1
|
Galvão EL, Assis TSMD, Pedras MJ, Cota GF, Simões TC, Rabello A. Economic impact of localized cutaneous leishmaniasis on adult patients of a referral service in Belo Horizonte, Minas Gerais State, Brazil. CAD SAUDE PUBLICA 2020; 36:e00136419. [PMID: 32696829 DOI: 10.1590/0102-311x00136419] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 12/06/2019] [Indexed: 11/22/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is a disease associated with low-income populations. Thus, in assessing the burden of this disease, it is important to include its economic impact on individuals. We aimed to evaluate CL economic impact on patients treated at a referral service in the State of Minas Gerais, Brazil. This is a cross-sectional study based on the analysis of interviews and medical records from which we assembled direct medical and non-medical costs related to CL, from a societal perspective. One hundred patients were included; 50% had a monthly per capita income of up to USD 259.60 and spent on average USD 187.32 with the disease, representing an average monthly impact of 22.5% (USD 133.80). The disease imposed direct medical costs, such as: private medical appointments, medications, medical exams, dressing material, and co-participation in health insurances. Direct non-medical costs were mainly related to patients' transportation to health centers (USD 4,911.00), but also included medically-necessary care, food, and domestic and business outsourcing services. Although the Brazilian public health system guarantees access to health care, CL still represents a substantial economic impact for patients. The main action to reduce the expenses with this disease is decentralizing services for CL diagnosis and therapeutic approach, as well as increasing their efficiency.
Collapse
Affiliation(s)
- Endi Lanza Galvão
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
| | | | | | | | | | - Ana Rabello
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
| |
Collapse
|
2
|
Vita GF, Pereira MAVDAC, Ferreira I, Sanavria A, Barbosa CG, Aurnheimer RDCM, Mello ERD, Silva CBD, Cabral RBG. STATUS OF THE AMERICAN TEGUMENTARY LEISHMANIASIS IN THE STATE OF RIO DE JANEIRO , BRAZIL, FROM 2004 TO 2013. Rev Inst Med Trop Sao Paulo 2016; 58:71. [PMID: 27680176 PMCID: PMC5048642 DOI: 10.1590/s1678-9946201658071] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 05/30/2016] [Indexed: 11/22/2022] Open
Abstract
The aim of the present study was to analyze the status of the American Tegumentary
Leishmaniasis (ATL) in the state of Rio de Janeiro, from 2004 to
2013, through its spatiotemporal distribution. We also described variables considered
relevant to the epidemiology of the disease, such as the clinical form, gender,
ethnic group, age group, and progression of disease. This is a descriptive study,
which used notified secondary data from the Brazilian Information System of
Notifiable Diseases (SINAN), Ministry of Health, Brazil, regarding confirmed
diagnoses. To help the calculation of coefficients of detection and mortality, we
used population data from the Brazilian Institute of Geography and Statistics (IBGE).
We analyzed 1,470 cases of ATL with the predominance of the cutaneous clinical form
(1,292/87.89%). The data has also revealed seven deaths, a predominance of males
(922/62.72%), and a higher incidence of ATL in the white ethnic group (731/49.72%).
We observed a high incidence of ATL in the group of 20 - 39 years old (477/32.44%).
We concluded that there was a decrease in the number of ATL cases in the state of
Rio de Janeiro, based on a coefficient of detection of
1.44/100.000 inhabitants in 2004 decreasing to 0.20/100.000 inhabitants in 2013. The
localities with the highest occurrences of ATL were the metropolitan region (843
cases) and the municipality of Rio de Janeiro (740 cases). In 2005,
the highest incidence of the disease was observed (351 cases) in the study. Among the
variables selected to describe the epidemiology of the disease, the following
categories: cutaneous clinical form, male patients, white ethnic group, and the age
group of 20 - 39 years old were more affected than the others.
Collapse
Affiliation(s)
- Gilmar Ferreira Vita
- Universidade Federal Rural do Rio de Janeiro(UFRRJ), Animal Biology Program of Post-Graduation, Seropédica, Rio de Janeiro, Brazil
| | | | - Ildemar Ferreira
- Universidade Federal Rural do Rio de Janeiro(UFRRJ), Institute of Animal Biology, Seropédica, Rio de Janeiro, Brazil
| | - Argemiro Sanavria
- Universidade Federal Rural do Rio de Janeiro(UFRRJ), Institute of Veterinary Medicine. Seropédica, Rio de Janeiro, Brazil
| | - Celso Guimarães Barbosa
- Universidade Federal Rural do Rio de Janeiro(UFRRJ), Institute of Chemical. Seropédica, Rio de Janeiro, Brazil
| | | | - Ericson Ramos de Mello
- Universidade Federal Rural do Rio de Janeiro(UFRRJ), Institute of Animal Biology, Seropédica, Rio de Janeiro, Brazil
| | - Claudia Bezerra da Silva
- Universidade Federal Rural do Rio de Janeiro(UFRRJ), Institute of Veterinary Medicine. Seropédica, Rio de Janeiro, Brazil
| | | |
Collapse
|
3
|
Menon SS, Rossi R, Nshimyumukiza L, Zinszer K. Decentralized control of human visceral leishmaniasis in endemic urban areas of Brazil: a literature review. Trop Med Health 2016; 44:9. [PMID: 27433128 PMCID: PMC4940922 DOI: 10.1186/s41182-016-0011-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 03/17/2016] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Human migration and concomitant HIV infections are likely to bring about major changes in the epidemiology of some parasitic infections in Brazil. Human visceral leishmaniasis (HVL) control is particularly fraught with intricacies. It is against a backdrop of decentralized health care that the complex HVL control initiatives are brought to bear. This comprehensive review aims to explore the obstacles facing decentralized HVL control in urban endemic areas in Brazil. METHOD A literature search was carried out in December 2015 by means of three databases: MEDLINE, Google Scholar, and Web of Science. RESULTS Although there have been many strides that have been made in elucidating the eco-epidemiology of Leishmania infantum, which forms the underpinnings of the national control program, transmission risk factors for HVL are still insufficiently elucidated in urban settings. Decentralized HVL epidemiological surveillance and control for animal reservoirs and vectors may compromise sustainability. In addition, it may hamper timely human HVL case management. With the burgeoning of the HIV-HVL co-infection, the potential human transmission may be underestimated. CONCLUSION HVL is a disease with focal transmission at a critical juncture, which warrants that the bottlenecks facing the control program within contexts of decentralized healthcare systems be taken into account. In addition, HIV-driven HVL epidemics may substantially increase the transmission potential of the human reservoir. Calculating the basic reproductive number to fine-tune interventions will have to take into consideration the specific socio-economic development context.
Collapse
Affiliation(s)
- Sonia S. Menon
- />International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 P3, 9000 Ghent, Belgium
- />Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada
| | | | - Leon Nshimyumukiza
- />Department of Social and Preventive Medicine, Laval University, Boston, USA
| | - Kate Zinszer
- />Boston Children’s Hospital, Harvard Medical School, Boston, MA USA
| |
Collapse
|
4
|
Diniz DS, Costa ASV, Escalda PMF. The effect of age on the frequency of adverse reactions caused by antimony in the treatment of American tegumentary leishmaniasis in Governador Valadares, State of Minas Gerais, Brazil. Rev Soc Bras Med Trop 2012; 45:597-600. [DOI: 10.1590/s0037-86822012000500011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Accepted: 10/04/2011] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION: Governador Valadares is an endemic area of American tegumentary leishmaniasis (ATL). The detection rate was 15.36 per 100,000 habitants from 2001 to 2006 (Miranda, 2008). This study aimed to analyze the effects of age on the frequency of adverse reactions caused by antimony in the treatment of ATL in the City of Governador Valadares, State of Minas Gerais, Brazil, during 2009. METHODS: Data were collected from the forms of the Information System for Notifiable Diseases, and from charts, questionnaires, and home visits to patients. RESULTS: The study included 40 patients, 26 (65%) of whom were males. Individuals over the age of 50 had a 66% higher rate of adverse effects than subjects who were 50 years old or less (CI 95%, 1.14-2.41). The average age of individuals who reported some type of adverse effect was 44.11 years (SD = 20.14), while the average age of the group that did not report any adverse effect was of 25.46 years (SD = 18.37; p < 0.01). Clinical healing was 67.5%, and 10% of patients discontinued the treatment. CONCLUSIONS: In the treatment of ATL, the age of patients should be considered, because most adverse reactions occur in individuals over 50 years of age. For this reason, the drug should be used with restriction in these cases.
Collapse
|
5
|
Cella W, Melo SCCSD, Dell Agnolo CM, Pelloso SM, Silveira TGV, Carvalho MDDB. Seventeen years of American cutaneous leishmaniasis in a Southern Brazilian municipality. Rev Inst Med Trop Sao Paulo 2012; 54:215-8. [PMID: 22850994 DOI: 10.1590/s0036-46652012000400006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Accepted: 04/27/2012] [Indexed: 11/22/2022] Open
Abstract
We reviewed the records of 151 patients diagnosed with American cutaneous leishmaniasis (ACL) from 1993 to 2009 in the municipality of Japura, Paraná, Brazil. Gender, age, occupation, place of residence, location of lesions, type and number of lesions were analyzed. The prevalence rate of ACL was 11.5/10,000 hab, of which 84.7% were male, 58.3% lived in rural area and 49.0% were farmers. The most frequent age group was between 30 to 39 years (26.6%). Skin lesions occurred in 92.7% of the patients with predominance in the lower limbs (23.9%) and 49.1% of the records did not include the number of lesions location due to incomplete filling. A single ulceration was present in 44.4%. Japurá is an endemic area for ACL, requiring public actions and preventive education.
Collapse
Affiliation(s)
- Wilsandrei Cella
- Programa de Pós-Graduação em Ciências da Saúde, UEM, Paraná, Brazil.
| | | | | | | | | | | |
Collapse
|
6
|
Nunes CSA, Yoshizawa JK, Oliveira RZD, Lima APD, Oliveira LZD, Lima MVND. Leishmaniose mucosa: considerações epidemiológicas e de tratamento. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2011. [DOI: 10.5712/rbmfc6(18)145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Na região Sul do Brasil, a leishmaniose tegumentar americana predomina no Estado do Paraná, especialmente ao Norte e Oeste, onde um dos circuitos de produção da doença é localizado. Estima-se que 3 a 5% dos casos de leishmaniose cutânea desenvolvam lesão mucosa, e que cerca de 1% destas podem evoluir para óbito. De longa data, as drogas de escolha para tratamento da doença são os compostos antimoniais sob a forma de sais pentavalentes. O objetivo deste estudo foi descrever características epidemiológicas e de tratamento dos pacientes com leishmaniose mucosa, diagnosticados no período de 2001 a 2007, em municípios localizados na área de abrangência da 13ª Regional de Saúde, com sede no município de Cianorte, no Paraná. As informações foram coletadas do prontuário ambulatorial e das fichas de investigação epidemiológicas do Sistema de Notificação e Informação de Agravos. No período estudado, foram notificados 505 casos de leishmaniose tegumentar americana, 30 deles (6%) na forma mucosa. Foram incluídos no estudo pacientes com diagnóstico de leishmaniose mucosa, que apresentavam exames complementares realizados antes e durante o tratamento. Os resultados evidenciaram a necessidade de acompanhamento cuidadoso dos doentes nas equipes de saúde, dado a possível evolução e presença de efeitos medicamentosos indesejáveis nos pacientes afetados pela condição.
Collapse
|
7
|
Monteiro WM, Neitzke-Abreu HC, Ferreira MEMDC, Melo GCD, Barbosa MDGV, Lonardoni MVC, Silveira TGV, Teodoro U. [Population mobility and production of American tegumentary leishmaniasis in the State of Paraná, southern Brazil]. Rev Soc Bras Med Trop 2010; 42:509-14. [PMID: 19967232 DOI: 10.1590/s0037-86822009000500007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2009] [Accepted: 09/24/2009] [Indexed: 11/22/2022] Open
Abstract
Information on the role of population mobility in maintaining American tegumentary leishmaniasis in the State of Paraná is scarce. Population mobility was evaluated as a risk factor for this endemic disease in three mesoregions of Paraná, using data built up at the State University of Maringá, covering 1987 to 2004. A total of 1,933 cases were notified, mostly among migrants (54.4%). The municipalities with the greatest numbers of cases notified were Maringá (358), Doutor Camargo (108) and Terra Boa (105). The rural cases were predominantly autochthonous (89.8%), while the urban cases were mostly among migrants (84.8%) (p < 0.0001). Among the rural autochthonous cases, there was no difference between the sexes (p = 0.127), whereas among the urban migrant cases, men predominated (p < 0.0001). The migrant cases were mostly related to mobility within and between municipalities. Population mobility seems to be an important variable in the epidemiology of this disease in the State of Paraná.
Collapse
|
8
|
Silva NSD, Muniz VD. Epidemiologia da leishmaniose tegumentar americana no Estado do Acre, Amazônia brasileira. CAD SAUDE PUBLICA 2009; 25:1325-36. [DOI: 10.1590/s0102-311x2009000600015] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2008] [Accepted: 01/21/2009] [Indexed: 11/22/2022] Open
Abstract
Efetuou-se estudo estatístico descritivo em 8.516 casos de leishmaniose tegumentar americana no Estado do Acre, Brasil, no período de 2001 a 2006 (segundo período), comparando-se com os resultados de publicação anterior com dados no mesmo estado entre 1992 e 1997 (primeiro período). A prevalência no estado mais que dobrou entre os dois momentos (55,7/10 mil habitantes de 1992 a 1997 e 128,5/10 mil habitantes entre 2001 e 2006. O sexo masculino foi o mais acometido (68,8%, n = 5.860) no segundo período. A média das idades foi de 26,3 anos, valor discretamente menor do que o do primeiro período. Pacientes com baixa escolaridade foram os mais acometidos pela doença. As demais variáveis avaliadas foram zona de residência, ocupação, critério de diagnóstico, forma clínica, tratamento, recidiva, tempo para procurar tratamento e evolução da doença. Conclui-se que houve piora nos indicadores epidemiológicos da leishmaniose tegumentar americana avaliados no estado entre os períodos estudados.
Collapse
|