Social determinants of mortality due to visceral leishmaniasis in Brazil (2001-2015): an ecological study

Nunes, Benício Luiz Bulhões Barros Paula; Leal, Thiago Cavalcanti; Paiva, João Paulo Silva de; Silva, Leonardo Feitosa da; Carmo, Rodrigo Feliciano do; Machado, Michael Ferreira; Araújo, Maria Deysiane Porto; Santos, Victor Santana; Souza, Carlos Dornels Freire de

doi:10.1590/0037-8682-0262-2019

Cited by 16 publications

(11 citation statements)

References 11 publications

(15 reference statements)

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“…Similar rates were found in a neighboring rural settlement in Mirante of Paranapanema [34,35]. Globally and countrywide, VL is considered a neglected disease that affects the poorest of the poor [17,33,34].…”

Section: Discussionsupporting

confidence: 66%

“…The Human Development Index (HDI) was used as an indicator for understanding the socioeconomic profile of the municipalities of São Paulo state. The HDI is a well-known and comparable indicator worldwide, reproducing studies in other states and regions countrywide [17]. The HDI value of the 45 municipalities in the RHN11 was obtained in Fundação Sistema Estadual de Análises de Dados (SEADE), from 1999 to 2016, coded and classified by the denominated quintile as a reference parameter.…”

Section: Mapping the Human Development Index In The Rnha11 Mesoregionmentioning

confidence: 79%

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Cases and distribution of visceral leishmaniasis in western São Paulo: A neglected disease in this region of Brazil

et al. 2021

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Visceral leishmaniasis (VL) is one of the most prevalent parasitic diseases worldwide. In 2019, 97% of the total numbers of cases in Latin America were reported in Brazil. In São Paulo state, currently 17.6% of infected individuals live in the western region. To study this neglected disease on a regional scale, we describe the spread of VL in 45 municipalities of the Regional Network for Health Assistance11(RNHA11). Environmental, human VL (HVL), and canine VL (CVL) cases, Human Development Index, and Lutzomyia longipalpis databases were obtained from public agencies. Global Moran’s I index and local indicators of spatial association (LISA) statistics were used to identify spatial autocorrelation and to generate maps for the identification of VL clusters. On a local scale, we determined the spread of VL in the city of Teodoro Sampaio, part of the Pontal of Paranapanema. In Teodoro Sampaio, monthly peri-domicile sand fly collection; ELISA, IFAT and Rapid Test serological CVL; and ELISA HVL serum surveys were carried out. In RNHA11 from 2000 to 2018, Lu. longipalpis was found in 77.8%, CVL in 69%, and HVL in 42.2% of the 45 municipalities, and 537 individuals were notified with HVL. Dispersion occurred from the epicenter in the north to Teodoro Sampaio, in the south, where Lu. longipalpis and CVL were found in 2010, HVL in 2018, and critical hotspots of CVL were found in the periphery. Moran’s Global Index showed a weak but statistically significant spatial autocorrelation related to cases of CVL (I = 0.2572), and 11 municipalities were identified as priority areas for implementing surveillance and control actions. In RNHA11, a complex array of socioeconomic and environmental factors may be fueling the epidemic and sustaining endemic transmission of VL, adding to the study of a neglected disease in a region of São Paulo, Brazil.

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Section: Discussionsupporting

confidence: 66%

Section: Mapping the Human Development Index In The Rnha11 Mesoregionmentioning

confidence: 79%

Cases and distribution of visceral leishmaniasis in western São Paulo: A neglected disease in this region of Brazil

et al. 2021

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“…Depending on the region, Leishmania is transmitted by different phlebotomine sand fly vectors ( 3 ). There is no human vaccine ( 4 , 5 ) and the prevalence of leishmaniasis is closely linked to the human development index and environmental degradation ( 6 , 7 ). This zoonosis remains a serious public health problem and is recognized as one of the 20 major neglected tropical diseases ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Feline Leishmaniasis Caused by Leishmania infantum: Parasite Sequencing, Seropositivity, and Clinical Characterization in an Endemic Area From Brazil

et al. 2021

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Zoonotic leishmaniasis caused by Leishmania infantum is a disease of One Health concern since human and animal cases and environmental damage are interconnected. L. infantum has a complex epidemiological cycle with multiple hosts, including mammals—humans, domestic, and wild animals—and arthropod vectors. Knowledge on mammal infections in endemic areas is crucial for developing control strategies. This work aimed to detect and characterize L. infantum infection in domestic cats from areas where human and canine leishmaniasis cases occur. No cases of feline leishmaniasis (FeL) had been previously reported in those areas. Five municipalities from Bahia state were chosen, comprising 2,480.8 km2 with 1,103,866 inhabitants. Ninety domiciliated and/or sheltered cats underwent clinical examination and serology by a rapid reference test recommended by the Brazilian government. Cytology, PCR, and parasite DNA sequencing were performed in bone marrow samples. Rapid tests detected antibodies in 5.6% (5/90) of the cats. Leishmania infantum infection was confirmed in 7.8% (7/90) of the cats by PCR, sequencing, and parasite isolation. Three out of the five municipalities (60%) had infected cats, and PCR positivity varied from 6.9 to 29%. One cat was categorized as harboring active L. infantum infection with amastigote forms in bone marrow smears. No clinical signs were detected at the first clinical exam, but 1 month later the cat developed severe FeL. The cat isolate was grown in culture, typed and its DNA sequence was homologous to the L. infantum reference strain (PP75). In conclusion, cats are potential hosts and may acquire L. infantum in endemic areas where canine and human cases occur. For cats, the need for surveillance, differential diagnosis and clinical care is highly recommended since a fast clinical progression of FeL developed in a subclinical animal. An accurate standardized immunodiagnostic assay for FeL is warranted.

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“…Moreover, social determinants have been related to VL mortality, especially in the North and Northeast regions. Recent ecological study highlighted high mortality rates of VL associated with unplanned urbanization and precariousness of households, where both reservoirs and breeding sites for disease vectors are present [ 59 ].…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, we recognize that the SVI can be an important tool for future health research in Brazil because it is a robust and multidimensional index developed for the purpose of guiding decision making of public managers and help researchers to better understand the different aspects of social vulnerability in Brazil [ 14 ]. Some studies applied SVI or its indicators in spatial analysis of leprosy [ 28 , 62 , 68 ] and VL mortality [ 59 ], but they showed promising insights for using the index in epidemiological research.…”

Section: Discussionmentioning

confidence: 99%

Space-time risk cluster of visceral leishmaniasis in Brazilian endemic region with high social vulnerability: An ecological time series study

et al. 2021

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Background Despite visceral leishmaniasis (VL) being epidemic in most Brazilian regions, the Northeast region is responsible for the highest morbidity and mortality outcomes within the country. Objective To analyse the spatiotemporal dynamics of VL cases to identify the temporal trends and high-risk areas for VL transmission, as well as the association of the disease with social vulnerability in Brazilian Northeast. Methods We carried out an ecological time series study employing spatial analysis techniques using all VL confirmed cases of 1,794 municipalities of Brazilian Northeast between the years 2000 to 2017. The Social Vulnerability Index (SVI) was used to represent the social vulnerability. Incidence rates were standardized and smoothed by the Local Empirical Bayesian Method. Time trends were examined through segmented linear regression. Spatiotemporal analysis consisted of uni- and bivariate Global and Local Moran indexes and space-time scan statistics. Results Incidence rate remained stable and ranged from 4.84 to 3.52 cases/100,000 inhabitants. There was higher case prevalence between males (62.71%), children and adolescents (63.27%), non-white (69.75%) and urban residents (62.58%). Increasing trends of new cases were observed among adult male subjects (≥ 40 years old) and urban residents. Importantly, VL incidence showed a direct spatial dependence. Spatial and space-time clusters were identified in sertão and meio-norte sub-regions, overlapping with high social vulnerability areas. Conclusions VL is a persistent health issue in Brazilian Northeast and associated with social vulnerability. Space-time clustering of VL cases in socially vulnerable municipalities demands intersectoral public policies of surveillance and control, with focus on reducing inequalities and improving living conditions for regional inhabitants.

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Social determinants of mortality due to visceral leishmaniasis in Brazil (2001-2015): an ecological study

Cited by 16 publications

References 11 publications

Cases and distribution of visceral leishmaniasis in western São Paulo: A neglected disease in this region of Brazil

Cases and distribution of visceral leishmaniasis in western São Paulo: A neglected disease in this region of Brazil

Feline Leishmaniasis Caused by Leishmania infantum: Parasite Sequencing, Seropositivity, and Clinical Characterization in an Endemic Area From Brazil

Space-time risk cluster of visceral leishmaniasis in Brazilian endemic region with high social vulnerability: An ecological time series study

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