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Hernandez HG, Brown GD, Lima ID, Coutinho JF, Wilson ME, Nascimento ELT, Jeronimo SMB, Petersen CA, Oleson JJ. Hierarchical spatiotemporal modeling of human visceral leishmaniasis in Rio Grande do Norte, Brazil. PLoS Negl Trop Dis 2023; 17:e0011206. [PMID: 37011128 PMCID: PMC10101641 DOI: 10.1371/journal.pntd.0011206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 04/13/2023] [Accepted: 03/01/2023] [Indexed: 04/05/2023] Open
Abstract
Visceral leishmaniasis (VL) is a neglected tropical disease that is globally distributed and has the potential to cause very serious illness. Prior literature highlights the emergence and spread of VL is influenced by multiple factors, such as socioeconomic status, sanitation levels or animal and human reservoirs. The study aimed to retrospectively investigate the presence and infectiousness of VL in Rio Grande do Norte (RN), Brazil between 2007 and 2020. We applied a hierarchical Bayesian approach to estimate municipality-specific relative risk of VL across space and time. The results show evidence that lower socioeconomic status is connected to higher municipality-specific VL risk. Overall, estimates reveal spatially heterogeneous VL risks in RN, with a high probability that VL risk for municipalities within the West Potiguar mesoregion are more than double the expected VL risk. Additionally, given the data available, results indicate there is a high probability of increasing VL risk in the municipalities of Natal, Patu and Pau dos Ferros. These findings demonstrate opportunities for municipality-specific public health policy interventions and warrant future research on identifying epidemiological drivers in at-risk regions.
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Affiliation(s)
- Helin G Hernandez
- Department of Biostatistics, University of Iowa, Iowa City, Iowa, United States of America
| | - Grant D Brown
- Department of Biostatistics, University of Iowa, Iowa City, Iowa, United States of America
| | - Iraci D Lima
- State Health Secretariat, State Government of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - José F Coutinho
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Mary E Wilson
- Departments of Internal Medicine and Microbiology & Immunology, University of Iowa, Iowa City, Iowa, United States of America
- Iowa City VA Medical Center, Iowa City, Iowa, United States of America
| | - Eliana L T Nascimento
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Department of Infectious Diseases, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Selma M B Jeronimo
- Institute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Department of Biochemistry, Federal University of Rio Grande do Norte, Natal, Brazil
- National Institute of Sciences and Technology of Tropical Disease, Natal, Rio Grande do Norte, Brazil
| | - Christine A Petersen
- Department of Epidemiology, University of Iowa, Iowa City, Iowa, United States of America
| | - Jacob J Oleson
- Department of Biostatistics, University of Iowa, Iowa City, Iowa, United States of America
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