Changes in the epidemiology of visceral leishmaniasis in Brazil from 2001 to 2014

Abstract

Introduction: Visceral leishmaniasis (VL) is a neglected disease, with territorial expansion and regional differences in Brazil that require explanation. This study aimed to describe changes in the epidemiology of VL in Brazil from 2001 to 2014. Methods: The incidence rates, sociodemographic and clinical data, and case evolution were subgrouped from 2001 to 2006 and from 2007 to 2014 and presented descriptively. Spatial distribution of disease incidence rates and changes in the spatial and temporal pattern were examined. Results: In total, 47,859 VL cases were reported in Brazil between 2001 and 2014, with predominance in the Northeast macroregion (55%), though the incidence rate in this region declined between the two study periods. The State of Tocantins had the highest crude rate (26.2/100,000 inhabitants), which was responsible for VL increasing in the North macroregion. VL predominated in the urban zone (70%), in children under 4 years (34%); however, an increase in the incidence of VL in adults older than 40 years was identified, with 12.3% and 31% in the first and second period, respectively. The mapping of crude rates and autochthonous canine cases showed territorial expansion. The temporal distribution of VL was consistent in Brazil in general, with no pattern observed, but regional differences were found. Conclusions: The incidence of VL is increasing in Brazil. In addition to the State of Tocantins, which had the highest rate, new outbreaks of VL have occurred in the South macroregion of Brazil with small decreases identified in the incidence rate in the Northeast.

Leishmaniose visceral e sua relação com fatores climáticos e ambientais no Estado do Tocantins, Brasil, 2007 a 2014

“…A leishmaniose visceral (LV) é uma doença causada pelo protozoário intracelular Leishmania infantum e transmitida por vetores, especialmente o flebotomíneo Lutzomyia longipalpis, cuja relação com fatores climáticos, ambientais e sociais tem sido explorada. No entanto, ainda se buscam explicações que permitam compreender a doença que, no Estado do Tocantins, apresenta a mais elevada incidência do Brasil (taxa de incidência 26,2/100 mil habitantes no período de 2007 a 2014) 1 .…”

Epidemiological aspects of human and canine visceral leishmaniasis in State of Alagoas, Northeast, Brazil

“…Visceral leishmaniasis is of great epidemiological importance in Alagoas, which can be seen in a published study where an epidemiological profile demonstrates the cases of lethality related to VL in Alagoas (Reis et al, 2017).…”

Abordagens Geográfica da Vigilância, Prevenção e Promoção da Saúde

“…No entanto, a eficácia dessas medidas tem sido questionada diante do atual panorama da doença no país (ROMERO; BOELART, 2010). Estima-se a ocorrência anual de 4.200 a 6.300 novos casos (ALVAR et al, 2012) em uma incidência aproximada de 2,0 casos/100 mil habitantes (REIS et al, 2017). Além disso, as áreas de ocorrência da LV têm se expandido, com relatos de autoctonia em 25% dos municípios de 21 unidades federativas (WERNECK, 2014).…”

“…Além disso, Mestre e Fontes (2007) previamente descreveram a instalação da epidemia da LV no estado por meio de análise dos casos notificados entre 1998 e 2005. No entanto, o caráter expansivo e as constantes mudanças de padrões epidemiológicos usualmente visualizadas na LV apontam para a necessidade de uma avaliação atualizada da ocorrência da doença nessa área (LIMA et al, 2018;REIS et al, 2017).…”