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Vasconcelos ADO, Bedoya-Pacheco SJ, Cunha E Silva RR, Magalhães MDAFM, de Sá TPSO, Dias CMG, Meneguete PS, de Almeida PMP, Pimentel MIF. Spatial-temporal distribution of visceral leishmaniasis in Rio de Janeiro, Brazil, 2001-2020: expansion and challenges. Trans R Soc Trop Med Hyg 2024; 118:448-457. [PMID: 38517304 DOI: 10.1093/trstmh/trae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 12/13/2023] [Accepted: 02/29/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Visceral leishmaniasis results from complex interactions among humans, dogs and environment. Brazil accounts for 97% of cases in the Americas. METHODS Twenty years (2001-2020) of the endemic disease in the state of Rio de Janeiro were studied. Incidence, lethality, sociodemographic and clinical characteristics were investigated, complemented with spatial methodologies (kernel and clusters). RESULTS Ninety-seven human cases and 625 dogs were reported. Of the 92 cities, 22 were human endemic areas. The state had a low incidence level (0.6 per 100 000). Lethality was higher compared with the Brazilian average. More than 90% of infections occurred in urban areas. Most cases (66%) occurred in men. The predominant age groups were 0-4 y (28.7%) and 20-39 y (32.9%). Fever (89.5%), splenomegaly (83.2%) and hepatomegaly (76.8%) were the main clinical manifestations. Spatial analysis showed a displacement of the human endemic: in the first decade (2001-2010), cases were concentrated in the Metropolitan region, and in the second decade (2011-2020) in the Médio Paraíba region of the state. Most of the endemic area (56.4%) had canine infections without reported human cases. CONCLUSIONS Disorderly urbanisation and precarious living conditions favour the transmission of the disease. Changes in the environment and migratory processes contribute to its expansion.
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Affiliation(s)
- Alex de O Vasconcelos
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil
| | - Sandro J Bedoya-Pacheco
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro, CEP: 21041-210, RJ, Brazil
| | - Rafael R Cunha E Silva
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil
| | - Mônica de A F M Magalhães
- Instituto de Comunicação e Informação Científica e Técnológica em Saúde, Fundação Oswaldo Cruz, Av. Brasil 4365, Pavilhão Haity Moussatché, Manguinhos, Rio de Janeiro, CEP 21040-900, RJ, Brazil
| | - Tayana P S O de Sá
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil
| | - Cristina M G Dias
- Secretaria de Estado de Saúde do Rio de Janeiro, Rua México 128 sala 420, Rio de Janeiro, CEP: 20031-142, RJ, Brazil
| | - Patrícia S Meneguete
- Secretaria de Estado de Saúde do Rio de Janeiro, Rua México 128 sala 420, Rio de Janeiro, CEP: 20031-142, RJ, Brazil
| | - Paula M P de Almeida
- Secretaria de Estado de Saúde do Rio de Janeiro, Rua México 128 sala 420, Rio de Janeiro, CEP: 20031-142, RJ, Brazil
| | - Maria Inês F Pimentel
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil
- Instituto de Comunicação e Informação Científica e Técnológica em Saúde, Fundação Oswaldo Cruz, Av. Brasil 4365, Pavilhão Haity Moussatché, Manguinhos, Rio de Janeiro, CEP 21040-900, RJ, Brazil
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2
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Vilas-Boas DF, Nakasone EKN, Gonçalves AAM, Lair DF, de Oliveira DS, Pereira DFS, Silva GG, Conrado IDSS, Resende LA, Zaldívar MF, Mariano RMDS, Dutra WO, Chávez-Fumagalli MA, Galdino AS, Silveira-Lemos D, Giunchetti RC. Global Distribution of Canine Visceral Leishmaniasis and the Role of the Dog in the Epidemiology of the Disease. Pathogens 2024; 13:455. [PMID: 38921753 PMCID: PMC11206782 DOI: 10.3390/pathogens13060455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/15/2024] [Accepted: 05/20/2024] [Indexed: 06/27/2024] Open
Abstract
Visceral leishmaniasis is a disease caused by protozoa of the species Leishmania (Leishmania) infantum (syn = Leishmania chagasi) and Leishmania (Leishmania) donovani, which are transmitted by hematophagous insects of the genera Lutzomyia and Phlebotomus. The domestic dog (Canis familiaris) is considered the main urban reservoir of the parasite due to the high parasite load on its skin, serving as a source of infection for sandfly vectors and, consequently, perpetuating the disease in the urban environment. Some factors are considered important in the perpetuation and spread of canine visceral leishmaniasis (CVL) in urban areas, such as stray dogs, with their errant behavior, and houses that have backyards with trees, shade, and organic materials, creating an attractive environment for sandfly vectors. CVL is found in approximately 50 countries, with the number of infected dogs reaching millions. However, due to the difficulty of controlling and diagnosing the disease, the number of infected animals could be even greater. In the four continents endemic for CVL, there are reports of disease expansion in endemic countries such as Brazil, Italy, Morocco, and Tunisia, as well as in areas where CVL is not endemic, for example, Uruguay. Socio-environmental factors, such as migration, drought, deforestation, and global warming, have been pointed out as reasons for the expansion into areas where it had been absent. Thus, the objective of this review is to address (i) the distribution of CVL in endemic areas, (ii) the role of the dog in the visceral leishmaniasis epidemiology and the factors that influence dog infection and the spread of the disease, and (iii) the challenges faced in the control of CVL.
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Affiliation(s)
- Diego Fernandes Vilas-Boas
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Eiji Kevin Nakasone Nakasone
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Ana Alice Maia Gonçalves
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Daniel Ferreira Lair
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Diana Souza de Oliveira
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Diogo Fonseca Soares Pereira
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Geralda Gabriele Silva
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Ingrid dos Santos Soares Conrado
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Lucilene Aparecida Resende
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Maykelin Fuentes Zaldívar
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Reysla Maria da Silveira Mariano
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Walderez Ornelas Dutra
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Miguel Angel Chávez-Fumagalli
- Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru;
| | - Alexsandro Sobreira Galdino
- Microorganism Biotechnology Laboratory, Federal University of São João Del-Rei (UFSJ), Midwest Campus, Divinópolis 35501-296, MG, Brazil;
| | - Denise Silveira-Lemos
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
| | - Rodolfo Cordeiro Giunchetti
- Laboratory of Biology of Cell Interactions, Institute of Biological Sciences, Department of Morphology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil; (D.F.V.-B.); (E.K.N.N.); (A.A.M.G.); (D.F.L.); (D.S.d.O.); (D.F.S.P.); (G.G.S.); (I.d.S.S.C.); (L.A.R.); (M.F.Z.); (R.M.d.S.M.); (W.O.D.); (D.S.-L.)
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Gutiérrez JD, Altamiranda-Saavedra M, Ávila-Jiménez J, Martins IA, Virginio F. Effect of environmental variables on the incidence of Visceral Leishmaniasis in Brazil and Colombia. Acta Trop 2024; 252:107131. [PMID: 38281614 DOI: 10.1016/j.actatropica.2024.107131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 01/30/2024]
Abstract
Visceral Leishmaniasis (VL) is the most severe of the three forms of Leishmaniasis. In the Americas, Brazil and Colombia present more than 90 % of the cases in the region. Our aim in this research was to estimate the association of the incidence rate of Visceral Leishmaniasis with the following environmental variables: the percentage of area suitable for the vector Lutzomyia longipalpis, the episodes of La Niña and El Niño, the Brazilian and Colombian biomes. Epidemiological data were obtained from the Brazilian Notifiable Diseases Information System and the Colombian National Public Health Surveillance System. Environmental data were downloaded from the NASA Giovanni web app, the Modis Sensor database, and the meteorological agencies of Australia, Japan, and the United States of America. Records of the presence of Lu. longipalpis were obtained from public databases and previous studies. As a result, the incidence per 10,000 inhabitants with LEBS for each El Niño-Southern Oscillation (ENSO) episode showed the largest values during El Niño 2015-2016, mainly in Brazil's Northeast and Central regions and the Northeast region of Colombia. Compared with the Neutral 2012-2014 episode, the episodes of El Niño 2015-2016 and La Niña 2010-2011 showed an average increase in the monthly incidence rate of VL, and the average increase was higher during El Niño 2015-2016 (aIRR = 2.304 vs.1.453) We found a positive association between the incidence rate of VL and the El Niño 2015-2016 episode and an impressive% of area suitable for the vector Lu. longipalpis in the Amazon region.An increase of 1 % in the area suitable for the vector Lu. longipalpis leads to an average rise of 0.8 % in the monthly incidence rate of VL. Our study shows a possible association between VL incidence and ENSO, with the most considerable incidence rates observed during El Niño 2015-2016 in Brazil's Northeast and Central regions and the Northeast region of Colombia. The present study is very important to better understand the Visceral Leishmaniasis transmission dynamics.
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Affiliation(s)
- Juan David Gutiérrez
- Facultad de Ciencias Médicas y de la Salud, Universidad de Santander, Instituto Masira, Bucaramanga, Santander, Colombia
| | - Mariano Altamiranda-Saavedra
- Grupo de Investigación Bioforense, Facultad de Derecho y Ciencias Forenses, Tecnológico de Antioquia Institución Universitaria, Antioquia, Colombia
| | - Julián Ávila-Jiménez
- Maestría en Ciencias Biológicas, Universidad Pedagógica y Tecnológica de Colombia, Tunja, Boyacá, Colombia
| | - Iris Amati Martins
- Laboratório de Ecologia da Paisagem e Conservação, LEPaC, Universidade de São Paulo, Brazil
| | - Flávia Virginio
- Grupo de Pesquisa em Entomologia Médica, Instituto Butantan, São Paulo, Brazil.
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Ávila IR, Silva ADC, Cardoso DT, Silva TAMD, Carneiro M, Barbosa DS, Bezerra JMT. Clinical-epidemiological aspects and prognostic factors associated with death from visceral leishmaniasis between the years 2010 to 2019 in the Central-West region of Brazil. Parasitol Int 2024; 98:102824. [PMID: 37977488 DOI: 10.1016/j.parint.2023.102824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/19/2023] [Accepted: 11/11/2023] [Indexed: 11/19/2023]
Abstract
In Brazil, the fatality rate for visceral leishmaniasis is high, and it is important to investigate its associated factors. The aim of this study was to analyze the clinical-epidemiological profile and prognostic factors associated with death from visceral leishmaniasis (VL) in the Central-West region of Brazil, between 2010 and 2019. A study of series of VL cases was carried out using data obtained from the Sistema de Informação de Agravos de Notificação (SINAN). Multivariate logistic regression was performed to identify variables associated with deaths. Male (64.96%); age group ≤5 years (28.51%); mixed race/color (59.20%); and level of education incomplete primary education (45.16%) were the most affected. The most frequent symptoms were fever (87.65%), weakness (77.56%), enlarged spleen (70.22%) and liver (67.33%), weight loss (67.22%) and pallor (63.41%). Co-infection with HIV was observed in 15.84% of patients. The parasitological diagnosis was positive in 74.17% and the Indirect Immunofluorescence (IIF) in 82.80%. The drug most used for treatment was pentavalent antimony (41.96%). Regarding the evolution of VL, cure was recorded for 82.90% of patients and death from VL in 8.30%. Factors associated with death from VL were: age group ≥20 and <60 (OR 2.95; 95% CI 1.98-4.38) and ≥60 (OR 5.84; 95% CI 3.63-9.38), edema (OR 2.27; 95% CI 1.64-3.13), pallor (OR 1.53; 95% CI 1.06-2.20), infectious condition (OR 1.56; 95% CI 1.12-2.15) and hemorrhagic phenomena (OR 2.87; 95% CI 2.02-4.08). New studies are needed in order to better manage VL control, monitoring, prevention and primary care strategies.
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Affiliation(s)
- Isabela Resende Ávila
- Programa de Pós-Graduação em Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Aline do Carmo Silva
- Programa de Pós-Graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Estadual do Maranhão, São Luís, Maranhão, Brazil
| | - Diogo Tavares Cardoso
- Programa de Pós-Graduação em Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Mariângela Carneiro
- Programa de Pós-Graduação em Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Programa de Pós-Graduação em Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Programa de Pós-Graduação em Ciências Biológicas, Núcleo de Pesquisas em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - David Soeiro Barbosa
- Programa de Pós-Graduação em Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Juliana Maria Trindade Bezerra
- Programa de Pós-Graduação em Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Programa de Pós-Graduação em Ciência Animal, Centro de Ciências Agrárias, Universidade Estadual do Maranhão, São Luís, Maranhão, Brazil; Curso de Licenciatura em Ciências Biológicas, Campus de Lago da Pedra, Universidade Estadual do Maranhão, Lago da Pedra, Maranhão, Brazil.
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Moura HB, Ker HG, Ramos LS, Nogueira LM, Machado JM, Dias DS, Rodrigues RAL, da Paz MC, Teixeira-Neto RG, Reis AB, Galdino AS, Silva ES. Diagnosis of Canine Visceral Leishmaniasis by Flow Cytometry Serology using the rMELEISH Multiepitope Antigen Coupled in a Functional Bead. Curr Pharm Biotechnol 2024; 25:2290-2299. [PMID: 38409720 DOI: 10.2174/0113892010268142231226115140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/26/2023] [Accepted: 12/04/2023] [Indexed: 02/28/2024]
Abstract
BACKGROUND Visceral leishmaniasis (VL) is a zoonotic disease, with dogs being the main reservoir of the Leishmania infantum parasite. OBJECTIVE To develop a new flow cytometry test to diagnosis canine VL (CVL) diagnosis. METHODS The current study addresses a new flow cytometry test using beads coupled to the multiepitope antigen rMELEISH. RESULTS In the study set of samples a sensitivity (87.1%) and specificity (89.9%) was observed. Considering the dogs' clinical status, 20/20 (100.0%) of the symptomatic sera tested positive, while 19/22 (86.4%) of the oligosymptomatic and 16/20 (80.0%) of asymptomatic were positive. In the non-infected control, all samples (0/30) tested as negative. In the cross-reaction control, the test was more efficient in dogs infected with L. braziliensis (2/10) and Trypanosoma cruzi (0/10), than those with Babesia canis (4/10) and Ehrlichia canis (4/10). Dogs immunized with different vaccines (Leishmune, Leish-Tec®, or LBSap) did not present serological reactivity. CONCLUSION The flow cytometry serology through coupling the antigen rMELEISH in functional beads showed high accuracy in diagnosing CVL.
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Affiliation(s)
- Henrique Bonifácio Moura
- Laboratório de Doenças Infecto-parasitárias, Universidade Federal de São João Del-Rei, Divinópolis, MG, 35501- 296, Brazil
| | - Henrique Gama Ker
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas (NUPEB), Universidade Federal de Ouro Preto, Ouro Preto, MG, 35400-000, Brazil
- Laboratório Multiusuário de Citometria de Fluxo, Núcleo de Pesquisas em Ciências Biológicas (NUPEB), Universidade Federal de Ouro Preto, Ouro Preto, MG, 35400-000, Brazil
| | - Luana S Ramos
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São João Del-Rei, Divinópolis, MG, 35501-296, Brazil
| | - Lais M Nogueira
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São João Del-Rei, Divinópolis, MG, 35501-296, Brazil
| | - Juliana M Machado
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São João Del-Rei, Divinópolis, MG, 35501-296, Brazil
| | - Daniel S Dias
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São João Del-Rei, Divinópolis, MG, 35501-296, Brazil
| | - Rita Alaíde Leandro Rodrigues
- Laboratório de Doenças Infecto-parasitárias, Universidade Federal de São João Del-Rei, Divinópolis, MG, 35501- 296, Brazil
| | - Mariana Campos da Paz
- Laboratório de Nanobiotecnologia & Bioativos, Universidade Federal de São João Del-Rei, Divinópolis, MG, 35501-296, Brazil
| | - Rafael Gonçalves Teixeira-Neto
- Laboratório de Doenças Infecto-parasitárias, Universidade Federal de São João Del-Rei, Divinópolis, MG, 35501- 296, Brazil
| | - Alexandre Barbosa Reis
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas (NUPEB), Universidade Federal de Ouro Preto, Ouro Preto, MG, 35400-000, Brazil
- Laboratório Multiusuário de Citometria de Fluxo, Núcleo de Pesquisas em Ciências Biológicas (NUPEB), Universidade Federal de Ouro Preto, Ouro Preto, MG, 35400-000, Brazil
| | - Alexsandro S Galdino
- Laboratório de Biotecnologia de Microrganismos, Universidade Federal de São João Del-Rei, Divinópolis, MG, 35501-296, Brazil
| | - Eduardo S Silva
- Laboratório de Doenças Infecto-parasitárias, Universidade Federal de São João Del-Rei, Divinópolis, MG, 35501- 296, Brazil
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Veras PST, de Santana MBR, Brodskyn CI, Fraga DBM, Solcà MS, De Menezes JPB, Leite BMM, Teixeira HMP. Elucidating the role played by bone marrow in visceral leishmaniasis. Front Cell Infect Microbiol 2023; 13:1261074. [PMID: 37860064 PMCID: PMC10582953 DOI: 10.3389/fcimb.2023.1261074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/08/2023] [Indexed: 10/21/2023] Open
Abstract
Leishmaniasis is a widespread group of infectious diseases that significantly impact global health. Despite high prevalence, leishmaniasis often receives inadequate attention in the prioritization of measures targeting tropical diseases. The causative agents of leishmaniasis are protozoan parasites of the Leishmania genus, which give rise to a diverse range of clinical manifestations, including cutaneous and visceral forms. Visceral leishmaniasis (VL), the most severe form, can be life-threatening if left untreated. Parasites can spread systemically within the body, infecting a range of organs, such as the liver, spleen, bone marrow and lymph nodes. Natural reservoirs for these protozoa include rodents, dogs, foxes, jackals, and wolves, with dogs serving as the primary urban reservoir for Leishmania infantum. Dogs exhibit clinical and pathological similarities to human VL and are valuable models for studying disease progression. Both human and canine VL provoke clinical symptoms, such as organ enlargement, fever, weight loss and abnormal gamma globulin levels. Hematologic abnormalities have also been observed, including anemia, leukopenia with lymphocytosis, neutropenia, and thrombocytopenia. Studies in dogs have linked these hematologic changes in peripheral blood to alterations in the bone marrow. Mouse models of VL have also contributed significantly to our understanding of the mechanisms underlying these hematologic and bone marrow abnormalities. This review consolidates information on hematological and immunological changes in the bone marrow of humans, dogs, and mice infected with Leishmania species causing VL. It includes findings on the role of bone marrow as a source of parasite persistence in internal organs and VL development. Highlighting gaps in current knowledge, the review emphasizes the need for future research to enhance our understanding of VL and identify potential targets for novel diagnostic and therapeutic approaches.
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Affiliation(s)
- Patricia Sampaio Tavares Veras
- Laboratory of Parasite - Host Interaction and Epidemiology, Gonçalo Moniz Institute-Fiocruz Bahia, Salvador, Bahia, Brazil
- National Institute of Science and Technology of Tropical Diseases, National Council for Scientific Research and Development (CNPq), Salvador, Brazil
| | - Maria Borges Rabêlo de Santana
- Laboratory of Parasite - Host Interaction and Epidemiology, Gonçalo Moniz Institute-Fiocruz Bahia, Salvador, Bahia, Brazil
| | - Claudia Ida Brodskyn
- Laboratory of Parasite - Host Interaction and Epidemiology, Gonçalo Moniz Institute-Fiocruz Bahia, Salvador, Bahia, Brazil
| | - Deborah Bittencourt Mothé Fraga
- Laboratory of Parasite - Host Interaction and Epidemiology, Gonçalo Moniz Institute-Fiocruz Bahia, Salvador, Bahia, Brazil
- Department of Preventive Veterinary Medicine and Animal Production, School of Veterinary Medicine and Animal Science, Federal University of Bahia, Salvador, Brazil
| | - Manuela Silva Solcà
- Laboratory of Parasite - Host Interaction and Epidemiology, Gonçalo Moniz Institute-Fiocruz Bahia, Salvador, Bahia, Brazil
- Department of Preventive Veterinary Medicine and Animal Production, School of Veterinary Medicine and Animal Science, Federal University of Bahia, Salvador, Brazil
| | | | - Bruna Martins Macedo Leite
- Laboratory of Parasite - Host Interaction and Epidemiology, Gonçalo Moniz Institute-Fiocruz Bahia, Salvador, Bahia, Brazil
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Soares MF, Costa SF, de Freitas JH, Rebech GT, Dos Santos MO, de Lima VMF. MiR-150 regulates the Leishmania infantum parasitic load and granzyme B levels in peripheral blood mononuclear cells of dogs with canine visceral leishmaniosis. Vet Parasitol 2023; 320:109958. [PMID: 37269731 DOI: 10.1016/j.vetpar.2023.109958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/17/2023] [Accepted: 05/20/2023] [Indexed: 06/05/2023]
Abstract
Leishmania infantum causes visceral leishmaniosis, a neglected tropical disease that can modulate the host immune response by altering the expression of small non-coding RNAs called microRNAs (miRNAs). Some miRNAs are differentially expressed in peripheral blood mononuclear cells (PBMCs) of dogs with canine visceral leishmaniosis (CanL), like the down-regulated miR-150. Even though miR-150 is negatively correlated with L. infantum parasitic load, it is unclear if miR-150 directly affects L. infantum parasitic load and (if so) how this miRNA would contribute to infection. Here, we isolated PBMCs from 14 naturally infected dogs (CanL group) and six healthy dogs (Control group) and treated them in vitro with miR-150 mimic or inhibitor. We measured L. infantum parasitic load using qPCR and compared treatments. We also measured miR-150 in silico predicted target protein levels (STAT1, TNF-α, HDAC8, and GZMB) using flow cytometry or enzyme-linked immunosorbent assays. Increasing miR-150 activity diminished L. infantum parasitic load in CanL PBMCs. We also found that inhibition of miR-150 reduced GZMB (granzyme B) levels. These findings demonstrate that miR-150 plays an important role in L. infantum infection in canine PBMCs, and they merit further studies aiming at drug development.
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Affiliation(s)
- Matheus Fujimura Soares
- Department of Clinical Medicine, Surgery and Animal Reproduction, São Paulo State University (UNESP), School of Veterinary Medicine, 793 Clóvis Pestana St., Araçatuba, São Paulo, 16050-680, Brazil
| | - Sidnei Ferro Costa
- Department of Clinical Medicine, Surgery and Animal Reproduction, São Paulo State University (UNESP), School of Veterinary Medicine, 793 Clóvis Pestana St., Araçatuba, São Paulo, 16050-680, Brazil
| | - Jéssica Henrique de Freitas
- Department of Clinical Medicine, Surgery and Animal Reproduction, São Paulo State University (UNESP), School of Veterinary Medicine, 793 Clóvis Pestana St., Araçatuba, São Paulo, 16050-680, Brazil
| | - Gabriela Torres Rebech
- Department of Clinical Medicine, Surgery and Animal Reproduction, São Paulo State University (UNESP), School of Veterinary Medicine, 793 Clóvis Pestana St., Araçatuba, São Paulo, 16050-680, Brazil
| | - Marilene Oliveira Dos Santos
- Department of Clinical Medicine, Surgery and Animal Reproduction, São Paulo State University (UNESP), School of Veterinary Medicine, 793 Clóvis Pestana St., Araçatuba, São Paulo, 16050-680, Brazil
| | - Valéria Marçal Felix de Lima
- Department of Clinical Medicine, Surgery and Animal Reproduction, São Paulo State University (UNESP), School of Veterinary Medicine, 793 Clóvis Pestana St., Araçatuba, São Paulo, 16050-680, Brazil.
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Braz MS, Sáfadi T, Ferreira RA, Morais MHF, Silva Z, Rocha CMBMD. Temporal relationship between human and canine visceral leishmaniasis in an urban area in southeastern Brazil: An application of the ARIMAX model. Prev Vet Med 2023; 215:105921. [PMID: 37149992 DOI: 10.1016/j.prevetmed.2023.105921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 03/09/2023] [Accepted: 04/11/2023] [Indexed: 05/09/2023]
Abstract
Visceral leishmaniasis (VL) is a neglected disease of public and animal health importance. With the urbanization of the disease, there is evidence of a temporal correlation between the occurrence of human (HVL) and canine (CVL) visceral leishmaniasis, usually with cases in dogs preceding those in humans. In this context, the objective of this study was to develop a time series model suitable for canine-human transmission of Leishmania infantum. Monthly cases of HVL and CVL from 2006 to 2018 in Belo Horizonte, Minas Gerais, Brazil, were evaluated, and monthly health indicators were calculated for HVL and CVL, i.e., incidence coefficient (HVL_IC) and proportion of seropositive dogs (PSD), respectively. The temporal relationship was evaluated using an autoregressive integrated moving average with exogenous variable (ARIMAX) model for two different periods (January 2006-August 2013 and September 2013-December 2018). During the 13 years studied, 1115 new cases of HVL and 103,358 dogs seropositive for CVL were recorded. HVL_IC and PSD exhibited decreasing trends throughout the first study period (January 2006-August 2013). According to the ARIMAX model adjusted for this period, there was a temporal relationship between HVL_IC and PSD, with HVL_IC being influenced by HVL_IC for the last two and five months and by PSD for the third previous month. For the second study period (September 2013-December 2018), it was not possible to fit an ARIMAX model. This study highlights the improvements made by VL surveillance since 2006 in Belo Horizonte and contributes to a better understanding of the epidemiology of the disease by public health policy-makers, doctors and veterinarians involved in the prevention and control of zoonoses.
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Affiliation(s)
- Mirian Silvia Braz
- Faculdade de Zootecnia e Medicina Veterinária, Departamento de Medicina Veterinária, Universidade Federal de Lavras, CEP 37200-900 Lavras, Minas Gerais, Brazil
| | - Thelma Sáfadi
- Instituto de Ciências Exatas, Departamento de Estatística, Universidade Federal de Lavras, CEP 37200-900 Lavras, Minas Gerais, Brazil
| | - Rafael Agostinho Ferreira
- Instituto de Ciências Exatas, Departamento de Estatística, Universidade Federal de Lavras, CEP 37200-900 Lavras, Minas Gerais, Brazil
| | - Maria Helena Franco Morais
- Prefeitura de Belo Horizonte, Secretaria Municipal de Saúde, Diretoria de Zoonoses, CEP 30130-012 Belo Horizonte, Minas Gerais, Brazil
| | - Zoraia Silva
- Rua Dr. Armando Amaral 247, CEP 37203-587 Lavras, Minas Gerais, Brazil
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Visceral Leishmaniasis Urbanization in the Brazilian Amazon Is Supported by Significantly Higher Infection Transmission Rates Than in Rural Area. Microorganisms 2022; 10:microorganisms10112188. [PMID: 36363780 PMCID: PMC9692416 DOI: 10.3390/microorganisms10112188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/24/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
This was an open cohort prospective study (2016−2018) that analyzed the prevalence and incidence rates of human Leishmania (L.) infantum chagasi-infection and the evolution of their clinical-immunological profiles in distinct urban and rural scenarios of American visceral leishmaniasis (AVL) in Pará State, in the Brazilian Amazon. These infection profiles were based on species-specific DTH/IFAT-IgG assays and clinical evaluation of infected individuals, comprising five profiles: three asymptomatic, Asymptomatic Infection [AI], Subclinical Resistant Infection [SRI], and Indeterminate Initial Infection [III]; and two symptomatic, Subclinical Oligosymptomatic Infection [SOI] and Symptomatic Infection [SI = AVL]. The two distinct scenarios (900 km away) were the urban area of Conceição do Araguaia municipality and the rural area of Bujaru municipality in the southeast and northeast of Pará State. Human populations were chosen based on a simple convenience sampling design (5−10% in each setting), with 1723 individuals (5.3%) of the population (32,464) in the urban area and 1568 individuals (8.9%) of the population (17,596) in the rural one. A serological survey (IFAT-IgG) of canine infection was also performed in both scenarios: 195 dogs in the urban area and 381 in the rural one. Prevalence and incidence rates of human infection were higher in the urban area (20.3% and 13.6/100 person-years [py]) than in the rural setting (14.1% and 6.8/100-py). The AI profile was the most prevalent and incident in both urban (13.4% and 8.1/100-py) and rural (8.3% and 4.2/100-py) scenarios, but with higher rates in the former. An III profile case evolved to SOI profile after four weeks of incubation and another to SI (=AVL) after six. The prevalence of canine infection in an urban setting (39.2%) was also higher (p < 0.05) than that (32%) in the rural zone. AVL urbanization in Pará State, in the Brazilian Amazon, has led to infection rates significantly higher than those in rural sites, requiring more intense control measures.
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Borges MS, Niero LB, da Rosa LDS, Citadini-Zanette V, Elias GA, Amaral PDA. Factors associated with the expansion of leishmaniasis in urban areas: a systematic and bibliometric review (1959-2021). J Public Health Res 2022; 11:22799036221115775. [PMID: 36062236 PMCID: PMC9434684 DOI: 10.1177/22799036221115775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 07/09/2022] [Indexed: 11/15/2022] Open
Abstract
This work describes a systematic and bibliometric review of the factors that contribute to the expansion of leishmaniasis in urban areas. Three scientific databases were used: Scientific Electronic Library (SciELO), Scopus and Web of Science, encompassing all original and review articles between 1959 and 2021. Three descriptors were used: "leishmaniasis" AND "urban" AND "rural." Planning, execution, summarization, and selection processes were performed using StArt (State of the Art through Systematic Review) software. We obtained a total of 304 articles, 60 of which concerned canine leishmaniasis. The factors associated with the expansion of leishmaniasis in urban areas are interrelated, including socioenvironmental and economic complexity, the type of leishmaniasis, the reservoirs, vectors, deforestation, disorderly occupation of space, poor sanitary conditions, and human migration trends. A lack of diagnosis and underreporting of cases in some regions may reflect the increase of cases seen in urban areas. A majority (n = 121) of studies were conducted in Brazil, followed by Iran (n = 43). In relation to publications; in general, output has increased over the years, particularly in 2021. The majority of published studies were in the area of epidemiology (n = 158).
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Affiliation(s)
- Marília Schutz Borges
- Mestra em Ciências Ambientais, Programa
de Pós-Graduação em Ciências Ambientais, Universidade do Extremo Sul Catarinense
(UNESC), Criciúma, Santa Catarina, Brasil
| | - Luana Budny Niero
- Farmacêutica e mestranda do Programa de
Pós-Graduação em Ciências Ambientais, Universidade do Extremo Sul Catarinense
(UNESC), Criciúma, Santa Catarina, Brasil
| | - Laíse Dimer Sant’ana da Rosa
- Acadêmica do curso de farmácia da
Universidade do Extremo Sul Catarinense (UNESC), Criciúma, Santa Catarina,
Brasil
| | - Vanilde Citadini-Zanette
- Doutora em Ecologia e Recursos
Naturais, Programa de Pós-Graduação em Ciências Ambientais, Universidade do Extremo
Sul Catarinense (UNESC), Criciúma, Santa Catarina, Brasil
| | - Guilherme Alves Elias
- Doutor em Ciências Ambientais, Programa
de Pós-Graduação em Ciências Ambientais, Universidade do Extremo Sul Catarinense
(UNESC), Criciúma, Santa Catarina, Brasil
| | - Patrícia de Aguiar Amaral
- Doutora em Ciências Farmacêuticas,
Programa de Pós-Graduação em Ciências Ambientais, Universidade do Extremo Sul
Catarinense (UNESC), Criciúma, Santa Catarina, Brasil
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Zapata Bedoya S, Walteros Acero DM, Mercado M. Modelos geoespaciales para control de brotes de SARS-CoV-2 en Cartagena y Barranquilla, Colombia, 2020. Rev Panam Salud Publica 2022; 46:e26. [PMID: 35432500 PMCID: PMC9004696 DOI: 10.26633/rpsp.2022.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/25/2020] [Indexed: 11/24/2022] Open
Abstract
Objetivo. Determinar la estructura temporal y espacial del virus del síndrome respiratorio agudo grave (SARS-CoV-2, por su sigla en inglés), causante de la enfermedad por coronavirus (COVID-19, por su sigla en inglés) en las ciudades de Cartagena y Barranquilla para tomar acciones necesarias que apoyen el rastreo de contactos. Métodos. Estudio ecológico transversal que incluye análisis espacial basado en densidades Kernel de variables como casos, alertas desde una aplicación móvil, vulnerabilidad poblacional, índice de pobreza multidimensional, aplicación de interpolación espacial (IDW, por su sigla en inglés) de los casos activos y, por último, la aplicación de la técnica de superposición espacial como resultado final. Se utilizó la base de datos del Instituto Nacional de Salud de las ciudades de Cartagena y Barranquilla y el Departamento de Estadística Nacional. Resultados. El análisis determinó el comportamiento epidemiológico ascendente de los casos en las dos ciudades e identificó la dirección espacial de propagación de la enfermedad en los barrios, a través de la interpolación espacial. Se detectaron las zonas en las cuales intervenir en 15 barrios de Cartagena y 13 de Barranquilla, en 50 metros alrededor de los casos activos con menos de 21 días de evolución y según las capas de riesgo geográfico, como mecanismo para frenar la propagación de la COVID-19. Conclusiones. El análisis espacial permitió determinar la estructura temporal y espacial como metodología complementaria útil para el rastreo de contactos, y aportó la evidencia científica necesaria para la aplicación de medidas de intervención directa donde fuera necesario, dirigidas a reducir el contagio del SARS-CoV-2.
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Valero NNH, Prist P, Uriarte M. Environmental and socioeconomic risk factors for visceral and cutaneous leishmaniasis in São Paulo, Brazil. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 797:148960. [PMID: 34303257 DOI: 10.1016/j.scitotenv.2021.148960] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/18/2021] [Accepted: 07/06/2021] [Indexed: 06/13/2023]
Abstract
Leishmaniasis is a vector-borne disease caused by the protozoan Leishmania spp. mainly affecting individuals of low socioeconomic status. In tropical regions the transmission risk to humans depends not only on environmental factors, such as vegetation cover and climate, but also on the socioeconomic characteristics of human populations. However, the relative contribution of these factors to disease risk and incidence is not well understood. Yet this information is critical for the development of epidemiological surveillance schemes and control practices. Leishmaniasis cases have increased in São Paulo state, Brazil over recent years but the underlying risk factors for transmission remain understudied. Here, we use generalized linear mixed models to quantify the association between occurrence and incidence (number of cases) of cutaneous (CL) and visceral (VL) leishmaniasis from 1998 to 2015, and landscape (native vegetation cover), climate (seasonal and interannual variation in precipitation and temperature) and socioeconomic factors (population, number of cattle heads, Human Development Index - HDI, Gini inequality index and income per capita) across the 645 municipalities of São Paulo state, Brazil. For CL, probability of occurrence was greater in municipalities with high native vegetation cover and economic inequality and in years with greater average winter precipitation. For VL, probability of occurrence was greater in years with high minimum spring precipitation and maximum annual temperatures, and in municipalities with larger HDI values and a greater number of cattle heads. The number of VL cases increased during years with high mean fall precipitation and, for both CL and VL the number of cases was greater in years of high annual mean temperature. Understanding how these risk factors influence spatial and temporal variation in the risk and incidence of leishmaniasis can contribute to the development of effective public health policies and interventions.
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Affiliation(s)
- Nerida Nadia H Valero
- Departamento de Ecologia, Instituto de Biociências, 321 Rua do Matão, Travessa 14, Cidade Universitária, Universidade de São Paulo, São Paulo, SP CEP 05508090, Brazil.
| | - Paula Prist
- EcoHealth Alliance, 520 Eighth Avenue, Ste. 1200, New York, NY 10018, United States of America
| | - María Uriarte
- Department of Ecology, Evolution & Environmental Biology, Columbia University, 1200 Amsterdam Ave., New York, NY 10027, United States
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Andrade AWF, Souza CDF, Carmo RF. Temporal and spatial trends in human visceral leishmaniasis in an endemic area in Northeast Brazil and their association with social vulnerability. Trans R Soc Trop Med Hyg 2021; 116:469-478. [PMID: 34664077 DOI: 10.1093/trstmh/trab160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/12/2021] [Accepted: 10/01/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Visceral leishmaniasis is a neglected tropical disease of great importance to public health due to its wide distribution and close relationship with social and economic conditions. This study aimed to analyse the spatiotemporal dynamics of human visceral leishmaniasis (HVL) in an endemic state in the Northeast Region of Brazil and its spatial correlation with the Social Vulnerability Index (SVI) and the Municipal Human Development Index (MHDI). METHODS The study included all confirmed cases of HVL in Bahia from 2010 to 2017. A joinpoint regression model was used for trend analysis. Incidence rates were smoothed by a local empirical Bayesian model. Global and local Moran indices and space-time scan statistics were used for identification of spatial clusters. Bivariate and multivariate analyses were carried out to investigate the relationship between HVL incidence and the SVI and MHDI. RESULTS Cases of HVL demonstrated stationary behaviour during the period analysed. A significant association was observed between the HVL incidence rate and social vulnerability, with high-risk clusters concentrated in the central region of the state. CONCLUSIONS HVL has a strong correlation with social vulnerability in the state of Bahia. This study may provide assistance in planning actions and organizing health services to combat HVL.
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Affiliation(s)
- Acácio W F Andrade
- Pós-Graduação em Ciências da Saúde e Biológicas, Universidade Federal do Vale do São Francisco, Av. José de Sá Maniçoba, sn, Centro, Petrolina, Pernambuco 56304-917, Brazil
| | - Carlos D F Souza
- Faculdade de Medicina, Universidade Federal de Alagoas, Av. Manoel Severino Barbosa, Bom Sucesso, Arapiraca, Alagoas 57309-005, Brazil
| | - Rodrigo F Carmo
- Pós-Graduação em Ciências da Saúde e Biológicas, Universidade Federal do Vale do São Francisco, Av. José de Sá Maniçoba, sn, Centro, Petrolina, Pernambuco 56304-917, Brazil
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Siqueira WF, Viana AG, Reis Cunha JL, Rosa LM, Bueno LL, Bartholomeu DC, Cardoso MS, Fujiwara RT. The increased presence of repetitive motifs in the KDDR-plus recombinant protein, a kinesin-derived antigen from Leishmania infantum, improves the diagnostic performance of serological tests for human and canine visceral leishmaniasis. PLoS Negl Trop Dis 2021; 15:e0009759. [PMID: 34534217 PMCID: PMC8480608 DOI: 10.1371/journal.pntd.0009759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/29/2021] [Accepted: 08/24/2021] [Indexed: 02/07/2023] Open
Abstract
Visceral leishmaniasis (VL) is caused by protozoa belonging to the Leishmania donovani complex and is considered the most serious and fatal form among the different types of leishmaniasis, if not early diagnosed and treated. Among the measures of disease control stand out the management of infected dogs and the early diagnosis and appropriate treatment of human cases. Several antigens have been characterized for use in the VL diagnosis, among them are the recombinant kinesin-derived antigens from L. infantum, as rK39 and rKDDR. The main difference between these antigens is the size of the non-repetitive kinesin region and the number of repetitions of the 39 amino acid degenerate motif (6.5 and 8.5 repeats in rK39 and rKDDR, respectively). This repetitive region has a high antigenicity score. To evaluate the effect of increasing the number of repeats on diagnostic performance, we designed the rKDDR-plus antigen, containing 15.3 repeats of the 39 amino acid degenerate motif, besides the absence of the non-repetitive portion from L. infantum kinesin. Its performance was evaluated by enzyme-linked immunosorbent assay (ELISA) and rapid immunochromatographic test (ICT), and compared with the kinesin-derived antigens (rKDDR and rK39). In ELISA with human sera, all recombinant antigens had a sensitivity of 98%, whereas the specificity for rKDDR-plus, rKDDR and rK39 was 100%, 96% and 71%, respectively. When evaluated canine sera, the ELISA sensitivity was 97% for all antigens, and the specificity for rKDDR-plus, rKDDR and rK39 was 98%, 91% and 83%, respectively. Evaluation of the ICT/rKDDR-plus, using human sera, showed greater diagnostic sensitivity (90%) and specificity (100%), when compared to the IT LEISH (79% and 98%, respectively), which is based on the rK39 antigen. These results suggest that the increased presence of repetitive motifs in the rKDDR-plus protein improves the diagnostic performance of serological tests by increasing the specificity and accuracy of the diagnosis.
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Affiliation(s)
- Williane Fernanda Siqueira
- Programa de Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Agostinho Gonçalves Viana
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - João Luís Reis Cunha
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Leticia Mansur Rosa
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lilian Lacerda Bueno
- Programa de Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Daniella Castanheira Bartholomeu
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mariana Santos Cardoso
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Toshio Fujiwara
- Programa de Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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15
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Luz JGG, Dias JVL, Carvalho AG, Piza PA, Chávez-Pavoni JH, Bulstra C, Coffeng LE, Fontes CJF. Human visceral leishmaniasis in Central-Western Brazil: Spatial patterns and its correlation with socioeconomic aspects, environmental indices and canine infection. Acta Trop 2021; 221:105965. [PMID: 34029529 DOI: 10.1016/j.actatropica.2021.105965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/05/2021] [Accepted: 05/15/2021] [Indexed: 10/21/2022]
Abstract
In this ecological study, we investigated spatial patterns of human visceral leishmaniasis (VL) incidence, its correlation with socioeconomic aspects, environmental indices (obtained through remote sensing) and canine VL during 2011-2016 in the municipality of Rondonópolis, a relevant endemic area for VL in Central-Western Brazil. Human VL cases were georeferenced and point patterns were analyzed by univariate Ripley's K function and Kernel density estimation (KDE). Poisson-based scan statistics were used to investigate spatial and spatiotemporal clusters of human VL incidence at the neighborhood level. Socioeconomic and environmental characteristics were compared between neighborhoods within and outside spatial human VL clusters. Also, we assessed the correlation between smoothed human VL incidence and canine VL seropositivity rates within and between neighborhoods. Human VL cases were clustered up to 2000 m; four hotspots were identified by KDE in peripheral areas. Spatial and spatiotemporal low-risk clusters for human VL were identified in central and southern areas. Neighborhoods within spatial low-risk cluster presented higher mean income, literacy rate, sanitary sewage service coverage and lower altitude, compared to the rest of the municipality. A positive correlation was found between the occurrence of human and canine VL. On the northern outskirts, high human VL incidence was spatially correlated with high canine VL seropositivity in surrounding neighborhoods. In conclusion, human VL demonstrated a heterogeneous, aggregated and peripheral spatial pattern. This distribution was correlated with intra-urban socioeconomic differences and canine VL seropositivity at the neighborhood level.
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dos Santos CVB, Sevá ADP, Werneck GL, Struchiner CJ. Does deforestation drive visceral leishmaniasis transmission? A causal analysis. Proc Biol Sci 2021; 288:20211537. [PMID: 34428972 PMCID: PMC8385339 DOI: 10.1098/rspb.2021.1537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 07/30/2021] [Indexed: 11/12/2022] Open
Abstract
Vector-borne diseases (VBDs) are important contributors to the global disease burden and are a key factor in perpetuating economic inequality. Although environmental changes are often cited as drivers of VBDs, the link between deforestation and VBD occurrence remains unclear. Here, we examined this relationship in detail using the spread of visceral leishmaniasis (VL) in São Paulo state (Brazil) as the case study. We used a two-step approach to estimate the causal effects (overall, direct, and indirect) of deforestation on the occurrence of the VL vector, canine visceral leishmaniasis (CVL), and human visceral leishmaniasis (HVL). We first estimated the parameters via a double Metropolis-Hastings algorithm and then estimated the causal effects through a Gibbs sampler. We observed that the odds of vector, CVL, and HVL occurrence were 2.63-, 2.07-, and 3.18-fold higher, respectively, in deforested compared with forested municipalities. We also identified a significant influence of the presence of vector, CVL, and HVL in one municipality on disease occurrence in previously naive neighbouring municipalities. Lastly, we found that a hypothetical reduction in deforestation prevalence from 50 to 0% across the state would reduce vector, CVL, and HVL occurrence by 11%, 6.67%, and 29.87%, respectively. Our results suggest that implementing an eco-friendly development strategy that considers trade-offs between agriculture, urbanization, and conservation could be an effective mechanism of controlling VL.
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Affiliation(s)
- Cleber Vinicius Brito dos Santos
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524, Maracanã, Rio de Janeiro, Brazil
| | - Anaiá da Paixão Sevá
- Departamento de Ciência Animal e Agrárias, Universidade Estadual de Santa Cruz, Campus Soane Nazaré de Andrade, Rodovia Jorge Amado Km 16, Salobrinho, Ilhéus, Bahia, Brazil
| | - Guilherme Loureiro Werneck
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524, Maracanã, Rio de Janeiro, Brazil
| | - Cláudio José Struchiner
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524, Maracanã, Rio de Janeiro, Brazil
- Escola de Matemática Aplicada, Fundação Getúlio Vargas, Praia de Botafogo 190, Botafogo, Rio de Janeiro, Brazil
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Andrade AWF, Souza CDF, Carmo RF. Analysis of spatial clustering, time trend, social vulnerability and risk of human visceral leishmaniasis in an endemic area in Brazil: an ecological study. Trans R Soc Trop Med Hyg 2021; 114:575-584. [PMID: 32300810 DOI: 10.1093/trstmh/traa024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 01/08/2020] [Accepted: 03/13/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND More than 95% of visceral leishmaniasis (VL) cases in Latin America occur in Brazil, most of them in the northeast. The objective of this study was to identify spatial clusters with the highest risks of VL and to analyse the temporal behaviour of the incidence and the effects of social vulnerability on the disease transmission dynamic in northeastern Brazil. METHODS All confirmed cases registered as residents in the state of Pernambuco during the period from 2007 to 2017 were analysed. The local empirical Bayesian method was applied and the association -between the VL incidence rate and municipal social vulnerability was tested via classic multivariate regression. RESULTS A total of 1186 new cases were registered during the study period. Spatial analysis showed heterogeneous distribution, with the highest rates observed in the São Francisco and Sertão mesoregions. Moreover, the main factors associated with VL were urban infrastructure, income and work. CONCLUSIONS It was observed that spatial and temporal techniques are important tools for defining risk areas for VL, in conjunction with the evaluation of indexes of social vulnerability, which was shown to be an important factor for comprehending associations with VL in the state of Pernambuco.
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Affiliation(s)
- Acácio W F Andrade
- Pós-Graduação em Ciências da Saúde e Biológicas, Universidade Federal do Vale do São Francisco, Av. José de Sá Maniçoba, s/n, Centro, Petrolina-PE, 56304-917, Brazil
| | - Carlos D F Souza
- Faculdade de Medicina, Universidade Federal de Alagoas Av. Manoel Severino Barbosa, Bom Sucesso, Arapiraca-AL, 57309-005, Brazil
| | - Rodrigo F Carmo
- Pós-Graduação em Ciências da Saúde e Biológicas, Universidade Federal do Vale do São Francisco, Av. José de Sá Maniçoba, s/n, Centro, Petrolina-PE, 56304-917, Brazil.,Pós-Graduação em Biociências, Universidade Federal do Vale do São Francisco Av. José de Sá Maniçoba, s/n, Centro, Petrolina-PE, 56304-917, Brazil
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da Silva Santana Cruz C, Soeiro Barbosa D, Oliveira VC, Cardoso DT, Guimarães NS, Carneiro M. Factors associated with human visceral leishmaniasis cases during urban epidemics in Brazil: a systematic review. Parasitology 2021; 148:639-647. [PMID: 33431094 PMCID: PMC11010180 DOI: 10.1017/s0031182021000019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/28/2020] [Accepted: 12/30/2020] [Indexed: 11/06/2022]
Abstract
Visceral leishmaniasis (VL) is endemic in 70 countries and has been reported in 12 countries of Latin America, with over 90% of the cases reported in Brazil, where epidemics have occurred since 1980. The objective of this review is to describe the factors associated with the occurrence of VL epidemics in humans in urban areas. A systematic review was conducted according to the PRISMA-P guidelines. The databases PubMed (by Medline), Cochrane Library, Embase, Amed, LILACS and grey literature [Google Scholar and handsearch of the database of the Information System for Notifiable Diseases (SINAN) of Brazil's Unified Health System] were used. The protocol was registered under PROSPERO (CRD42019128998). Climatic, environmental factors and indicators of urban social structure were described as influencing the outbreaks in the North and Northeast regions. Gender and age characteristics were related to a greater chance of developing VL in the Central-West, Northeast and Southeast regions. Vector indicators showed a positive correlation with the incidence of VL in studies in the Northeast region. In the Southeast and Northeast regions, studies revealed the presence of dogs with positive correlation with VL. Knowledge gaps remain regarding the contribution to the increase in the risk factors described in ecological approaches, as no analysis was performed at the individual level, and it is still necessary to discuss the influence of other associated elements in epidemic episodes in the spread of VL.
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Affiliation(s)
- Cleya da Silva Santana Cruz
- Programa de Pós-graduação em Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, 30130-100, Belo Horizonte, MG, Brazil
| | - David Soeiro Barbosa
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901, Belo Horizonte, MG, Brazil
| | - Vinícius Cunha Oliveira
- Pós-graduação em Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 39100-000, Diamantina, MG, Brazil
| | - Diogo Tavares Cardoso
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901, Belo Horizonte, MG, Brazil
| | - Nathália Sernizon Guimarães
- Programa de Pós-graduação em Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, 30130-100, Belo Horizonte, MG, Brazil
| | - Mariângela Carneiro
- Programa de Pós-graduação em Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, 30130-100, Belo Horizonte, MG, Brazil
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901, Belo Horizonte, MG, Brazil
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Ramos PKS, Gonçalves LP, Alves ACO, Casseb SM, Lima LVDR, Campos MB, Vasconcelos Dos Santos T, Silveira FT. Urine qPCR diagnoses over the entire clinical-immunological spectrum of human Leishmania (L.) infantum chagasi-infections in the Brazilian Amazon. Parasitol Int 2020; 81:102273. [PMID: 33333246 DOI: 10.1016/j.parint.2020.102273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/17/2020] [Accepted: 12/10/2020] [Indexed: 10/22/2022]
Abstract
The clinical-immunological spectrum of human Leishmania (L.) infantum chagasi-infections in the Brazilian Amazon has been defined using DTH/IFAT-IgG immune assays and the clinical statuses of infected individuals, revealing five profiles: three asymptomatic [Asymptomatic Infection (AI), Subclinical Resistant Infection (SRI), and Indeterminate Initial Infection (III)], and two symptomatic profiles [Subclinical Oligosymptomatic Infection (SOI) and Symptomatic Infection (SI = American visceral leishmaniasis/AVL)]. We evaluated the diagnostic potential of urine qPCR over the entire spectrum of infection. Resine Instagene Matrix® was used for DNA extraction from urinary sediment, with amplification carried out using SYBR® Green Taq with the RV1 and RV2 primers. We examined urine samples from 151 individuals from an endemic area of AVL in Pará State in the Brazilian Amazon, including: 91 (60.3%) with diagnoses of previous infections [13 (14.3%) sharing the AI profile, 13 (14.3%) with the SRI profile, 43 (47.2%) with III, 12 (13.2%) with SI (treated AVL), and 10 (11%) with SI (untreated AVL)]; sixty (39.7%) were DTH(-)/IFAT-IgG(-) (the uninfected group). The urine qPCR was positive in 61.5% of both the AI and SRI profiles, 65% of the III profile, 50% of treated AVL, 100% of untreated AVL, and 6.7% of the uninfected group. Those results confirmed the urine qPCR diagnosis in 100% of untreated AVL cases as well as in more than 60% of the cases with asymptomatic AI, SRI, and III profiles - indicating it as a promising tool for monitoring the evolution of human L. (L.) infantum chagasi-infections in endemic areas.
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Affiliation(s)
- Patrícia Karla Santos Ramos
- Parasitology Department, Evandro Chagas Institute (Surveillance Secretary of Health, Ministry of Health), Ananindeua, Pará State, Brazil.
| | - Lucas Pantoja Gonçalves
- Parasitology Department, Evandro Chagas Institute (Surveillance Secretary of Health, Ministry of Health), Ananindeua, Pará State, Brazil
| | - Ana Camila Oliveira Alves
- Parasitology Department, Evandro Chagas Institute (Surveillance Secretary of Health, Ministry of Health), Ananindeua, Pará State, Brazil
| | - Samir Mansour Casseb
- Arbovirology Department, Evandro Chagas Institute (Surveillance Secretary of Health, Ministry of Health), Ananindeua, Pará State, Brazil
| | - Luciana Vieira do Rêgo Lima
- Parasitology Department, Evandro Chagas Institute (Surveillance Secretary of Health, Ministry of Health), Ananindeua, Pará State, Brazil
| | - Marliane Batista Campos
- Parasitology Department, Evandro Chagas Institute (Surveillance Secretary of Health, Ministry of Health), Ananindeua, Pará State, Brazil
| | - Thiago Vasconcelos Dos Santos
- Parasitology Department, Evandro Chagas Institute (Surveillance Secretary of Health, Ministry of Health), Ananindeua, Pará State, Brazil
| | - Fernando Tobias Silveira
- Parasitology Department, Evandro Chagas Institute (Surveillance Secretary of Health, Ministry of Health), Ananindeua, Pará State, Brazil; Tropical Medicine Nucleus, Federal University of Pará, Pará State, Brazil
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da Silva WJ, Cardoso DT, Morais MHF, Carneiro M, Moraga P, Barbosa DS. Spatiotemporal patterns and integrated approach to prioritize areas for surveillance and control of visceral leishmaniasis in a large metropolitan area in Brazil. Acta Trop 2020; 211:105615. [PMID: 32621931 DOI: 10.1016/j.actatropica.2020.105615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/17/2020] [Accepted: 06/30/2020] [Indexed: 11/17/2022]
Abstract
Visceral leishmaniasis (VL) is a neglected disease with worldwide distribution. Brazil is the country with the largest number of cases in the Americas, and the state of Minas Gerais presents a high VL-related burden and a high case fatality rate. We aimed to analyse the spatial and spatiotemporal patterns of VL occurrence and to identify priority risk areas for surveillance and control in the metropolitan region of Belo Horizonte-MG, the third largest metropolitan area in Brazil. An ecological study was conducted considering all cases of VL in humans confirmed from 2006 to 2017. The crude and smoothed incidence rates were used to analyse the distribution patterns of the disease (dispersed, random, or clustered) based on global and local indicators of spatial association and space-time risk assessment. Positive spatial autocorrelation and spatial dependence were found between incidence rates. It was possible to observe a high concentration of VL cases in the metropolitan core area, with the identification of two high-risk clusters in strictly urban areas, showing an urban association with the disease. Ten municipalities were categorised as high risk for VL occurrence. Our results provide evidence for making decisions in surveillance programs, suggesting the prioritisation of the municipalities with more risk of transmission.
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Affiliation(s)
- Wellington Junior da Silva
- Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Av. Presidente Antônio Carlos 6627, 31270-901, Belo Horizonte, Minas Gerais, Brazil
| | - Diogo Tavares Cardoso
- Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Av. Presidente Antônio Carlos 6627, 31270-901, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Helena Franco Morais
- Belo Horizonte Health Department, Avenida Afonso Pena 2336, 30130-012, Belo Horizonte, Minas Gerais, Brazil
| | - Mariângela Carneiro
- Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Av. Presidente Antônio Carlos 6627, 31270-901, Belo Horizonte, Minas Gerais, Brazil
| | - Paula Moraga
- Department of Mathematical Sciences, University of Bath, North Rd, Claverton Down, BA2 7AY, Bath, United Kingdom
| | - David Soeiro Barbosa
- Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Av. Presidente Antônio Carlos 6627, 31270-901, Belo Horizonte, Minas Gerais, Brazil; London School of Hygiene and Tropical Medicine, University of London, Keppel St, Bloomsbury, WC1E 7HT, London, United Kingdom.
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Falcão de Oliveira E, de Oliveira AG, de Arruda CCP, Fernandes WDS, de Medeiros MJ. Spatio-temporal modeling of visceral leishmaniasis in Midwest Brazil: An ecological study of 18-years data (2001-2018). PLoS One 2020; 15:e0240218. [PMID: 33007033 PMCID: PMC7531797 DOI: 10.1371/journal.pone.0240218] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 09/23/2020] [Indexed: 11/18/2022] Open
Abstract
Visceral leishmaniasis (VL) is a neglected vector-borne disease associated with socioeconomic and environmental issues. In Brazil, epidemics of VL have occurred in major cities since 1980. Applied models for medical and epidemiological research have been used to assess the distribution and characteristics of disease endpoints and identify and characterize potential risk factors. This study described the demographic features of VL and modeled the spatio-temporal distribution of human VL cases and their relationship with underlying predicitve factors using generalized additive models. We conducted an ecological study covering an 18-year period from the first report of an autochthonous case of VL in Campo Grande, state of Mato Grosso do Sul, in 2001 to 2018. The urban area of the city has 74 neighborhoods, and they were the units of analysis of our work. Socioeconomic and demographic data available from Brazilian public databases were considered as covariables. A total of 1,855 VL cases were reported during the study period, with an annual mean incidence rate of 13.23 cases per 100,000 population and a cumulative crude incidence of 235.77 per 100,000 population. The results showed the rapid transition from epidemic to endemic and the centrifugal dispersal pattern of the disease. Moreover, the model highlighted that the urban quality of life index, which is calculated based on income, education, housing conditions, and environmental sanitation data, plays a role in VL occurrence. Our findings highlighted the potential for improving spatio-temporal segmentation of control measures and the cost-effectiveness of integrated disease management programs as soon as VL is difficult to control and prevent and has rapid geographical dispersion and increased incidence rates.
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Affiliation(s)
- Everton Falcão de Oliveira
- Instituto Integrado de Saúde, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
- Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
- * E-mail: (EFO); (MJM)
| | - Alessandra Gutierrez de Oliveira
- Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
- Instituto de Biociências, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
| | | | - Wagner de Souza Fernandes
- Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
| | - Márcio José de Medeiros
- Campus Macaé, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
- * E-mail: (EFO); (MJM)
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Abstract
Human visceral leishmaniasis (HVL) cases are important public health problems due to their zoonotic aspect, with high rates of morbidity and mortality in Brazil. The aim of this this study was to identify spatial patterns in both rates of HVL cases in Brazilian states during the period from 2006 to 2015. This is an ecological study, using geoprocessing tools to create choropleth maps, based on secondary data from open access platforms, to identify priority areas for control actions of the disease. Data were collected in 2017 and analysed according to the global and local Moran's I, using TerraView 4.2.2 software. Similar clusters were observed in neighbouring municipalities in thematic maps of HVL, suggesting spatial similarity in the distribution of the disease in humans mainly in the North and Northeast Regions, which concentrate the states with the highest rates of HVL. Heterogeneous spatial patterns were observed in the distribution of HVL, which show municipalities that need higher priority in the intensification of disease surveillance and control strategies.
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Del Carro KB, Leite GR, de Oliveira Filho AG, dos Santos CB, de Souza Pinto I, Fux B, Falqueto A. Assessing geographic and climatic variables to predict the potential distribution of the visceral leishmaniasis vector Lutzomyia longipalpis in the state of Espírito Santo, Brazil. PLoS One 2020; 15:e0238198. [PMID: 32946444 PMCID: PMC7500671 DOI: 10.1371/journal.pone.0238198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 08/11/2020] [Indexed: 11/18/2022] Open
Abstract
Visceral leishmaniasis (VL) is an infectious disease caused by the protozoa Leishmania chagasi, whose main vector in South America is Lutzomyia longipalpis. The disease was diagnosed in the Brazilian state of Espírito Santo (ES) for the first time in 1968. Currently, this disease has been considered endemic in 10 municipalities. Furthermore, the presence of L. longipalpis has been detected in eight other municipalities where the transmission has not been reported thus far. In this study, we performed species distribution modeling (SDM) to identify new and most likely receptive areas for VL transmission in ES. The sandflies were both actively and passively collected in various rural area of ES between 1986 and 2017. The collection points were georeferenced using a global positioning system device. Climatic data were retrieved from the WorldClim database, whereas geographic data were obtained from the National Institute for Space Research and the Integrated System of Geospatial Bases of the State of Espírito Santo. The maximum entropy algorithm was used through the MIAmaxent R package to train and test the distribution models for L. longipalpis. The major contributor to model generation was rocky outcrops, followed by temperature seasonality. The SDM predicted the expansion of the L. longipalpis-prone area in the Doce River Valley and limited the probability of expanding outside its watershed. Once the areas predicted suitable for L. longipalpis occurrence are determined, we can avoid the inefficient use of public resources in conducting canine serological surveys where the vector insect does not occur.
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Affiliation(s)
- Karina Bertazo Del Carro
- Tropical Medicine Unit, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
- * E-mail:
| | - Gustavo Rocha Leite
- Tropical Medicine Unit, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | | | - Claudiney Biral dos Santos
- Tropical Medicine Unit, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
- Center for Entomology and Malacology, Espírito Santo State Health Department, Serra, Espírito Santo, Brazil
| | - Israel de Souza Pinto
- Tropical Medicine Unit, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Blima Fux
- Tropical Medicine Unit, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Aloísio Falqueto
- Tropical Medicine Unit, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
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Donato LE, de Freitas LRS, Duarte EC, Romero GAS. Visceral leishmaniasis lethality in Brazil: an exploratory analysis of associated demographic and socioeconomic factors. Rev Soc Bras Med Trop 2020; 53:e20200007. [PMID: 32935778 PMCID: PMC7491564 DOI: 10.1590/0037-8682-0007-2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 06/17/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION It is believed that delays in diagnosis and treatment of Visceral Leishmaniasis (VL) contribute significantly to the burden of VL lethality in Brazil. METHODS This study included several parts: a descriptive cross-sectional study of the individual characteristics of deaths from disease; a descriptive ecological study of the spatial distribution of deaths from disease; and an ecological analytical study to evaluate the association between disease lethality rates and the demographic, socioeconomic, and health indicators. The study population comprised all cases diagnosed throughout the country per the National Disease Notification System (SINAN) and the total number of disease deaths recorded in the Mortality Information System (SIM) from 2007 to 2012. RESULTS Of the 223 deaths from disease captured by pairing the databases, 59.1% were reported as "death from other causes". There were significant associations between VL lethality rate and municipalities with the highest proportion of vulnerable individuals (rate ratio (RR)=1.18, 95% confidence interval (CI): 1.01-1.27), with VL lower incidence rate (RR=0.62, 95% CI: 0.58-0.67) and a higher incidence rate of Acquired Immune Deficiency Syndrome (AIDS) (RR=1.20, 95% CI: 1.17-1.51). CONCLUSIONS Linking the SINAN and SIM databases allowed the inclusion of 14% of otherwise underreported deaths from VL for the study period, showing that this method is useful for the surveillance of VL-related deaths. The size of the municipal population, proportion of the vulnerable population, incidence of disease, and the incidence of AIDS were associated with municipal lethality rates related to VL in Brazil.
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Affiliation(s)
- Lucas Edel Donato
- Ministério da Saúde, Secretaria de Vigilância em Saúde, Brasília,
DF, Brasil
| | | | - Elisabeth Carmen Duarte
- Universidade de Brasília, Faculdade de Medicina, Programa de
Pós-Graduação em Medicina Tropical, Brasília, DF, Brasil
| | - Gustavo Adolfo Sierra Romero
- Universidade de Brasília, Faculdade de Medicina, Programa de
Pós-Graduação em Medicina Tropical, Brasília, DF, Brasil
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Lopes JV, Michalsky ÉM, Pereira NCL, Paula AJVD, Souza AGM, Pinheiro LC, Lima ACVMDR, Avelar DMD, França-Silva JC, Lanzetta VAS, Melo JD, Fortes-Dias CL, Dias ES. Canine visceral leishmaniasis in area with recent Leishmania transmission: prevalence, diagnosis, and molecular identification of the infecting species. Rev Soc Bras Med Trop 2020; 53:e20200141. [PMID: 32935783 PMCID: PMC7491567 DOI: 10.1590/0037-8682-0141-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/15/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION: Canine visceral leishmaniasis (CVL) is an endemic disease in Brazil, and
integrated control actions have been adopted by the Brazilian Ministry of
Health to control its spread. However, the transmission profile is unknown
in areas with recent CVL cases, including Itaúna, located in the Brazilian
state of Minas Gerais, where the present study was carried out. METHODS: A total of 2,302 dogs from 12 neighborhoods were serologically tested for
canine VL using the current diagnostic protocol adopted by the Brazilian
Ministry of Health. Test positivity rate (TPR) and CVL prevalence were
determined for each neighborhood. The presence of
Leishmania was assessed in 60 seropositive dogs which
had been recommended for euthanasia. Twenty-two of them (37%) were
asymptomatic, and 38 (63%) were symptomatic for CVL. Parasitological
(myeloculture and smear/imprint) and molecular (PCR) methods were employed
for Leishmania detection in bone marrow, spleen, mesenteric
lymph nodes, and ear skin. The infecting Leishmania species
was identified by DNA sequencing. RESULTS: CVL prevalence (per 1,000 dogs) varied from 0.0-166.67, depending on the
neighborhood, with a mean of 68.96 (SD 51.38). Leishmania
DNA was detected in at least one tissue from all seropositive dogs, with
comparable TPR among tissues. Leishmania parasites were
identified in most (54/60) seropositive dogs, and the infecting parasite was
identified as Leishmania infantum in all of these. CONCLUSIONS: Prevalence of CVL is a contributor to the spread of visceral leishmaniasis
in Itaúna.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Jarbas de Melo
- Prefeitura Municipal de Itaúna, Centro de Controle de Zoonoses, Itaúna, MG, Brasil
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Machado CAL, Sevá ADP, Dantas-Torres F, Horta MC. Spatial analysis and epidemiological profile of visceral leishmaniasis, northeastern Brazil: A cross-sectional study. Acta Trop 2020; 208:105520. [PMID: 32413361 DOI: 10.1016/j.actatropica.2020.105520] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/28/2020] [Accepted: 04/28/2020] [Indexed: 02/03/2023]
Abstract
Most visceral leishmaniasis (VL) cases reported in Brazil are from the northeast region, where the disease is strongly linked to poverty. In spite of the still existing inequalities, many social improvements were achieved in the past decades in this region, but the possible impact of these improvements on VL remains poorly investigated. We conducted a cross-sectional study coupled with a spatial analysis of VL cases notified in northeastern Brazil from 2007 to 2017. In total, 21,703 cases were reported during this period, with an annual incidence of 3.6 cases per 100,000 inhabitants. Children under 10 years old and males were more affected, and most cases were from urban areas. Living in municipalities situated in the Cerrado, Amazon or, to a lesser extent, in the Caatinga biomes was a risk factor for VL. This study indicates that the epidemiological profile of VL patients remained unchanged in northeastern Brazil, suggesting that social improvements achieved in this region were not enough to mitigate the risk of this disease among the most affected populations.
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Affiliation(s)
| | - Anaiá da Paixão Sevá
- Universidade Estadual de Santa Cruz, Campus Soane Nazaré de Andrade, Rod. Jorge Amado, Km 16 - Salobrinho, Ilhéus, Bahia, 45662-900 Brazil
| | - Filipe Dantas-Torres
- Instituto Aggeu Magalhães (Fiocruz-PE), Campus da UFPE - Av. Prof. Moraes Rego, s/n - Cidade Universitária, Recife, Pernambuco, 50740-465 Brazil
| | - Maurício Claudio Horta
- Universidade Federal Rural de Pernambuco, Dom Manuel de Medeiros, s/n - Dois Irmãos, Recife Pernambuco, 52171-900, Brazil; Universidade Federal do Vale do São Francisco, Rodovia BR-407, KM 12 Lote 543 S/n Projeto de Irrigação Nilo Coelho, Petrolina, Pernambuco, 56300-000, Brazil.
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Detection of Metalloproteases and Cysteine Proteases RNA Transcripts of Leishmania (Leishmania) infantum in Ear Edge Skin of Naturally Infected Dogs. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2615787. [PMID: 32685457 PMCID: PMC7333044 DOI: 10.1155/2020/2615787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/12/2020] [Accepted: 05/26/2020] [Indexed: 12/03/2022]
Abstract
Leishmania spp. proteases have been proposed as virulence factors contributing to adaptive success these parasites to the mammalian hosts. Since these enzymes are poorly studied in naturally infected dogs, this work aims to show the differences in metalloprotease and cysteine proteases gene expression in ear edge skin of dogs naturally infected by Leishmania (Leishmania) infantum. A cohort of dogs (n = 20) naturally infected by L. (L.) infantum was clinically classified as asymptomatic, oligosymptomatic, and polysymptomatic and the parasite load range estimated. The analysis of proteases expression by RT-PCR in the ear edge skin was also assessed, suggesting more transcripts of proteases in cDNA samples from polysymptomatic dogs than oligosymptomatic and asymptomatic ones. Metalloprotease RT-PCR assays yielded products (202 bp) in all assessed cDNA dog samples. In contrast, cysteine proteases transcripts (227 bp) had shown to be better detected in cDNA samples of polysymptomatic dogs, compared with cDNA samples from asymptomatic and oligosymptomatic dogs. Predictive in silico assays suggested that secondary structures of metalloproteasee mRNAs can be more stable than cysteine proteases at the skin temperature of dogs. Evidence is presented that during natural infection of dogs by L. (L.) infantum, this parasite produces transcripts of metalloprotease and cysteine protease RNA in the skin from asymptomatic, oligosymptomatic, and polysymptomatic dogs.
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28
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Lima L, Vasconcelos-Dos-Santos T, Campos M, Ramos PK, Gomes C, Laurenti M, da Matta V, Corbett C, Silveira F. New record of preclinical diagnosis of American visceral leishmaniasis in Amazonian Brazil encourages optimizing disease control. Parasite Epidemiol Control 2020; 10:e00154. [PMID: 32435706 PMCID: PMC7232079 DOI: 10.1016/j.parepi.2020.e00154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 04/29/2020] [Accepted: 05/02/2020] [Indexed: 12/30/2022] Open
Abstract
The clinical-immunological spectrum of human Leishmania (L.) infantum chagasi-infection in Amazonian Brazil has recently been reviewed based on the combined use of the delayed-type hypersensitivity (DTH) and indirect fluorescence antibody test (IFAT-IgG/IgM), both with homologous L. (L.) infantum chagasi-antigens, and associated with the clinical evaluation of infected individuals. This diagnostic approach has allowed to identify the broadest clinical-immunological spectrum of human L. (L.) infantum chagasi-infection composed by five clinical-immunological profiles of infection: three asymptomatic, 1) Asymptomatic Infection (AI) [DTH+/++++, IFAT−], 2) Subclinical Resistant Infection (SRI) [DTH+/++++, IFAT+/++], and 3) Indeterminate Initial Infection (III) [DTH−, IFAT+/++], and two symptomatic ones, 4) Symptomatic Infection (SI) [=American visceral leishmaniasis - AVL] and, 5) Subclinical Oligosymptomatic Infection (SOI), both with the same immune profile [DTH−, IFAT+++/++++]. Herein, we confirm for the third time the preclinical diagnosis of AVL through IgM-antibody response in an early asymptomatic case of infection (profile III), a 17-year-old boy who evolved to AVL (=profile SI) six weeks after the initial infection diagnosis, confirming that the combined use of DTH and IFAT-(IgG/IgM) assays associated with the clinical evaluation of infected individuals is potentially useful for monitoring human L. (L.) infantum chagasi-infection in endemic areas as well as optimizing AVL control.
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Affiliation(s)
- Luciana Lima
- Parasitology Department, Evandro Chagas Institute, Ananindeua, Para State, Brazil
| | | | - Marliane Campos
- Parasitology Department, Evandro Chagas Institute, Ananindeua, Para State, Brazil
| | - Patrícia Karla Ramos
- Parasitology Department, Evandro Chagas Institute, Ananindeua, Para State, Brazil
| | - Claudia Gomes
- Pathology Department, Medical School of São Paulo University, São Paulo, São Paulo State, Brazil
| | - Marcia Laurenti
- Pathology Department, Medical School of São Paulo University, São Paulo, São Paulo State, Brazil
| | - Vania da Matta
- Pathology Department, Medical School of São Paulo University, São Paulo, São Paulo State, Brazil
| | - Carlos Corbett
- Pathology Department, Medical School of São Paulo University, São Paulo, São Paulo State, Brazil
| | - Fernando Silveira
- Parasitology Department, Evandro Chagas Institute, Ananindeua, Para State, Brazil.,Nucleus of Tropical Medicine, Federal University of Pará, Belém, Para State, Brazil
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29
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Environmental and socioeconomic risk factors associated with visceral and cutaneous leishmaniasis: a systematic review. Parasitol Res 2020; 119:365-384. [PMID: 31897789 DOI: 10.1007/s00436-019-06575-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 12/10/2019] [Indexed: 12/11/2022]
Abstract
We performed a systematic review of the literature published since 1900 about leishmaniasis a neglected vector-borne disease, focused on environmental and social risk factors for visceral (VL) and cutaneous leishmaniasis (CL) to better understand their impact on the incidence of disease. The search terms were "leishmaniasis" AND "risk factors" using Google Scholar, PudMed, and Scielo. We reviewed 177 articles, 95 studies for VL, 75 for CL, and 7 on both forms. We identified 14 categories of risk factors which were divided into three groups: socioeconomic (7), environmental (5), and climate (2) variables. Socioeconomic factors were also associated with disease incidence in vulnerable human populations of arid and tropical developing regions. Environmental and climate factors showed significant associations with the incidence of VL and CL in all the studies that considered them. Proximity to natural vegetation remnants increased disease risk in both the New and Old World while the climate conditions favorable for disease transmission differed among regions. We propose a common conceptual framework for both clinical forms that highlights networks of interaction among risk factors. In both clinical forms, the interplay of these factors played a major role in disease incidence. Although there are similarities in environmental and socioeconomic conditions that mediate the transmission cycle of tropical, arid, and Mediterranean regions, the behavior of vector and reservoirs in each region is different. Special attention should be given to the possibility of vector adaptation to urban environments in developing countries where populations with low socioeconomic status are particularly vulnerable to the disease.
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30
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Space-time analysis of the incidence of human visceral leishmaniasis (VL) and prevalence of canine VL in a municipality of southeastern Brazil: Identification of priority areas for surveillance and control. Acta Trop 2019; 197:105052. [PMID: 31233726 DOI: 10.1016/j.actatropica.2019.105052] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/01/2019] [Accepted: 06/01/2019] [Indexed: 12/13/2022]
Abstract
Human and canine visceral leishmaniasis (HVL and CVL, respectively) represent serious public health issues in Brazil. The surveillance and control measures currently employed have had limited effect in impeding the territorial expansion of the disease and in reducing the number of cases. We have investigated the space-time distribution of HVL incidence rates and CVL prevalence in the coverage areas of the 148 primary healthcare units in Belo Horizonte (MG, Brazil) during a 6-year period in order to identify those that should be prioritized for disease control actions. Data were smoothed using the empirical Bayes method and analyzed by space-time scanning and application of univariate global Moran's I index and local indicators of spatial association (LISA) statistics to identify spatial autocorrelations. Point data of CVL were analyzed using the Kernel method. Bivariate global Moran's I and LISA techniques were employed to identify spatial correlations between HVL and CVL. Based on our results, we were able to formulate two proposals for establishing the prioritization of coverage areas, namely: (i) classification of maximum priority areas as identified by bivariate LISA for HVL and CVL, and (ii) combination of maximum priority areas with high priority areas as identified by univariate LISA for HVL. According to our proposals, 27 coverage areas in Belo Horizonte were categorized as maximum priority and a further 13 were classified as high priority. Our proposals, which are based on practical, feasible and inexpensive statistical tools, will contribute to a better understanding of VL distribution in urban settings and improving the efficiency of governmental control programs.
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31
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Lamattina D, Berrozpe PE, Casas N, Moya SL, Giuliani MG, Costa SA, Arrabal JP, Martínez MF, Rivero MR, Salas M, Humeres CA, Liotta DJ, Meichtry MB, Salomón OD. Twice upon a time: The progression of canine visceral leishmaniasis in an Argentinean city. PLoS One 2019; 14:e0219395. [PMID: 31276573 PMCID: PMC6611631 DOI: 10.1371/journal.pone.0219395] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 06/21/2019] [Indexed: 11/18/2022] Open
Abstract
Canine Visceral Leishmaniasis (CVL) prevalence, spatial distribution and associated factors were assessed in four locations in Iguazú department in 2014 and in Puerto Iguazú city again in 2018. The city areas were divided into a grid of 400x400m cells. All cells were sampled in 2014 and a random subsampling was developed in 2018. In each cell, five dogs clustered in a 'critical scenario' (prone to have vectors) were sampled. A rapid immunochromatographic dipstick was used to detect antibodies against Leishmania infantum, confirming by lymph node smears observation and PCR. For Puerto Iguazú, Generalized Linear Models (GLMs) were constructed considering environmental, dog and clinical variables. Pearson's Chi square and Fisher's exact tests were employed to evaluate the association between CVL, dog clinical signs and infestation with other parasites. Cartographic outputs were made and Moran's I indices were calculated as spatial autocorrelation indicators. CVL prevalence rates were 26.18% in 2014 and 17.50% in 2018. No associations were established in environmental models, but dog age and repellent use were significant when running 2014 dog models. Clinical models showed significant associations between seropositive dogs and ophthalmological, dermal signs and onychogryphosis in 2014. In 2018, only adenomegaly was associated. The results of global Moran´s I were not significant but regarding local analysis, six sites in 2014 and one in 2018 presented autocorrelation with neighboring sites. The decrease in CVL prevalence may be associated to transmission stabilization, which could explain the lack of associations with dog-related variables. Further, spatial distribution of CVL is a poor evidence for design of transmission control measures but could be important in case of intensive parasite circulation or when the first autochthonous cases appear. For control success, sensitivity of diagnostic methods, political will and adequate material resources remain critical. Modeling of multiple variables will be required to identify factors that drive disease stabilization/destabilization.
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Affiliation(s)
- Daniela Lamattina
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
| | - Pablo Eduardo Berrozpe
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Natalia Casas
- Dirección Nacional de Epidemiología y Análisis de la Situación de Salud, Ministerio de Salud y Desarrollo Social de la Nación, Buenos Aires, Argentina
| | - Sofía Lorian Moya
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Magalí Gabriela Giuliani
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
| | - Sebastián Andrés Costa
- Instituto de Biología Subtropical, Facultad de Ciencias Forestales, Universidad Nacional de Misiones, Puerto Iguazú, Misiones, Argentina
| | - Juan Pablo Arrabal
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
| | - Mariela Florencia Martínez
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
| | - María Romina Rivero
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Martín Salas
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
| | - Cristian Alejandro Humeres
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
| | - Domingo Javier Liotta
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
| | - María Belén Meichtry
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
| | - Oscar Daniel Salomón
- Instituto Nacional de Medicina Tropical (INMeT), Ministerio de Salud y Desarrollo Social de la Nación, Puerto Iguazú, Misiones, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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Failure of the dog culling strategy in controlling human visceral leishmaniasis in Brazil: A screening coverage issue? PLoS Negl Trop Dis 2019; 13:e0007553. [PMID: 31242193 PMCID: PMC6615633 DOI: 10.1371/journal.pntd.0007553] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 07/09/2019] [Accepted: 06/17/2019] [Indexed: 11/19/2022] Open
Abstract
In the present study, we assessed the annual screening coverage (i.e., the percentage of dogs that are screened for anti-Leishmania antibodies annually) in the municipality of Sobral, Ceará state, Brazil. Data on the number of dogs screened during 2008−2017 (except 2010) were obtained from the Centre for Zoonoses Control of Sobral. The annual screening coverage during 2012−2017 was calculated. Data on human visceral leishmaniasis (VL) cases during 2008−2017 were compiled from the National Disease Notification System. Correlation analyses were performed to assess the correlation between canine and human data. During 2008−2017, 73,964 dogs (range, 0 to 13,980 dogs/year) were serologically screened and 2,833 (3.8%) were positive. The annual screening coverage during 2012−2017 ranged from 11.1% to 45.7%. There were no significant correlations between the number of dogs culled and the number of human VL cases, canine positivity and human VL incidence, number of dogs culled and human VL incidence, or between canine positivity and number of human VL cases. An inconsistent and relatively low annual screening coverage was found in the study area, with no dog being screened in 2010 due to the lack of serological tests. Our results highlight that many dogs potentially infected with Leishmania infantum have been virtually overlooked by public health workers in the study area, perhaps with a negative, yet underestimated, impact on the control of canine and human VL. Hence, the failure of the dog culling strategy in controlling human VL in Brazil may be due to the low screening coverage and low percentage of culled dogs, rather than the absence of associations between canine and human infections. The euthanasia of Leishmania-seropositive dogs has been recommended for controlling human visceral leishmaniasis (VL) in some countries where this zoonosis is endemic. We assessed the annual screening coverage (i.e., the percentage of dogs living in a given area that are screened for anti-Leishmania antibodies annually) in the municipality of Sobral, Ceará state, one of the main foci of human VL in Brazil. From 2008 to 2017, nearly 74,000 dogs were screened and 3.8% of them were positive for anti-Leishmania antibodies. No statistically significant correlation was found between the number of dogs culled annually and the incidence of human VL. The annual screening coverage ranged from 11.1% to 45.7%. Our results highlight an inconsistent and relatively low annual screening coverage, indicating that dogs potentially infected with L. infantum have been virtually overlooked by public health workers in the study area.
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Prestes-Carneiro LE, Daniel LAF, Almeida LC, D'Andrea LZ, Vieira AG, Anjolete IR, André L, Flores EF. Spatiotemporal analysis and environmental risk factors of visceral leishmaniasis in an urban setting in São Paulo State, Brazil. Parasit Vectors 2019; 12:251. [PMID: 31113445 PMCID: PMC6528369 DOI: 10.1186/s13071-019-3496-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 05/09/2019] [Indexed: 12/04/2022] Open
Abstract
Background In Latin America, Brazil harbors the most cases of human visceral leishmaniasis (HVL). Since the early 1980s, the disease has spread to the urban centers of the north, and now the south and west of Brazil; it reached São Paulo state in the southeast in 1996, and Presidente Prudente in the western region in 2010. Our aim was to describe the spatiotemporal analysis and environmental risk factors associated with the dispersion of VL in Presidente Prudente, an urban setting with recent transmission. Methods An entomological survey was carried out from 2009 to 2015. A canine visceral leishmaniasis (CVL) serosurvey was performed from 2010 to 2015 using enzyme-linked immunosorbent assays (ELISA), a dual-path platform CVL rapid test, and indirect fluorescent antibodies (IFAT). Data from HVL cases were obtained from the Municipal Surveillance Epidemiology Center from 2013 to 2017. Data on water drainage and forest fragments were obtained from public platforms and irregular solid-waste deposits were determined by monthly inspections of the urban area. Kernel density maps of the distribution of CVL were constructed. Results From 2009 to 2015, Lutzomyia longipalpis sand flies were found in all seven areas of Presidente Prudente. From 2010 to 2015, 40,309 dogs were serologically screened and 638 showed positive results, i.e. a prevalence rate of 1.6%. From 2013 to 2017, six human cases were diagnosed with a mortality rate of 33.3%. In 2015, 56 points of irregular solid-waste deposits were identified, predominantly in the neighborhoods. Three different hotspots of CVL showed an increased distribution of vectors, seropositive dogs, irregular solid-waste deposits, forest fragments and water drainage. Conclusions The use of tools that analyze the spatial distribution of vectors, canine and human VL as environmental risk factors were essential to identifying the areas most vulnerable to the spread or maintenance of VL. The results may help public health authorities in planning prevention and control measures to avoid expansion and future outbreaks.
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Affiliation(s)
- Luiz E Prestes-Carneiro
- Infectious Diseases and Immunology Department, Universidade do Oeste Paulista, Presidente Prudente, São Paulo, Brazil.
| | - Loris A F Daniel
- Infectious Diseases and Immunology Department, Universidade do Oeste Paulista, Presidente Prudente, São Paulo, Brazil
| | - Lívia C Almeida
- Infectious Diseases and Immunology Department, Universidade do Oeste Paulista, Presidente Prudente, São Paulo, Brazil
| | - Lourdes Zampieri D'Andrea
- Center for Biomedical Sciences and Regional Laboratory, Instituto Adolfo Lutz, Presidente Prudente, São Paulo, Brazil.,Statistics Department, School of Sciences and Technology, São Paulo State University, Presidente Prudente Campus, Presidente Prudente, São Paulo, Brazil
| | - André G Vieira
- Municipal Secretariat of Environment, Presidente Prudente, São Paulo, Brazil
| | - Ivete R Anjolete
- Supervision in Control of Endemics, Presidente Prudente, São Paulo, Brazil
| | - Lenira André
- Statistics Department, School of Sciences and Technology, São Paulo State University, Presidente Prudente Campus, Presidente Prudente, São Paulo, Brazil
| | - Edilson F Flores
- Statistics Department, School of Sciences and Technology, São Paulo State University, Presidente Prudente Campus, Presidente Prudente, São Paulo, Brazil
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Cardoso DT, de Souza DC, de Castro VN, Geiger SM, Barbosa DS. Identification of priority areas for surveillance of cutaneous leishmaniasis using spatial analysis approaches in Southeastern Brazil. BMC Infect Dis 2019; 19:318. [PMID: 30975100 PMCID: PMC6458754 DOI: 10.1186/s12879-019-3940-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 03/27/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) is an important public health problem in Brazil and in several tropical regions of the world. In the Americas, Brazil is the country with the highest number of registered cases. In Brazil, the state of Minas Gerais has the highest number of cases in the southeastern region. In the present study, we used spatial analysis in the State of Minas Gerais to identify municipalities of priority during a nine-year period (2007-2015), which might be used to guide surveillance and control measures. METHODS An ecological study with spatial analysis of autochthonous cases of CL was performed in the state of Minas Gerais between 2007 and 2015. We calculated incidence rates, used Empirical Bayesian smoothing for each municipality, and divided the analyses into three-year intervals. In order to analyze the existence of spatial autocorrelation, and to define priority areas, Moran's Global Index and Local Indicators of Spatial Association (LISA) were used. RESULTS The mean incidence rate for the entire state was 6.1/100,000 inhabitants. For Minas Gerais, analysis of CL cases over time revealed a successive increase of indicated mesoregions with high priority municipalities. Eight of the designated mesoregions contained municipalities classified as high priority areas in any of the three evaluated trienniums, and four mesoregions had high priority municipalities throughout the entire investigation. CONCLUSIONS Within the southeastern region of Brazil, Minas Gerais State stands out, with highest CL incidence rates. Using spatial analysis, we identified an increasing numbers of cases in the municipalities classified as high priority areas in different mesoregions of the state. This information might be of value to direct surveillance and control measures against CL and to understand the dynamics of the expansion of CL in Minas Gerais. Similar approaches might be used to map CL in other regions throughout Brazil, or in any other country, where national notification and control programs exist.
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Affiliation(s)
- Diogo Tavares Cardoso
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG, 31270-901, Brazil.
| | - Dayane Costa de Souza
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG, 31270-901, Brazil
| | - Vanessa Normandio de Castro
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG, 31270-901, Brazil
| | - Stefan Michael Geiger
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG, 31270-901, Brazil
| | - David Soeiro Barbosa
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG, 31270-901, Brazil
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Marcondes M, Day MJ. Current status and management of canine leishmaniasis in Latin America. Res Vet Sci 2019; 123:261-272. [PMID: 30708238 DOI: 10.1016/j.rvsc.2019.01.022] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 01/18/2019] [Accepted: 01/20/2019] [Indexed: 12/14/2022]
Abstract
Latin America encompasses diverse geographical, cultural and socio-economic conditions, which are reflected in the challenges for infectious disease control in the region. One of the most significant regional infectious diseases for humans and domestic dogs is leishmaniasis, occurring as visceral leishmaniasis (VL) caused by Leishmania infantum (syn. L. chagasi) transmitted by sand flies (Lutzomyia longipalpis) and with a canine reservoir, and the more common cutaneous leishmaniasis (CL) involving multiple Leishmania spp. (particularly L. braziliensis), sand fly vectors and reservoir hosts. VL is spreading within Latin America for reasons related to mass migration of human and canine populations, with incursion into novel environments (e.g. related to deforestation) coupled with a background of poverty and poor public health infrastructure. The challenges for control of VL also include: (1) the accurate identification of infected dogs (particularly subclinically infected dogs) with the current reliance on serological rather than molecular diagnostic methods, (2) controversy surrounding the ethics and efficacy of culling of seropositive dogs, (3) the limited efficacy of currently available canine vaccines and their potential to interfere with interpretation of serological testing, (4) the expense associated with distribution of insecticidal dog collars, which may prove to be the most valuable control method, and (5) the cost and therefore accessibility of licensed medical treatment for canine leishmaniasis by the general population. Resolution of these isssues will necessitate a 'One Health' approach to co-ordination of resources between human and veterinary healthcare.
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Affiliation(s)
- Mary Marcondes
- São Paulo State University (Unesp), School of Veterinary Medicine, Araçatuba, 16050-680 Araçatuba, São Paulo, Brazil.
| | - Michael J Day
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Australia
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Machado G, Alvarez J, Bakka HC, Perez A, Donato LE, de Ferreira Lima Júnior FE, Alves RV, Del Rio Vilas VJ. Revisiting area risk classification of visceral leishmaniasis in Brazil. BMC Infect Dis 2019; 19:2. [PMID: 30606104 PMCID: PMC6318941 DOI: 10.1186/s12879-018-3564-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 11/28/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Visceral leishmaniasis (VL) is a neglected tropical disease of public health relevance in Brazil. To prioritize disease control measures, the Secretaria de Vigilância em Saúde of Brazil's Ministry of Health (SVS/MH) uses retrospective human case counts from VL surveillance data to inform a municipality-based risk classification. In this study, we compared the underlying VL risk, using a spatiotemporal explicit Bayesian hierarchical model (BHM), with the risk classification currently in use by the Brazil's Ministry of Health. We aim to assess how well the current risk classes capture the underlying VL risk as modelled by the BHM. METHODS Annual counts of human VL cases and the population at risk for all Brazil's 5564 municipalities between 2004 and 2014 were used to fit a relative risk BHM. We then computed the predicted counts and exceedence risk for each municipality and classified them into four categories to allow comparison with the four risk categories by the SVS/MH. RESULTS Municipalities identified as high-risk by the model partially agreed with the current risk classification by the SVS/MH. Our results suggest that counts of VL cases may suffice as general indicators of the underlying risk, but can underestimate risks, especially in areas with intense transmission. CONCLUSION According to our BHM the SVS/MH risk classification underestimated the risk in several municipalities with moderate to intense VL transmission. Newly identified high-risk areas should be further evaluated to identify potential risk factors and assess the needs for additional surveillance and mitigation efforts.
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Affiliation(s)
- Gustavo Machado
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607 USA
| | - Julio Alvarez
- VISAVET Health Surveillance Center, Universidad Complutense, Avda Puerta de Hierro S/N, 28040 Madrid, Spain
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense, Avda Puerta de Hierro S/N, 28040 Madrid, Spain
| | | | - Andres Perez
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St Paul, MN 55108 USA
| | - Lucas Edel Donato
- Secretaria de Vigilância em Saúde, Ministério da Saúde (SVS-MH), Brasília, Brazil
| | | | - Renato Vieira Alves
- Secretaria de Vigilância em Saúde, Ministério da Saúde (SVS-MH), Brasília, Brazil
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Coura-Vital W, Leal GGDA, Marques LA, Pinheiro ADC, Carneiro M, Reis AB. Effectiveness of deltamethrin-impregnated dog collars on the incidence of canine infection by Leishmania infantum: A large scale intervention study in an endemic area in Brazil. PLoS One 2018; 13:e0208613. [PMID: 30532255 PMCID: PMC6287856 DOI: 10.1371/journal.pone.0208613] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 11/20/2018] [Indexed: 11/18/2022] Open
Abstract
To reduce morbidity and mortality caused by visceral leishmaniasis (VL), the Brazilian Visceral Leishmaniasis Control and Surveillance Program promotes the diagnosis and treatment of cases, vector control, euthanasia of seropositive dogs, and health education. Nevertheless, the effectiveness of these measures is questionable as they lead to little reduction in the transmission of the disease. Thus, the effectiveness of strategies such as insecticide-impregnated collars, spot-on insecticides, and immunization of dogs should be assessed. Herein, we evaluated the effectiveness of deltamethrin-impregnated collars on reducing the incidence of Leishmania infantum infection in dogs living in an endemic area of VL. An intervention study was conducted and a total 5,850 dogs were analyzed in baseline. Of these 3,742 seronegative dogs were divided into two groups: collared and uncollared (control). Dogs were followed for 12 months and three interventions were performed. The Cox regression model was used to evaluate the effectiveness of the collar. All analyzes were performed by Intention-to-treat and per-protocol. By intention-to-treat, the incidence rates of L. infantum infection were 7.5 and 7.9 in the collar group, and 6.5 and 13.2 per 1,000 dogs-months in the control group after 6 and 12 months, respectively. In the per-protocol analysis, the incidence rates in the control group were similar to those observed in the intention-to-treat analysis. In the collar group, the incidence rate was 5.1/1,000 dogs-months after 6 and 12 months. The effectiveness by intention-to-treat after adjustment by the multivariate Cox model was 48%. In the analysis per-protocol, the effectiveness increased to 63%. Although collar use was effective when it was evaluated by intention-to-treat, higher effectiveness was found in the per-protocol analysis after one year of follow-up. The data emphasize the importance of the uninterrupted use of deltamethrin-impregnated collars to increase protection against canine VL.
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Affiliation(s)
- Wendel Coura-Vital
- Programa de Pós-Graduação em Ciências Farmacêuticas, Departamento de Análises Clínicas, Escola de Farmácia, Universidade Federal de Ouro Preto, Minas Gerais, Brazil
- Laboratório de Imunopatologia, Programa de Pós-Graduação em Ciências Biológicas, Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
- * E-mail:
| | - Gleisiane Gomes de Almeida Leal
- Laboratório de Imunopatologia, Programa de Pós-Graduação em Ciências Biológicas, Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Luana Araújo Marques
- Centro de Controle de Zoonoses, Secretaria Municipal de Saúde, Governador Valadares, Minas Gerais, Brazil
| | - Aimara da Costa Pinheiro
- Centro de Controle de Zoonoses, Secretaria Municipal de Saúde, Governador Valadares, Minas Gerais, Brazil
| | - Mariângela Carneiro
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Alexandre Barbosa Reis
- Laboratório de Imunopatologia, Programa de Pós-Graduação em Ciências Biológicas, Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais—INCT-DT, Salvador, Bahia, Brazil
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da Rocha ICM, Dos Santos LHM, Coura-Vital W, da Cunha GMR, Magalhães FDC, da Silva TAM, Morais MHF, Oliveira E, Reis IA, Carneiro M. Effectiveness of the Brazilian Visceral Leishmaniasis Surveillance and Control Programme in reducing the prevalence and incidence of Leishmania infantum infection. Parasit Vectors 2018; 11:586. [PMID: 30419944 PMCID: PMC6233359 DOI: 10.1186/s13071-018-3166-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 10/24/2018] [Indexed: 12/02/2022] Open
Abstract
Background Control strategies adopted by the Brazilian Visceral Leishmaniasis Surveillance and Control Programme (VLSCP) include identifying and culling seropositive infected dogs, early diagnosis and treatment of human cases, chemical control of the vector and population awareness. This study evaluated the effectiveness of the VLSCP on the prevalence and incidence rates of Leishmania infantum in children residing in areas under different VLSCP intervention times. Methods A quasi-experimental epidemiological study with a panel (two cross-sectional) and a concurrent cohort was performed in three areas of Belo Horizonte, southeast Brazil. The first cross-sectional study (I) was carried out with 1875 children, 478 of which were enrolled in the cohort study. In the second cross-sectional study (II), 413 additional children were included, totalizing 891 children. Laboratory diagnosis was performed by ELISA-rK39. Analyses included multilevel logistic and Poisson regression models. Results The incidence rates of L. infantum infection were: 14.4% in the area where VLSCP intervention was initiated in 2006 (AI2006); 21.1% in the area where intervention was initiated in 2008 (AI2008); and 11.6% in the area where intervention was initiated in 2010 (AI2010 - control area). A follow-up period of 24 months showed that the persons-time incidence rates in AI2006, AI2008, and AI2010 were: 6.2/100, 10/100, and 5.6/100 persons/24 months, respectively. The final prevalence rates of infection (cross-sectional II - in 2012), compared to the initial rates (cross-sectional I - in 2010), increased 83.7% in AI2006, 74.1% in AI2008, and decreased 5% in AI2010. Analysis of the effectiveness revealed that children residing in AI2008 are more likely to be infected (OR = 1.84; 95% CI: 1.06-3.23) and present a higher risk of infection (IRR = 1.76; 95% CI: 1.05-2.95) compared to those in AI2010. No statistically significant differences were observed in asymptomatic infection (OR and IRR) in AI2006 compared to AI2010. Conclusions The VLSCP was not effective at controlling L. infantum infection in areas where interventions had respectively been carried out for six and four years. However, it is unclear what the consequences in terms of human infection and diseases would be in the absence of the VLSCP. Efforts to improve the effectiveness of control measures remain a necessary priority. Electronic supplementary material The online version of this article (10.1186/s13071-018-3166-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Iara Caixeta Marques da Rocha
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Secretaria Municipal de Saúde de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
| | - Letícia Helena Marques Dos Santos
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Wendel Coura-Vital
- Departamento de Análises Clínicas, Pós-graduação em Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil.,Pós-graduação em Ciências Biológicas, Núcleo de Pesquisa em Ciências Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Gisele Macedo Rodrigues da Cunha
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Fernanda do Carmo Magalhães
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Thais Almeida Marques da Silva
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Instituto de Ensino e Pesquisa da Santa Casa Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
| | | | - Edward Oliveira
- Laboratório de Pesquisas Clínicas, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Ilka Afonso Reis
- Departamento de Estatística, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mariângela Carneiro
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. .,Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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Lana RS, Michalsky ÉM, Lopes LO, Lara-Silva FO, Nascimento JL, Pinheiro LC, França-Silva JC, Mendes TSC, Fortes-Dias CL, Dias ES. Ecoepidemiological aspects of visceral leishmaniasis in an endemic area in the Steel Valley in Brazil: An ecological approach with spatial analysis. PLoS One 2018; 13:e0206452. [PMID: 30376577 PMCID: PMC6207327 DOI: 10.1371/journal.pone.0206452] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 10/12/2018] [Indexed: 11/18/2022] Open
Abstract
Leishmaniases are a group of infectious diseases transmitted by phlebotomine sand flies, and their distribution depends on the presence of vectors, parasites, reservoirs and susceptible hosts in the same environment. In the last decades, visceral leishmaniasis (VL) has become urbanized and reached economically important cities in countries within the transmission zone. Our study was conducted in one of those cities-Ipatinga-in the state of Minas Gerais, Brazil, where the first autochthonous case of VL dates back to 2011. Since no data regarding the epidemiological triad of VL (etiological agent/vector/domestic reservoir) were available for this city, we characterized the local entomological fauna, identified the presence of specific Leishmania DNA in the captured phlebotomine sand flies, and assessed the incidence of canine and human VL. For the entomological survey, we set twenty light traps in ten districts of the city with reports of human and canine VL. The insect captures were performed monthly, during one year, starting in March 2015. A total of 1501 specimens of phlebotomine sand flies belonging to 16 distinct species were captured, with predominance (61.9%) of Lutzomyia longipalpis. Leishmania infantum DNA was detected in L. longipalpis and in Evandromyia cortelezzii test samples. A total of 9,136 dogs were examined, 1,355 of which (14.8%) were serologically positive for VL. The cases were georeferenced and the data were plotted in thematic maps, along with human cases of VL registered by the local Department of Health, during the study period. Our results confirm that the VL transmission cycle is active in Ipatinga, with the presence of vectors carrying Leishmania DNA, canine and human cases of the disease. Spatial analysis allowed for the observation of a positive relationship between canine and human cases of VL and the identification of areas with high priority for control actions in the city. The mapping of high-risk areas, together with an epidemiological study in urban areas, is fundamental to improve the efficacy of the Program for Surveillance and Control of VL (PSCVL) in Brazil.
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Affiliation(s)
- Rosana S. Lana
- Laboratório de Leishmanioses, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Érika M. Michalsky
- Laboratório de Leishmanioses, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Lívia O. Lopes
- Laboratório de Leishmanioses, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Fabiana O. Lara-Silva
- Laboratório de Leishmanioses, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Jeiza L. Nascimento
- Laboratório de Leishmanioses, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Letícia C. Pinheiro
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - João C. França-Silva
- Laboratório de Leishmanioses, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Telma S. C. Mendes
- Departamento de Vigilância em Saúde, Secretaria Municipal de Saúde, Ipatinga, Minas Gerais, Brazil
| | - Consuelo L. Fortes-Dias
- Laboratório de Enzimologia, Diretoria de Pesquisa e Desenvolvimento, Fundação Ezequiel Dias, Belo Horizonte, Minas Gerais, Brazil
- * E-mail: (ESD); (CLFD)
| | - Edelberto S. Dias
- Laboratório de Leishmanioses, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
- * E-mail: (ESD); (CLFD)
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Current Visceral Leishmaniasis Research: A Research Review to Inspire Future Study. BIOMED RESEARCH INTERNATIONAL 2018; 2018:9872095. [PMID: 30105272 PMCID: PMC6076917 DOI: 10.1155/2018/9872095] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 05/25/2018] [Accepted: 06/10/2018] [Indexed: 11/21/2022]
Abstract
Visceral leishmaniasis (VL), one of the deadliest parasitic diseases in the world, causes more than 50,000 human deaths each year and afflicts millions of people throughout South America, East Africa, South Asia, and Mediterranean Region. In 2015 the World Health Organization classified VL as a neglected tropical disease (NTD), prompting concentrated study of the VL epidemic using mathematical and simulation models. This paper reviews literature related to prevalence and prevention control strategies. More than thirty current research works were reviewed and classified based on VL epidemic study methods, including modeling approaches, control strategies, and simulation techniques since 2013. A summarization of these technical methods, major findings, and contributions from existing works revealed that VL epidemic research efforts must improve in the areas of validating and verifying VL mathematical models with real-world epidemic data. In addition, more dynamic disease control strategies must be explored and advanced simulation techniques must be used to predict VL pandemics.
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Bruhn FRP, Morais MHF, Cardoso DL, Bruhn NCP, Ferreira F, Rocha CMBMD. Spatial and temporal relationships between human and canine visceral leishmaniases in Belo Horizonte, Minas Gerais, 2006-2013. Parasit Vectors 2018; 11:372. [PMID: 29954428 PMCID: PMC6022701 DOI: 10.1186/s13071-018-2877-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 04/29/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Visceral leishmaniasis is a serious public health problem in Brazil, and control of this disease constitutes a major challenge. The purpose of this study was to assess the existing spatial and temporal relationships between cases of canine visceral leishmaniasis (CanL) and human visceral leishmaniasis (HVL) recorded in Belo Horizonte, State of Minas Gerais, from 2006 to 2013. METHODS Data provided by the Belo Horizonte Health Services regarding the disease control routine were analyzed in order to perform a retrospective observational and ecological study. Information regarding the incidence rate of HVL and canine seroprevalence was examined in relation to control actions performed atthe 148 coverage areas of healthcare centers for the period between 2006 and 2013. A time series analysis was performed using the Gretl 1.9.12 software followed by the assessment of the existing increasing or declining trend and seasonality in the occurrence of CanL and HVL. Autoregressive integrated moving average (ARIMA) models were adjusted, intervention analysis was performed, vector autoregressive models were developed, and Granger causality was used for testing temporal relationships between variables. The hot spot analysis tool was used for cluster identification through Getis-OrdGi statistics. The ArcGis for desktop 10.2.1 software was used for spatial analysis. RESULTS We identified 866 HVL cases in Belo Horizonte between 2006 and 2013. The mean proportion of canine seroprevalence (PCP) was 7.31% and the mean proportion of monitored hosts (PMH) was 6.73%.HVL and PCP showed a decreasing trend, while PMH increased over time (P<0.05). Vector Autoregressive (VAR) and Granger analysis showed a temporal relation between CanL and HVL cases. Maps illustrating the spatial distribution of cases and obituaries of HVL and CanL cases also showed an apparent association between the occurrence of leishmaniasis in humans, and data about canine cases recorded in the previous years. CONCLUSIONS Cases of HVL were preceded by PMH and PCP cases. Similar results were observed for intraspecific cases (i.e. between PCP and other canine cases and between HVL and other HVL cases), which indicated the existence of favorable environmental conditions for the transmission and spread of L. infantum in Belo Horizonte.
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Affiliation(s)
- Fábio Raphael Pascoti Bruhn
- Federal University of Pelotas (UFPel), Department of Preventive Veterinary, Zoonosis Control Center of UFPel, Capão do Leão, Rio Grande do Sul Brazil
| | | | - Denis Lucio Cardoso
- Department of Preventive Veterinary, Federal University of Lavras (UFLA), Belo Horizonte, Minas Gerais Brazil
| | - Nádia Campos Pereira Bruhn
- Center of Mercosul Integration, Federal University of Pelotas (UFPel), Pelotas, Rio Grande do Sul Brazil
| | - Fernando Ferreira
- Department of Preventive Veterinary Medicine and Animal Health, School of Veterinary Medicine, University of São Paulo, São Paulo, Brazil
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Kazimoto TA, Amora SSA, Figueiredo FB, Magalhães JME, Freitas YBN, Sousa MLR, Melo AECDS, Campos MP, Alves ND, Werneck GL. Impact of 4% Deltamethrin-Impregnated Dog Collars on the Prevalence and Incidence of Canine Visceral Leishmaniasis. Vector Borne Zoonotic Dis 2018; 18:356-363. [PMID: 29683394 DOI: 10.1089/vbz.2017.2166] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In Brazil, visceral leishmaniasis is caused by the protozoan Leishmania infantum, primarily transmitted by Lutzomyia longipalpis and with the dog as its main urban reservoir. This study aims to evaluate the effectiveness of 4% deltamethrin-impregnated dog collars (DMC) DIC, Scalibor® 65 cm model and MSD manufacturer, on the prevalence and incidence of canine visceral leishmaniasis (CVL) and on the rate of infection of sandflies by L. infantum. The research was conducted in two areas of the municipality Mossoró, State of Rio Grande do Norte in Northeast of Brazil. Two semiannual serosurveys, followed by culling seropositive dogs, and searches for phlebotominae were performed in the control area (CA), whereas in the collar intervention area (IA), aside from those procedures, DMC were fitted to dogs every 6 months. CVL was diagnosed by the Dual Path Platform rapid test (TR-DPP®) and the Immunoenzymatic assay (EIE). The sandflies were collected monthly, identified, and the females were submitted to Quantitative Real-Time Polymerase Chain Reaction for detection of L. infantum DNA. The use of collars was associated with a 53-59% reduction in the incidence of CVL. The most abundant phlebotomine species were L. longipalpis (81.8%). Positive pools of L. longipalpis were obtained in the IA only in the first survey, whereas the presence of the DNA of the parasite in the vector was observed in the CA in both surveys. We conclude that the continuous use of these collars may have the potential to reduce both the incidence of CVL and the rate of infected phlebotomine sandflies.
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Affiliation(s)
- Thaís Aparecida Kazimoto
- 1 Programa de Pós-Graduação em Ambiente, Tecnologia e Sociedade, Universidade Federal Rural do Semi-Árido , Mossoró, Brazil
| | - Sthenia Santos Albano Amora
- 1 Programa de Pós-Graduação em Ambiente, Tecnologia e Sociedade, Universidade Federal Rural do Semi-Árido , Mossoró, Brazil
| | | | - Jamille Maia E Magalhães
- 1 Programa de Pós-Graduação em Ambiente, Tecnologia e Sociedade, Universidade Federal Rural do Semi-Árido , Mossoró, Brazil
| | | | - Maressa Laíse Reginaldo Sousa
- 1 Programa de Pós-Graduação em Ambiente, Tecnologia e Sociedade, Universidade Federal Rural do Semi-Árido , Mossoró, Brazil
| | | | - Monique Paiva Campos
- 3 Laboratório de Pesquisa Clínica em Dermatozoonosesde Animais Domésticos, Instituto Nacional de Infectologia Evandro Chagas , Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Nilza Dutra Alves
- 1 Programa de Pós-Graduação em Ambiente, Tecnologia e Sociedade, Universidade Federal Rural do Semi-Árido , Mossoró, Brazil
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Bruhn FRP, Morais MHF, Bruhn NCP, Cardoso DL, Ferreira F, Rocha CMBM. Human visceral leishmaniasis: factors associated with deaths in Belo Horizonte, Minas Gerais state, Brazil from 2006 to 2013. Epidemiol Infect 2018; 146:565-570. [PMID: 29463341 PMCID: PMC9134532 DOI: 10.1017/s0950268818000109] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 12/04/2017] [Accepted: 01/05/2018] [Indexed: 11/06/2022] Open
Abstract
The aim of this study was to evaluate the distribution of cases and the social determinants associated with death from human visceral leishmaniasis (HVL) and VL-HIV co-infection in Belo Horizonte, Minas Gerais state, Brazil, between 2006 and 2013. Descriptive statistics and analysis of associations were performed using chi-square of the raised variables, such as sex, age, skin colour and schooling of cases of HVL. During the study period, there were 866 cases of HVL with 111 deaths in Belo Horizonte. Morbidity and lethality rates (LR) of HVL in Belo Horizonte remained high over almost all the years evaluated, with an average incidence rate of 4.18 cases/100 000 inhabitants and a LR of 11.16%. With respect to skin colour, it was found that people characterised as black or mulatto had higher morbidity, followed by white. Regarding schooling, LR was more prevalent among individuals with lower education. One of the social risk factors was co-infection with HIV, which was present in many cases of HVL. Furthermore, it was found that older age and the male sex were also risk factors for death from HVL in Belo Horizonte.
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Affiliation(s)
- F. R. P. Bruhn
- Federal University of Pelotas (UFPel), Department of Preventive Veterinary, Zoonosis Control Center of UFPel, Capão do Leão, Rio Grande do Sul, Brazil
| | - M. H. F. Morais
- Municipal Department of Health of Belo Horizonte, Minas Gerais, Brazil
| | - N. C. P. Bruhn
- Federal University of Pelotas, Center of Mercosul Integration, Pelotas, Rio Grande do Sul, Brazil
| | - D. L. Cardoso
- Department of Veterinary Medicine, Federal University of Lavras, Lavras, Minas Gerais, Brazil
| | - F. Ferreira
- University of São Paulo, Department of Preventive Veterinary Medicine and Animal Health, School of Veterinary Medicine, São Paulo, Brazil
| | - C. M. B. M. Rocha
- Department of Veterinary Medicine, Federal University of Lavras, Lavras, Minas Gerais, Brazil
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Carvalho AGD, Luz JGG, Rodrigues LD, Dias JVL, Fontes CJF. High seroprevalence and peripheral spatial distribution of visceral leishmaniasis among domestic dogs in an emerging urban focus in Central Brazil: a cross-sectional study. Pathog Glob Health 2018; 112:29-36. [PMID: 29460695 DOI: 10.1080/20477724.2018.1438229] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
The Brazilian municipality of Rondonópolis is an emerging urban focus of intense transmission of visceral leishmaniasis (VL), where few investigations have addressed canine reservoirs. This study assessed the seroprevalence and spatial distribution of canine visceral leishmaniasis (CVL) in the urban area of Rondonópolis. A CVL serosurvey was conducted between October 2016 and February 2017 using an immunochromatographic rapid test and enzyme-linked immunosorbent assay. Domestic dogs were sampled from 25 heterogeneous regions previously defined by the Spatial 'K'luster Analysis by Tree Edge Removal algorithm, which considered the socioeconomic and environmental features from the last demographic census. The CVL spatial distribution was analyzed by kernel density estimation (KDE) and spatial scan statistic. All the autochthonous human VL cases reported between 2014 and 2016 were georeferenced. Of the 600 dogs tested, 115 were seropositive in both tests. The overall CVL prevalence was 19.2% (95%CI: 16.1-22.3%), which varied widely among the evaluated regions (0.0-35.1%). Almost 25% of the sampled households (n = 405) had at least one infected dog. KDE demonstrated that positive CVL households were concentrated in the peripheral areas of the city. Spatial scan statistics detected a spatial cluster with significantly low CVL prevalence in the central region (relative risk = 0.37; p = 0.04), where only one human VL case was reported. Thus, we demonstrated a high prevalence of CVL in domestic dogs from diverse socioeconomic and environmental urban contexts in Rondonópolis. The CVL cases were peripherally distributed and occurred more frequently in areas that had reported human VL.
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Affiliation(s)
- Amanda Gabriela de Carvalho
- a School of Medicine, Institute of Exact and Natural Sciences , Federal University of Mato Grosso , Rondonópolis , Brazil.,b School of Medicine , Post-Graduation Program in Health Sciences, Federal University of Mato Grosso , Cuiabá , Brazil
| | - João Gabriel Guimarães Luz
- a School of Medicine, Institute of Exact and Natural Sciences , Federal University of Mato Grosso , Rondonópolis , Brazil.,b School of Medicine , Post-Graduation Program in Health Sciences, Federal University of Mato Grosso , Cuiabá , Brazil
| | - Luane Dantas Rodrigues
- a School of Medicine, Institute of Exact and Natural Sciences , Federal University of Mato Grosso , Rondonópolis , Brazil
| | - João Victor Leite Dias
- c School of Medicine , Federal University of Jequitinhonha and Mucuri Valleys , Téofilo Otoni , Brazil
| | - Cor Jesus Fernandes Fontes
- b School of Medicine , Post-Graduation Program in Health Sciences, Federal University of Mato Grosso , Cuiabá , Brazil.,d Júlio Müller University Hospital, University of Mato Grosso , Cuiabá , Brazil
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Manotas-Berdugo H, Toro-Maldonado J, Rodríguez-Rodríguez J, Salgado-García D. [Urban outbreak of leishmaniasis in Colombia]. Rev Salud Publica (Bogota) 2018; 20:89-93. [PMID: 30183890 DOI: 10.15446/rsap.v20n1.47135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 11/04/2017] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To describe the epidemiology, clinical characteristics and treatment of children with visceral Leishmaniasis in Neiva- Huila, from April to June 2012. METHODOLOGY We performed a descriptive study of an outbreak of visceral leshmaniasis in children from the urban area of Neiva. RESULTS There were seven cases in children younger than five years. All of them had prolonged fever, hepato-splenomegaly, severe anemia and leukopenia. Five were admitted with severe thrombocytopenia, without hemorrhagic manifestations. Six patients received first-line treatment with miltefosine, five of them had treatment failure requirirng therapy escalation to amphotericin B, two received liposomal amphotericin B and three deoxycholate amphotericin B. The main vector identified was the Lutzomyia gomezi and its main reservoir were canines. CONCLUSION We describe the first visceral leishmaniasis outbreak in children living in an urban area, with no mortality. Most of the cases had a good response to amphotericin B.
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Affiliation(s)
- Hernán Manotas-Berdugo
- HM: MD. Esp. Pediatría. Hospital Universitario Hernando Moncaleano. Neiva, Huila. Colombia.
| | - Jessica Toro-Maldonado
- JT: MD. Esp. Pediatría. Hospital Universitario Hernando. Hospital Universitario Hernando Moncaleano. Neiva, Huila. Colombia.
| | | | - Doris Salgado-García
- DS: MD. Esp. Pediatría. Hospital Universitario Hernando Moncaleano. Neiva, Huila. Colombia.
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Brandão E, Romero S, da Silva MAL, Santos FLN. Neglected tropical diseases in Brazilian children and adolescents: data analysis from 2009 to 2013. Infect Dis Poverty 2017; 6:154. [PMID: 29096720 PMCID: PMC5668976 DOI: 10.1186/s40249-017-0369-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 10/13/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Neglected tropical diseases (NTDs) prevail in conditions of poverty and contribute to the maintenance of social inequality. Out of the NTDs prioritized by the Brazilian Ministry of Health, four parasitic infections require mandatory notification: acute Chagas disease, leishmaniasis, malaria, and schistosomiasis. Data on the behaviour of these NTDs in the young population are currently limited. This study seeks to analyse the epidemiological aspects of these parasitic infections in children and adolescents in Brazil. METHODS A retrospective exploratory ecological study was conducted. A spatial analysis of the cases reported between 2009 and 2013 in individuals aged between 0 and 19 years that were notified through the Health Notification Aggravation Information System (SINAN) was performed. RESULTS In total, 64,567 cases of cutaneous and visceral leishmaniasis, malaria, schistosomiasis, and acute Chagas disease were recorded in the SINAN database, representing a rate of 20.15 cases per 100,000 inhabitants. The average age of the cases was 12.2 years and 62.32% were male. Four hundred and three deaths related to these obligatorily reported parasites were recorded, indicating a case fatality rate of 0.62%. Visceral leishmaniasis and acute Chagas disease had the highest rates of lethality. A heterogeneous spatial distribution of the studied parasites was observed. CONCLUSIONS The number of cases and the lethality rate described in this study show that these diseases still represent a serious problem for public health in Brazil. This points to the need to encourage new research and the reformulation of social, economic, and public health policies aimed at ensuring better health and living conditions for all individuals, especially those among the populations considered vulnerable, as is the case of the young.
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Affiliation(s)
- Eduardo Brandão
- National Reference Service for Filariasis, Aggeu Magalhães Institute (Fiocruz-PE), Recife, Pernambuco Brazil
- Faculty of Medical Sciences, National University of Rosario, Rosario, Santa Fe Argentina
| | - Sebastián Romero
- Faculty of Medical Sciences, National University of Rosario, Rosario, Santa Fe Argentina
| | - Maria Almerice Lopes da Silva
- Laboratory of Communicable Diseases, Parasitology Department, Aggeu Magalhães Institute (Fiocruz-PE), Recife, Pernambuco Brazil
| | - Fred Luciano Neves Santos
- Laboratory of Pathology and Bio-Intervention, Gonçalo Moniz Institute (Fiocruz-BA), Salvador, Bahia Brazil
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da Silva TAM, Coura-Vital W, Barbosa DS, Oiko CSF, Morais MHF, Tourinho BD, de Melo DPO, Reis IA, Carneiro M. Spatial and temporal trends of visceral leishmaniasis by mesoregion in a southeastern state of Brazil, 2002-2013. PLoS Negl Trop Dis 2017; 11:e0005950. [PMID: 28985218 PMCID: PMC5646873 DOI: 10.1371/journal.pntd.0005950] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 10/18/2017] [Accepted: 09/11/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Visceral leishmaniasis (VL) is expanding in Brazil and in other South American countries, a process that has been associated with the urbanization of the disease. This study analyzes the spatial and temporal distribution of VL in the Brazilian state of Minas Gerais and identifies the areas with higher risks of transmission. METHODOLOGY An ecological study with spatial and time series analyzes of new confirmed cases of VL notified to the Brazilian Notifiable Disease Information System between 2002 and 2013, considering the 12 mesoregions of Minas Gerais. Two complementary methodologies were used: thematic maps of incidence and Poisson (log-linear) generalized linear model. Thematic maps using crude and smoothed cumulative incidences were generated for four trienniums. Poisson Regression measured the variation of the average number of cases from one year to the following, for each mesoregion. PRINCIPAL FINDINGS The 5,778 cases analyzed revealed a heterogeneous spatial and temporal distribution of VL in Minas Gerais. Six mesoregions (Central Mineira, Jequitinhonha, Metropolitan area of Belo Horizonte, Northwest of Minas, North of Minas, and Vale do Rio Doce) were responsible for the expansion and maintenance of VL, with incidence rates as high as 26/100,000 inhabitants. The Vale do Rio Doce and Jequitinhonha mesoregions showed a considerable increase in the incidence rates in the last period studied. The other six mesoregions reported only sporadic cases and presented low and unsteady incidence rates, reaching a maximum of 1.2/100,000 inhabitants. CONCLUSIONS/SIGNIFICANCE The results contribute to further the current understanding about the expansion of VL in Minas Gerais and may help guide actions for disease control.
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Affiliation(s)
- Thais Almeida Marques da Silva
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Instituto de Ensino e Pesquisa da Santa Casa Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
| | - Wendel Coura-Vital
- Laboratório de Epidemiologia e Citologia, Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - David Soeiro Barbosa
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Carla Sayuri Fogaça Oiko
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | - Ilka Afonso Reis
- Departamento de Estatística, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mariângela Carneiro
- Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Saraiva L, Leite CG, Lima ACVMDR, Carvalho LOAD, Pereira AAS, Rugani JMN, Rego FD, Gontijo CMF, Andrade JD. Seasonality of sand flies (Diptera: Psychodidae) and Leishmania DNA detection in vector species in an area with endemic visceral leishmaniasis. Mem Inst Oswaldo Cruz 2017; 112:309-318. [PMID: 28327794 PMCID: PMC5354617 DOI: 10.1590/0074-02760160438] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 12/09/2016] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Leishmaniases are a serious health problem in southeast Brazil, including the city of Belo Horizonte (BH), Minas Gerais state (MG), where there are high rates of incidence and mortality due to visceral leishmaniases. BH is divided into nine sanitary districts (SD) of which one, the Venda Nova SD, was selected for this study because it has high rates of positivity for canine leishmaniasis and high incidence of human leishmaniasis. OBJECTIVES This study aimed to survey the sand fly fauna in Venda Nova SD from August 2011 to July 2013 and perform a descriptive analysis of the vector population. METHODS The sampling was carried out using automatic HP light traps at all covered areas of the Venda Nova SD, in a total of eighteen light traps. Sampled specimens were identified following Galati (2003), and females were submitted to molecular techniques for the detection and identification of Leishmania DNA. A simple environmental description was done for it area and Kernel estimation was used to infer vector density for each study site. FINDINGS A total of 2,427 sand fly specimens belonging to eight species and five genera were collected of which 95.3% were Lutzomyia longipalpis. The seasonal variation curve was delineated by this species. Lu. longipalpis was the most abundant at all collection points and in all months of the study, and exhibited a natural infection rate of 1.01% for Leishmania infantum and 1.77% for Leishmania braziliensis. MAIN CONCLUSIONS The results show the presence and adaptation of Lu. longipalpis to the anthropic environment of BH and reinforces its role as the main vector of L. infantum in the region.
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Affiliation(s)
- Lara Saraiva
- Fundação Oswaldo Cruz-Fiocruz, Centro de Pesquisas René Rachou, Grupo de Estudos em Leishmanioses, Belo Horizonte, MG, Brasil
| | - Camila Gonçalves Leite
- Prefeitura Municipal de Belo Horizonte, Gerência de Controle de Zoonoses, Belo Horizonte, MG, Brasil
| | | | | | - Agnes Antônia Sampaio Pereira
- Fundação Oswaldo Cruz-Fiocruz, Centro de Pesquisas René Rachou, Grupo de Estudos em Leishmanioses, Belo Horizonte, MG, Brasil
| | - Jerônimo Marteleto Nunes Rugani
- Fundação Oswaldo Cruz-Fiocruz, Centro de Pesquisas René Rachou, Grupo de Estudos em Leishmanioses, Belo Horizonte, MG, Brasil
| | - Felipe Dutra Rego
- Fundação Oswaldo Cruz-Fiocruz, Centro de Pesquisas René Rachou, Grupo de Estudos em Leishmanioses, Belo Horizonte, MG, Brasil
| | - Célia Maria Ferreira Gontijo
- Fundação Oswaldo Cruz-Fiocruz, Centro de Pesquisas René Rachou, Grupo de Estudos em Leishmanioses, Belo Horizonte, MG, Brasil
| | - José Dilermando Andrade
- Fundação Oswaldo Cruz-Fiocruz, Centro de Pesquisas René Rachou, Grupo de Estudos em Leishmanioses, Belo Horizonte, MG, Brasil
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Naufal Spir PR, Prestes-Carneiro LE, Fonseca ES, Dayse A, Giuffrida R, D’Andrea LAZ. Clinical characteristics and spatial distribution of Visceral leishmaniasis in children in São Paulo state: an emerging focus of Visceral leishmaniasis in Brazil. Pathog Glob Health 2017; 111:91-97. [PMID: 28221822 PMCID: PMC5375614 DOI: 10.1080/20477724.2017.1289666] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Visceral leishmaniasis (VL) is an emerging zoonosis, and Brazil harbors about 90% of those infected in Latin America. Since 1998, the disease has been spreading quickly in São Paulo state, and the western region is considered an emerging focus of VL in Brazil. Our aim was to evaluate the clinical characteristics and spatial distribution of VL in children referred to a public tertiary hospital located in the western region of São Paulo state, Brazil. METHODS Medical records of children up to 18 years of age who were diagnosed with VL between January 2006 and December 2010 were reviewed. Geospatial analysis was performed using the ArcGIS 10.2 platform. RESULTS Sixty-three patients were enrolled in the study; the median age was 3.3 ± 3.3 years. The median time interval between the onset of clinical symptoms and diagnosis was 16.1 ± 11.1 days, and the median time in the pediatric ward was 18.0 ± 9.4 days. Liposomal amphotericin B was the first-line treatment in 90.5% of the patients and 9.6% relapsed. One patient died (1.6%), and 19% were submitted to the pediatric intensive care unit. CONCLUSION The short interval between the onset of symptoms, diagnosis, and treatment and the reduced number of days of hospitalization certainly influenced the small number of deaths, relapses, and severity among the children infected with VL. However, the disease is spreading fast in the western region of São Paulo state. Thus, integrated actions and effective monitoring of the disease are needed to complement curative practices.
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Affiliation(s)
| | | | | | - Aline Dayse
- Department of Pediatrics, Regional Hospital, Presidente Prudente, Brazil
| | - Rogério Giuffrida
- Department of Immunology and Infectious Diseases, University of Oeste Paulista, Presidente Prudente, Brazil
| | - Lourdes Aparecida Zampieri D’Andrea
- Department of Geography, São Paulo State University, Presidente Prudente, Brazil
- Center of Regional Laboratory V, Adolfo Lutz Institute, Presidente Prudente, Brazil
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Ursine RL, Dias JVL, Morais HA, Pires HHR. Human and canine visceral leishmaniasis in an emerging focus in Araçuaí, Minas Gerais: spatial distribution and socio-environmental factors. Mem Inst Oswaldo Cruz 2017; 111:505-11. [PMID: 27384080 PMCID: PMC4981116 DOI: 10.1590/0074-02760160133] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 06/07/2016] [Indexed: 12/02/2022] Open
Abstract
This study aimed to analyse the spatial distribution of human (2007-2013) and canine (2013) visceral leishmaniasis (VL) in the city of Araçuaí, Minas Gerais, Brazil, and identify the socio-environmental factors related to their occurrence. The spatial distribution of human and canine cases was analysed by kernel density estimation (KDE) and the K function. The KDE values were analysed for correlation between human and canine LV and for normalised difference vegetation index (NDVI). Socio-environmental aspects of household structures and surroundings were evaluated. The spatial distribution of human and canine VL cases exhibited a significant aggregated pattern in distances greater than 350 and 75 m, respectively. The higher occurrence of human and canine infection occurred in the central area of the city. A positive correlation between the densities of human and canine cases was observed, as well as a negative correlation between NDVI and densities of human and canine cases. Socio-environmental analysis revealed that the large amount of animals, organic material from trees and deficiencies in environmental sanitation are possibly contributing to the continuation of the transmission cycle of Leishmania infantum in Araçuaí. These results can contribute to the planning by competent agencies to reduce the incidence of infection in the city.
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Affiliation(s)
- Renata Luiz Ursine
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Grupo de Extensão e Pesquisa em Saúde Coletiva, Diamantina, MG, Brasil
| | - João Victor Leite Dias
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Grupo de Extensão e Pesquisa em Saúde Coletiva, Diamantina, MG, Brasil
| | - Harriman Aley Morais
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Grupo de Extensão e Pesquisa em Saúde Coletiva, Diamantina, MG, Brasil
| | - Herton Helder Rocha Pires
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Grupo de Extensão e Pesquisa em Saúde Coletiva, Diamantina, MG, Brasil
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