pearson RD, et al. Changing demographics of visceral leishmaniasis in northeast Brazil: Lessons for the future. PLoS Negl Trop Dis [Internet]. 2018 [cited 2024 Jun 06]; 12(3): 1-12. Available from: https://doi.org/10.1371/journal.pntd.0006164
Coura-Vital W, Araújo VEM, Reis IA, Amâncio FF, Reis AB, Carneiro M. Prognostic Factors and Scoring System for Death from Visceral Leishmaniasis: An Historical Cohort Study in Brazil. PLoS Negl Trop Dis [Internet]. 2014 [cited 2024 Jun 06]; 8(12):1-12. Available from: 10.1371/journal.pntd.0003374
Maia-Elkhoury ANS, Romero GAS, Valadas SYOB, Sousa-Gomes ML, Lindoso JAL, Cupolillo E, et al. Premature deaths by visceral leishmaniasis in Brazil investigated through a cohort study: A challenging opportunity? PLoS Negl Trop Dis [Internet]. 2019 [cited 2024 Jun 06]; 13(12):1-10. Available from: https://doi.org/10.1371/journal.pntd.0007841
Driemeier M, Oliveira PA, Druzian AF, Brum LFL, Pontes ERJC, Dorval MEC, et al. Late diagnosis: a factor associated with death from visceral leishmaniasis in elderly patients. Pathog Glob Health [Internet]. 2015 [cited 2024 Jun 06]; 109(6): 283–289. Available from: https://doi.org/10.1179/2047773215Y.0000000029
Martins-Melo FR, Lima MS, Ramos AN, Alencar CH, Heukebach J. Mortality and Case Fatality Due to Visceral Leishmaniasis in Brazil: A Nationwide Analysis of Epidemiology, Trends and Spatial Patterns. PLoS One [Internet]. 2014 [cited 2024 Jun 06]; 9(4): 1-12. Available from: https://doi.org/10.1371/journal.pone.0093770
Hailu T, Yimer M, Mulu W, Abera B. Challenges in visceral leishmaniasis control and elimination in the developing countries: A review. J Vector Borne Dis [Internet] 2016 [cited 2024 Jun 06]; 53(3): 193–198. Available from: https://pubmed.ncbi.nlm.nih.gov/27681541/
Barbosa IR. Leishmaniose visceral humana no município de Natal-RN: análise clínico-epidemiológica e espacial. Rev Ciência Plur [Internet]. 2016 [cited 2024 Jun 06]; 2(1): 89–101. Available from: https://doi.org/10.21680/2446-7286.2016v2n1ID8559
Von Zuben APB, Donalísio MR. Dificuldades na execução das diretrizes do Programa de Vigilância e Controle da Leishmaniose Visceral em grandes municípios brasileiros. Cad Saude Publica [Internet]; 2016 [cited 2024 Jun 06); 32(6):1-12. Available from: doi.org/10.1590/0102-311X00087415
Furtado AS, Nunes FBBF, Santos AM, Caldas AJM. Análise espaço-temporal da leishmaniose visceral no estado do Maranhão, Brasil. Cien Saude Colet [Internet]. 2015 [cited 2024 Jun 06]; 20(12): 3935–3942. Available from: https://doi.org/10.1590/1413-812320152012.01672015
Costa JML, Viana GMC, Saldanha ACR, Nascimento MDSM, Alvim AC, Burattini MN, et al. Leishmaniose visceral no estado do Maranhao, Brasil: a evolução de uma epidemia. Cad Saúde Públ [Internet]. 1995 [cited 2024 Jun 06];11(2):321–324. Available from: https://doi.org/10.1590/S0102-311X1995000200016
Ferreira AF, Sousa EA, García GSM, Reis AS, Corona F, Lima MS, et al. Leprosy in the North and Northeast regions of Brazil: an integrated spatiotemporal approach. Trop Med Int Heal [Internet]. 2020 [cited 2024 Jun 06]; 25(2): 193–208. Available from: https://doi.org/10.1111/tmi.13343
Szwarcwald CL, Montilla DER, Marques AP, Damacena GN, Almeida WS, Malta DC. Inequalities in healthy life expectancy by Federated States. Rev Saude Publica [Internet]; 2017 [cited 2024 Jun 06]. 51(1):1-7. Available from: doi.org/10.1590/s1518-8787.2017051000105
Bezerra FJA, Bernardo TRR, Ximenes LJF, Saboya AVJ. Perfil socioeconômico do Maranhão. BNB [Internet]. 2015 [cited 2024 Jun 06]. Available from: https://www.bnb.gov.br/s482-dspace/handle/123456789/1730
Rinaldi L, Musella V, Cringoli G. Geospatial tools in parasitology: highlighting their usefulness at the beginning of the third millennium. Sci Parasitol [Internet]. 2010 [cited 2024 Jun 06]; 11(1): 7–13. Available from: https://scientia.zooparaz.net/2010_11_01/sp2010-pp07-13%20-%20Rinaldi.pdf
Werneck GL. Controle da leishmaniose visceral no Brasil: o fim de um ciclo? Cad Saude Publica [Internet]. 2016 [cited 2024 Jun 06].32(6):1-2. Available from: doi.org/10.1590/0102-311X00ED010616
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Copyright (c) 2024 Caíque Jordan Nunes Ribeiro, Bianca Vanessa dos Santos Ribeiro, Allan Dantas dos Santos, Márcio Bezerra Santos, Priscila Lima dos Santos, Karina Conceição Gomes Machado de Araújo, Guilherme Reis de Santana Santos, David Vinicius dos Santos Santana, Liliane Moretti Carneiro, Tatiana Rodrigues de Moura
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