Space-time cluster analysis of American visceral leishmaniasis in Bauru, São Paulo State, Brazil

Abstract

A space-time analysis of American visceral leishmaniasis (AVL) in humans in 1 . Dogs are considered important reservoir hosts in urban areas as they carry the agent for long periods of time, favoring biologic vector-borne infections and, as a result, maintenance of protozoa 2,3 . In human begins, AVL is described as a serious disease and early diagnosis and treatment are vital to avoid fatalities 4,5 .In Brazil, AVL affects most parts of the national territory and represents an important public health issue, especially in fast-growing urban areas. Recent data shows that cases reported in this country make up 90% of all cases registered in Latin America 5 . In the State of São Paulo, canine visceral leishmaniasis occurs in 71 cities while the human form is present in 52 urban centers 6 .Despite the prevention and control measures implemented in the State of São Paulo, human and canine AVL are still spreading 6 . One of the most affected cities is Bauru, where 354 human cases were confirmed between 2003 (data collected up to April 2011 7 . Up to date, the space-time pattern of this disease in the City of São Paulo has not been evaluated, emphasizing the need for studies that address this question.ARTIGO ARTICLE

Spatio-temporal analysis of the occurrence of human visceral leishmaniasis in Araçatuba, State of São Paulo, Brazil

“…In 2010-2015, no spatio-temporal clusters were detected and no spatial dependence was observed at any distance in the point pattern analysis, which coincides with the period of low rates and relative stability in the incidence. Similar to a previous study conducted in Araçatuba, Souza et al 11 , Vieira et al 12 , and Cardim et al 13 performed a spatial and spatio-temporal analysis of HVL in the Cites of Bauru, Birigui, and Adamantina, SP and clusters were detected. Furthermore, Ripley's K-function was applied in a study on CVL and HVL occurrence in the City of Araçua, Minas Gerais State, Brazil 14 .…”

“…Considering that the HVL case distribution is mainly associated with areas with higher vector density [16][17][18] , higher canine presence and CVL prevalence 11,14,[24][25][26][27][28] , and worse socioeconomic, demographic, and environmental conditions [21][22][23] , the HVL clustering would be seen as a consequence of all these conditions collectively.…”

Visceral leishmaniasis: Spatiotemporal heterogeneity and drivers underlying the hotspots in Muzaffarpur, Bihar, India

“…The size of hotspots make it is most likely that both human movement and the movement of sand flies play an important role in the spread of infection [49][50][51]. The role of population density, access to health services, vector characteristics and vector control strategies, which have shown to be potent drivers of other vector-borne infections, would pose interesting additional factors to explore in future analyses as potential drivers of VL hotspots [23,[52][53][54][55][56].…”

Dificuldades na execução das diretrizes do Programa de Vigilância e Controle da Leishmaniose Visceral em grandes municípios brasileiros

“…Em Bauru, a LV foi notificada pela primeira vez em 2003 e, apesar da implantação de controle e prevenção, a doença continua a se expandir na área urbana com aumento do número de casos, bem como da letalidade 18,19 . Embora em números absolutos seja a cidade com menos casos entre as estudadas, tem coeficientes de incidência mais altos que Fortaleza e Belo Horizonte.…”