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da Consolação Magalhães Cunha M, Conrad Bohm B, Morais MHF, Dias Campos NB, Schultes OL, Pereira Campos Bruhn N, Pascoti Bruhn FR, Caiaffa WT. Temporal trends of dengue cases and deaths from 2007 to 2020 in Belo Horizonte, Brazil. Int J Environ Health Res 2024; 34:2248-2263. [PMID: 37485862 DOI: 10.1080/09603123.2023.2237420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
Dengue, a disease with multifactorial determinants, is linked to population susceptibility to circulating viruses and the extent of vector infestation. This study aimed to analyze the temporal trends of dengue cases and deaths in Belo Horizonte, Minas Gerais, Brazil, from 2007 to 2020. Data from the Notifiable Diseases Information System (Sinan) were utilized for the investigation. To assess the disease's progression over the study period and predict its future incidence, time series analyses were conducted using a generalized additive model (GAM) and a seasonal autoregressive integrated moving average (SARIMA) model. Over the study period, a total of 463,566 dengue cases and 125 deaths were reported. Notably, there was an increase in severe cases and deaths, marking hyperendemics characterized by simultaneous virus circulation (79.17% in 2016-50% in 2019). The generalized additive model revealed a non-linear pattern with epidemic peaks in 2010, 2013, 2016, and 2019, indicating an explosive pattern of dengue incidence. The SARIMA (3,1,1) (0,0,0)12 model was validated for each year (2015 to 2019). Comparing the actual and predicted numbers of dengue cases, the model demonstrated its effectiveness for predicting cases in the municipality. The rising number of dengue cases emphasizes the importance of vector surveillance and control. Enhanced models and predictions by local health services will aid in anticipating necessary control measures to combat future epidemics.
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Affiliation(s)
| | - Bianca Conrad Bohm
- Veterinary Epidemiology Laboratory, Preventive Veterinary Department, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | | | - Natalia Bruna Dias Campos
- Urban Health Observatory - Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Olivia Lang Schultes
- Urban Health Observatory - Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Fabio Raphael Pascoti Bruhn
- Veterinary Epidemiology Laboratory, Preventive Veterinary Department, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - Waleska Teixeira Caiaffa
- Urban Health Observatory - Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
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2
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Colombo SA, Bicalho GC, de Oliveira CSF, de Magalhães Soares DF, Salvato LA, Keller KM, Bastos CDVE, Morais MHF, Rodrigues AM, Cunha JLR, de Azevedo MI. Emergence of zoonotic sporotrichosis due to Sporothrix brasiliensis in Minas Gerais, Brazil: A molecular approach to the current animal disease. Mycoses 2023; 66:911-922. [PMID: 37452233 DOI: 10.1111/myc.13631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/24/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023]
Abstract
Sporotrichosis is a neglected fungal zoonosis with significant impacts on human and animal health. Accurate diagnosis, treatment, and understanding of the transmission dynamics of Sporothrix species are essential for mitigating the spread of sporotrichosis. This study aimed to identify the Sporothrix species involved in the ongoing outbreaks of animal sporotrichosis in the metropolitan region of Belo Horizonte, Minas Gerais, Brazil, and analyse the phylogenetic relationships between pathogenic species to investigate the outbreak origin. Additionally, to better understand the evolution of the disease, we conducted a retrospective survey of positive feline and canine cases from November 2017 to July 2021 with proven cultures for Sporothrix. A significant increase in animal cases over the last 4 years was observed, with cats being the most affected host. Sporothrix brasiliensis was the predominant agent in 100% of the clinical isolates (n = 180) molecularly identified. Phylogenetic and haplotype analysis points towards the cases isolated from Minas Gerais sharing the haplotype originating from a long-lasting outbreak of cat-transmitted sporotrichosis in Rio de Janeiro, however, with a secondary contribution from genotypes circulating in other outbreaks in Brazil. Thus, we present clear evidence of the circulation of different S. brasiliensis genotypes associated with animal sporotrichosis in the metropolitan region of Belo Horizonte. Genetic monitoring can contribute to understanding the causal agent for zoonotic sporotrichosis in epidemiological processes and help to implement disease prevention and control measures.
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Affiliation(s)
- Salene Angelini Colombo
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Gustavo Canesso Bicalho
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Lauranne Alves Salvato
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Kelly Moura Keller
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Camila de Valgas E Bastos
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Anderson Messias Rodrigues
- Departamento de Microbiologia, Imunologia e Parasitologia, Disciplina de Biologia Celular, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - João Luis Reis Cunha
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maria Isabel de Azevedo
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Bohm BC, Morais MHF, Cunha MDCM, Bruhn NCP, Caiaffa WT, Bruhn FRP. Determining the relationship between dengue and vulnerability in a Brazilian city: a spatial modeling analysis. Pathog Glob Health 2023:1-11. [PMID: 37602571 DOI: 10.1080/20477724.2023.2247273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023] Open
Abstract
Dengue is a viral infection transmitted by the Aedes aegypti mosquito. This study aimed to assess the distribution of cases and deaths from dengue and severe dengue, and its relationship with social vulnerability in Belo Horizonte, State of Minas Gerais, Brazil, from 2010 to 2018. The incidence and lethality rates of dengue and their relationship with sex, age, education, skin color, and social vulnerability were studied using chi-square tests, Ordinary Least Squares (OLS), and Geographically Weighted Regression (GWR) analyses. The number of cases of dengue in Belo Horizonte during the study period was 324,044 dengue cases, with 1,334 cases of severe dengue and 88 deaths. During the past few decades, the incidence rate of both dengue and severe cases varied, with an average incidence rate of respectively 1515.5 and 6.2/100,000 inhabitants. The increase in dengue cases was directly related to areas with higher social vulnerability areas and more working-age people. Also, the disease is more severe in people self-declared as black, elderly, and male. The findings of this study might provide relevant information for health services in the organization of control and prevention policies for this problem, emphasizing the most vulnerable urban areas and categories.
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Affiliation(s)
- Bianca Conrad Bohm
- Veterinary Epidemiology Laboratory, Preventive Veterinary Department, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | | | | | | | - Waleska Teixeira Caiaffa
- Urban Health Observatory - Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Fábio Raphael Pascoti Bruhn
- Preventive Veterinary Department, Zoonoses Control Center (UFPel), Federal University of Pelotas, Pelotas, 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Cunha MDCM, Ju Y, Morais MHF, Dronova I, Ribeiro SP, Bruhn FRP, Lima LL, Sales DM, Schultes OL, Rodriguez DA, Caiaffa WT. Disentangling associations between vegetation greenness and dengue in a Latin American city: Findings and challenges. Landsc Urban Plan 2021; 216:None. [PMID: 34675450 PMCID: PMC8519391 DOI: 10.1016/j.landurbplan.2021.104255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 08/11/2021] [Accepted: 09/14/2021] [Indexed: 05/07/2023]
Abstract
Being a Re-Emerging Infectious Disease, dengue causes 390 million cases globally and is prevalent in many urban areas in South America. Understanding the fine-scale relationships between dengue incidence and environmental and socioeconomic factors can guide improved disease prevention strategies. This ecological study examines the association between dengue incidence and satellite-based vegetation greenness in 3826 census tracts nested in 474 neighborhoods in Belo Horizonte, Brazil, during the 2010 dengue epidemic. To reduce potential bias in the estimated dengue-greenness association, we adjusted for socioeconomic vulnerability, population density, building height and density, land cover composition, elevation, weather patterns, and neighborhood random effects. We found that vegetation greenness was negatively associated with dengue incidence in a univariate model, and this association attenuated after controlling for additional covariates. The dengue-greenness association was modified by socioeconomic vulnerability: while a positive association was observed in the least vulnerable census tracts, the association was negative in the most vulnerable areas. Using greenness as a proxy for vegetation quality, our results show the potential of vegetation management in reducing dengue incidence, particularly in socioeconomically vulnerable areas. We also discuss the role of water infrastructure, sanitation services, and tree cover in lowering dengue risk.
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Affiliation(s)
- Maria da Consolação Magalhães Cunha
- Observatory for Urban health in Belo Horizonte, School of Medicine, Federal University of Minas Gerais, Brazil
- Pontifical Catholic University of Minas Gerais, Brazil
| | - Yang Ju
- Institute of Urban and Regional Development, University of California, 316 Wurster Hall, University of California, Berkeley, Berkeley, CA 94720, USA
- Corresponding author.
| | | | - Iryna Dronova
- Department of Environmental Science, Policy, and Management, Department of Landscape Architecture and Environmental Planning, University of California, Berkeley, USA
| | - Sérvio Pontes Ribeiro
- Laboratory of Ecology of Diseases and Forests, Nucleous of Biology/NUPEB and Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Brazil
| | | | - Larissa Lopes Lima
- Observatory for Urban health in Belo Horizonte, School of Medicine, Federal University of Minas Gerais, Brazil
- Federal Center for Technological Education of Minas Gerais, Brazil
| | - Denise Marques Sales
- Observatory for Urban health in Belo Horizonte, School of Medicine, Federal University of Minas Gerais, Brazil
| | - Olivia Lang Schultes
- Observatory for Urban health in Belo Horizonte, School of Medicine, Federal University of Minas Gerais, Brazil
| | - Daniel A. Rodriguez
- Department of City and Regional Planning and Institute of Transportation Studies, University of California, Berkeley, USA
| | - Waleska Teixeira Caiaffa
- Observatory for Urban health in Belo Horizonte, School of Medicine, Federal University of Minas Gerais, Brazil
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da Silva TAM, Morais MHF, Lopes HMDOR, Gonçalves SA, Magalhães FDC, Amâncio FF, Antunes CMF, Carneiro M. Prognostic factors associated with death from visceral leishmaniasis: a case-control study in Brazil. Trans R Soc Trop Med Hyg 2021; 114:346-354. [PMID: 32118274 DOI: 10.1093/trstmh/traa010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 12/18/2019] [Accepted: 01/24/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The aim of this study was to identify the prognostic factors associated with death from visceral leishmaniasis (VL) considering the clinical evolution of patients through a case-control study. METHODS We randomly selected 180 cases (death caused by VL) and 180 controls (cured) from Belo Horizonte's hospitals in Brazil, according to data found in the patients' medical records. Five models of multivariate logistic regression were performed following the chronological order of the variables between the onset of the symptoms and evolution of the VL cases. RESULTS Considering the multivariate models and the stages of clinical evolution of VL, the prognostic factors associated with death are: age >60 y, minor hemorrhagic phenomena, increased abdominal volume, jaundice, dyspnea, malnutrition, TB, billirubin >2 mg/dL, Aspartate Aminotransferase (AST) or Alanine Aminotransferase (ALT) >100 U/L, leukocytes >7000/mm3, hemoglobin <7 g/dL, platelets <50 000/mm3 and infection without defined focus and bleeding. CONCLUSIONS Knowledge regarding the prognostic factors associated with death from VL in different stages of the disease in large Brazilian urban centers such as Belo Horizonte may help optimize patient management strategies and contribute to reduce the high fatality rates in these cities.
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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.,Laboratório de Epidemiologia e Bioestatística, Programa de Pós-graduação Stricto Sensu em Medicina e Biomedicina, Instituto de Ensino e Pesquisa Santa Casa BH, Belo Horizonte, Minas Gerais, Brazil
| | | | | | - Stefanne Aparecida Gonçalves
- 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
| | - Frederico Figueiredo Amâncio
- 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
| | - Carlos Maurício Figueiredo Antunes
- Laboratório de Epidemiologia e Bioestatística, Programa de Pós-graduação Stricto Sensu em Medicina e Biomedicina, Instituto de Ensino e Pesquisa Santa Casa BH, 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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Andrade EHP, Moreira SM, Paiva MT, Zibaoui HM, Salvato LA, Azevedo MID, Oliveira CSFD, Soares DFDM, Keller KM, Magalhães SL, Morais MHF, Costa JRDR, Bastos CDVE. Characterization of animal sporotrichosis in a highly urbanized area. Comp Immunol Microbiol Infect Dis 2021; 76:101651. [PMID: 33915403 DOI: 10.1016/j.cimid.2021.101651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/01/2021] [Accepted: 04/09/2021] [Indexed: 11/24/2022]
Abstract
An epidemiological characterization of animal sporotrichosis was carried out between 2017 and 2018, in a highly urbanized area in Brazil, including outcomes and the spatial distribution of the cases according to the health vulnerability index (HVI) of the study territory. One hundred and sixty-five cats and four dogs suspected of sporotrichosis were identified by a surveillance and control program previously implemented in the study area. One hundred and five of these animals (62.1 %) were considered positive for Sporothrix spp., of which 103 were cats and two were dogs. Cases predominated among male cats (53.4 %), although gender did not present a statistically significant association (p > 0.05) with sporotrichosis cases. Considering the positive cats, 55.4 % were not neutered and free access to the street was reported as a habit for 86.4 % of them. Roaming free in the streets increased the chance of infection by 2.54 times. We observed a high frequency of euthanasia or death (48.8 %) among 86 infected cats available to be included in the follow-up stage of the study, even when they were treated (46.5 %) and a low cure rate (31 %). The disease spread, unrelated to the HVI in the territory. Data produced suggested that avoiding access to the street seems to have greater importance to sporotrichosis control in cats than neutering and reinforces the importance of health education, especially in relation to responsible feline ownership. The free offer of diagnosis and treatment also should be taken into consideration as important measures to control the disease.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Kelly Moura Keller
- Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Campos NBD, Morais MHF, Ceolin APR, Cunha MDCM, Nicolino RR, Schultes OL, Friche AADL, Caiaffa WT. Twenty-Two years of dengue fever (1996-2017): an epidemiological study in a Brazilian city. Int J Environ Health Res 2021; 31:315-324. [PMID: 31468989 DOI: 10.1080/09603123.2019.1656801] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
This ecological study analyzed the temporal pattern of clinically diagnosed and laboratory confirmed dengue cases in Belo Horizonte, Minas Gerais, Brazil from 1996 to 2017. The study was divided into two analytical parts, the first of which evaluated the association between dengue incidence and host and climatic factors. The second part encompassed data from 2002 to 2017 and examined dengue incidence in relation to virus serotype and an intra-urban socioeconomic index. Over 22 years there were 469,171 cases and four epidemic peaks. There was an increase in the number, severity, and lethality of cases over the last 10 years of the study period. Biological and environmental factors appear to modulate the behavior of dengue in a large urban center.
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Affiliation(s)
- Natalia Bruna Dias Campos
- Municipal Health Department, Belo Horizonte, Minas Gerais
- Urban Health Observatory of Belo Horizonte (OSUBH in Portuguese), School of Medicine, Federal University of Minas Gerais
| | | | - Ana Paula Romanelli Ceolin
- Urban Health Observatory of Belo Horizonte (OSUBH in Portuguese), School of Medicine, Federal University of Minas Gerais
| | | | | | - Olívia Lang Schultes
- Urban Health Observatory of Belo Horizonte (OSUBH in Portuguese), School of Medicine, Federal University of Minas Gerais
| | - Amélia Augusta de Lima Friche
- Urban Health Observatory of Belo Horizonte (OSUBH in Portuguese), School of Medicine, Federal University of Minas Gerais
| | - Waleska Teixeira Caiaffa
- Urban Health Observatory of Belo Horizonte (OSUBH in Portuguese), School of Medicine, Federal University of Minas Gerais
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Coura-Vital W, Cardoso DT, Ker FTDO, Magalhães FDC, Bezerra JMT, Viegas AM, Morais MHF, Bastos LS, Reis IA, Carneiro M, Barbosa DS. Spatiotemporal dynamics and risk estimates of COVID-19 epidemic in Minas Gerais State: analysis of an expanding process. Rev Inst Med Trop Sao Paulo 2021; 63:e21. [PMID: 33787741 PMCID: PMC7997666 DOI: 10.1590/s1678-9946202163021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 02/20/2021] [Indexed: 12/24/2022] Open
Abstract
COVID-19 is an infectious disease caused by the recently discovered coronavirus
SARS-Cov-2. The disease became pandemic affecting many countries globally,
including Brazil. Considering the expansion process and particularities during
the initial stages of the epidemic, we aimed to analyze the spatial and
spatiotemporal patterns of COVID-19 occurrence and to identify priority risk
areas in Minas Gerais State, Southeast Brazil. An ecological study was performed
considering all data from human cases of COVID-19 confirmed from the
epidemiological week (EW) 11 (March 08, 2020) to EW 26 (June 27, 2020). Crude
and smoothed incidence rates were used to analyze the distribution of disease
patterns based on global and local indicators of spatial association and
space-time risk assessment. Positive spatial autocorrelation and spatial
dependence were found. Our results suggest that the metropolitan region of the
State capital Belo Horizonte (MRBH) and Vale do Rio Doce mesoregions, as major
epidemic foci in the beginning of the expansion process, have had important
influence on the dispersion of SARS-CoV-2 in Minas Gerais State. Triangulo
Mineiro/Alto Paranaiba region presented the highest risk of infection. In
addition, six statistically significant spatiotemporal clusters were identified
in the State, three at high risk and three at low risk. Our findings contribute
to a greater understanding of the space-time disease dynamic and discuss
strategies for identification of priority areas for COVID-19 surveillance and
control.
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Affiliation(s)
- Wendel Coura-Vital
- Universidade Federal de Ouro Preto, Escola de Farmácia, Departamento de Análises Clínicas, Ouro Preto, Minas Gerais, Brazil
| | - Diogo Tavares Cardoso
- Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Belo Horizonte, Minas Gerais, Brazil
| | | | - Fernanda do Carmo Magalhães
- Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Belo Horizonte, Minas Gerais, Brazil
| | - Juliana Maria Trindade Bezerra
- Universidade Estadual do Maranhão, Campus de Lago da Pedra, Curso de Ciências Biológicas, Lago da Pedra, Maranhão, Brazil
| | - Ana Maria Viegas
- Prefeitura Municipal de Belo Horizonte, Belo Horizonte, Minas Gerais, Brasil.,Prefeitura Municipal de Contagem, Contagem, Minas Gerais, Brazil
| | - Maria Helena Franco Morais
- Prefeitura Municipal de Belo Horizonte, Belo Horizonte, Minas Gerais, Brasil.,Prefeitura Municipal de Contagem, Contagem, Minas Gerais, Brazil
| | - Leonardo Soares Bastos
- Fundação Oswaldo Cruz, Programa de Computação Científica, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ilka Afonso Reis
- Universidade Federal de Minas Gerais, Instituto de Ciências Exatas, Belo Horizonte, Minas Gerais, Brazil
| | - Mariângela Carneiro
- Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Belo Horizonte, Minas Gerais, Brazil
| | - David Soeiro Barbosa
- Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Belo Horizonte, Minas Gerais, Brazil
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10
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Schultes OL, Morais MHF, Cunha MDCM, Sobral A, Caiaffa WT. Spatial analysis of dengue incidence and Aedes aegypti ovitrap surveillance in Belo Horizonte, Brazil. Trop Med Int Health 2020; 26:237-255. [PMID: 33159826 DOI: 10.1111/tmi.13521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Understanding the intra-urban spatial dynamics of Aedes aegypti and dengue transmission is important to effectively guide vector control. Ovitraps are a sensitive, cost-effective vector surveillance tool, yet few longitudinal studies have evaluated ovitrap indices and dengue occurrence. We aimed to assess the spatial patterns of dengue incidence and Ae. aegypti ovitrap positivity index (OPI) over time and to examine the spatial relationship between these two variables. METHODS This study used 12 years (2007-2018) of dengue case records and biweekly Ae. aegypti ovitrap data in Belo Horizonte, Brazil. We aggregated data by year and health centre catchment area (n = 152) and used both univariate and bivariate global Moran's I statistic and LISA to evaluate spatial clustering. RESULTS Annual dengue incidence ranged from 18 to 6262/100 000 residents and displayed spatial autocorrelation in 10/12 years, with shifting areas of high incidence. Annual OPI ranged from 35.7 to 47.6% and was clustered in all study years, but unlike dengue had consistent spatial patterns over time. Bivariate analysis found both positive (6/12 years) and negative (1/12 years) spatial associations between the two variables. CONCLUSIONS Low detected presence of Ae. aegypti was not a limiting factor in dengue transmission. However, stable spatial distribution of OPI suggests that certain areas may have persistent breeding sites. Future research should identify factors related to persistent Ae. aegypti hotspots to better guide vector management. Vector control efforts should be paired with additional data on population immunity, circulating serotypes and urban factors to better predict and control outbreaks.
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Affiliation(s)
- Olivia Lang Schultes
- Urban Health Observatory of Belo Horizonte, Federal University of Minas Gerais, Brazil
| | | | | | - Andréa Sobral
- National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, 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] [What about the content of this article? (0)] [Affiliation(s)] [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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12
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Paiva MT, de Oliveira CSF, Nicolino RR, Bastos CV, Lecca LO, de Azevedo MI, Keller KM, Salvato LA, Brandão ST, de Oliveira HMR, Morais MHF, Ecco R, Lech AJZ, Haddad JPA, de Magalhães Soares DF. Spatial association between sporotrichosis in cats and in human during a Brazilian epidemics. Prev Vet Med 2020; 183:105125. [PMID: 32891900 DOI: 10.1016/j.prevetmed.2020.105125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 08/15/2020] [Accepted: 08/15/2020] [Indexed: 12/31/2022]
Abstract
Sporotrichosis is a subcutaneous granulomatous disease caused by the fungus Sporothrix spp. In Brazil, S. brasiliensis is reported in regions of outbreaks and epidemics in the zoonotic form of the disease where cats play an important role in the transmission of the disease to humans. Therefore, it is important to assess how the presence of infected cats impacts the risk for sporotrichosis in humans. The objective of this study was to analyze the spatial association of sporotrichosis in cats and in humans from Belo Horizonte, a Brazilian city where an epidemics of sporotrichosis occurs since the first human case register in 2015, through an inhomogeneous Poisson process model. Feline and human cases of sporotrichosis recorded between January 2016 and June 2019 were georeferenced by address and spatial point patterns were generated. Feline case intensity and human demographic density were calculated using a kernel smoothed estimate. The distance to the nearest feline case was also compute. Model parameters were estimated by Maximum Likelihood Estimate. The model validation was performed by the evaluation of partial residual, leverage and influence measure. There were 343 cases of cats and 135 human cases of sporotrichosis. The average incidence of human sporotrichosis in the period was 1.343 per 100 thousand inhabitants, which is relatively low in relation to the population, but higher than that observed in other regions in zoonotic outbreak of the disease. The southern region of the municipality has a higher intensity of feline cases. According to the fitted model, the risk for human sporotrichosis is greater when at distances very close to a feline case, with a virtually stable effect for distances greater than 1 km. Regarding the intensity of feline cases there is a gradual increase in risk as the intensity of cases increases. From the leverage analysis it was observed that the model was particularly sensitive to the occurrence of human cases in the south and east regions, places with extreme values of covariates. Poisson point process model seems to be a reasonable approach in spatial epidemiology when multiple sources of infection are involved, and there is a low incidence of the disease as long as it is reasonable to assume independence between cases. Interventions for disease prevention and control in humans are suggested to encompass disease control in cats and the search for feline cases, focused on diagnosis and control, close to reported human cases.
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Affiliation(s)
- Marcelo Teixeira Paiva
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Camila Stefanie Fonseca de Oliveira
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rafael Romero Nicolino
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Camila Valgas Bastos
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lívian Otávio Lecca
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Isabel de Azevedo
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Kelly Moura Keller
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lauranne Alves Salvato
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Silvana Tecles Brandão
- Secretaria Municipal da Saúde, Prefeitura Municipal de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
| | | | - Maria Helena Franco Morais
- Secretaria Municipal da Saúde, Prefeitura Municipal de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
| | - Roselene Ecco
- Departamento de Clínica e Cirurgia Veterinária. Escola de Veterinária da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Anna Julia Zilli Lech
- Universidade Federal do Paraná, Departamento de Medicina Veterinária, Curitiba, Paraná, Brazil
| | - João Paulo Amaral Haddad
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Morais MHF, Sabroza PC, Pessanha JE, Sobral A. Visceral leishmaniasis control actions: epidemiological indicators for its effectiveness evaluation in a Brazilian urban area. CAD SAUDE PUBLICA 2020; 36:e00060219. [PMID: 32520123 DOI: 10.1590/0102-311x00060219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 11/19/2019] [Indexed: 11/22/2022] Open
Abstract
This research applies indicators concerning control of the visceral leishmaniasis canine reservoir in the city of Belo Horizonte, Minas Gerais State, Brazil. Data were obtained from the Zoonoses Control Information System (SCZOO) and the Brazilian Information System on Diseases of Notification (SINAN) database. First we analyzed (i) existing associations between canine epidemiological indicators, where the dependent variable was the canine seroprevalence A (2007 to 2013), and the independent variables were, as follows: canine seroprevalence B (2006 to 2012); percentage of positive dogs by ELISA test reagents that were not euthanized; the relationship between the human and canine population; canine population testing coverage by census surveys; and the years of study (2006 to 2013); (ii) then, we examined the association between human visceral leishmaniasis (HVL) cases between 2007 to 2013 and the mentioned variables related to dogs and years. Statistical analysis was done by a generalized linear model (GLM). One unit increases in canine seroprevalence B and canine seroprevalence A were associated to 13% and 12% increases in HVL rates, respectively. The increase in one human/dog ratio unit was associated with a 13% decrease in HVL rates. Canine seroprevalence, human/dog ratio and non-euthanasia of ELISA-reactive dogs in the environment were adequate indicators for analyzing the canine enzootic transmission and the occurrence of HVL cases.
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Affiliation(s)
| | | | | | - Andrea Sobral
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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14
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Lecca LO, Paiva MT, de Oliveira CSF, Morais MHF, de Azevedo MI, Bastos CDVE, Keller KM, Ecco R, Alves MRS, Pais GCT, Salvato LA, Xaulim GDMD, Barbosa DS, Brandão ST, Soares DFDM. Associated factors and spatial patterns of the epidemic sporotrichosis in a high density human populated area: A cross-sectional study from 2016 to 2018. Prev Vet Med 2020; 176:104939. [PMID: 32143029 DOI: 10.1016/j.prevetmed.2020.104939] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 02/17/2020] [Accepted: 02/23/2020] [Indexed: 12/19/2022]
Abstract
An epidemiological characterization of human and feline sporotrichosis was carried out between 2016 and 2018, in a high density-populated area in Brazil. Professionals were trained to identify suspect cats and notify vets to interview the owners and collect swabs of the wounds from these animals. Mycological cultures were performed, and colonies identified as Sporothrix spp. Subsequently, data regarding the outcome from suspect animals were collected. Confirmed cases of human sporotrichosis (56) were also counted and analyzed for spatial distribution. 118 positive animals were observed. The prevalence of feline sporotrichosis was 8.36 ‰ (CI 95 %, 5.38-9.55 ‰). The odds for being positive in animals that lived only partially at home were 3.02 times greater than for those cats without access to the street (OR 3.02, CI 95 % 1,96-10,43). There was no statistically significant association between environmental variables and positive diagnosis, corroborating the hypothesis that direct transmission by infected cats plays a greater role in the occurrence and continuous outbreaks of sporotrichosis in Brazil. Among the positive animals, 61.90 % (CI 95 % 58.95-64.96) died, and they had an odds to die in the next six months 6.30 times greater than negative animals (p < 0.05, OR 6.30, CI 95 % 2,79-14,42). The case fatality rate was 55.08 % in cats (CI 95 % 49.20-51.15). The cause-specific death rate was 4.6 ‰ in cats (CI 95 % 3.4-6 ‰). Only 7.62 % (CI 95 % 7.12-8.16) positive cats were treated and cured. Among dead positive animals, 29.23 % were inappropriately discarded. In the study period 56 human cases were recorded in the Barreiro region. Regions with highest prevalence of feline sporotrichosis, had greater frequencies of both human and feline cases. This is the first report on the epidemic of sporotrichosis in Minas Gerais, Brazil. The free offer for treatment and veterinary care for these animals should be taken into consideration, as well as the collection and incineration of the dead ones, as measures of public health, followed by the guidance and care for the human patient.
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Affiliation(s)
- Lívian Otávio Lecca
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Marcelo Teixeira Paiva
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Camila Stefanie Fonseca de Oliveira
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Helena Franco Morais
- Diretoria de Zoonoses, Secretaria Municipal da Saúde, Prefeitura Municipal de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Isabel de Azevedo
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Camila de Valgas E Bastos
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Kelly Moura Keller
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Roselene Ecco
- Departamento de Clínica e Cirurgia Veterinária, Escola de Veterinária da Universidade Federal de Minas Gerais Belo Horizonte, Minas Gerais, Brazil
| | - Márcia Regina Silva Alves
- Diretoria de Zoonoses, Secretaria Municipal da Saúde, Prefeitura Municipal de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
| | - Graziella Coelho Tavares Pais
- Diretoria de Zoonoses, Secretaria Municipal da Saúde, Prefeitura Municipal de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
| | - Lauranne Alves Salvato
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Gustavo de Morais Donancio Xaulim
- Departamento de Medicina Veterinária Preventiva, Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - David Soeiro Barbosa
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais Belo Horizonte, Minas Gerais, Brazil
| | - Silvana Tecles Brandão
- Diretoria de Zoonoses, Secretaria Municipal da Saúde, Prefeitura Municipal de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
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Silva SCPFE, Gomes LB, Carvalho PCFB, Santos AGRC, Borges LFNM, Oliveira CSF, Morais MHF, Pereira PLL, Amaral Haddad JP, Soares DFDM. Effectiveness of the mass use of deltamethrin-impregnated dog collars for preventing transmission of canine leishmaniasis by Lutzomyia spp.: A cluster randomized controlled trial. Prev Vet Med 2019; 171:104770. [PMID: 31536935 DOI: 10.1016/j.prevetmed.2019.104770] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 08/21/2019] [Accepted: 09/03/2019] [Indexed: 11/25/2022]
Abstract
Visceral leishmaniasis (VL) is a zoonosis that greatly impacts public health, especially in developing countries. The effectiveness of deltamethrin-impregnated dog collars for preventing transmission of canine leishmaniasis (CanL) by the sand fly Lutzomyia spp. in countries with high incidence of the disease, such as Brazil, remains unknown. A cluster randomized controlled trial was carried out to evaluate the effectiveness of these collars in preventing infection of dogs with Leishmania infantum. Two areas were selected in a municipality endemic for VL in Brazil: an experimental area (EA) and a control area (CA). In both areas, blood samples were collected from dogs for detection of CanL. Seronegative dogs from the EA received collars impregnated with deltamethrin 4%. After six months, the dogs were retested for CanL and the incidence of the disease, the relative risk, and the effectiveness of collaring determined. In the baseline survey, 1020 dogs from the EA and 589 from the CA were examined. The prevalence calculated for EA was 4.41% (CI95% 3.27-5.91), and 7.13% (CI95% 5.25-9.59) for CA. In the second evaluation, 454 dogs from the EA and 292 from the CA were examined. The person-time incidence calculated for EA was 3.51% (CI95% 1.30-7.48), and for CA was 11.81% (CI95% 7.03-18.23). The difference between the calculated incidences was statistically significant (p = 0.009). The relative risk was 0.2972 (CI95% 0.1204-0.7339; p = 0.009), and the efficacy of the proposed measure was estimated in 70.27%. This report evaluated the effectiveness of the mass use of deltamethrin-impregnated dog collars in areas of transmission of VL by Lutzomyia spp. Collaring was able to protect dogs and may represent an effective strategy that could be implemented to control infection in both dogs and humans in Brazil and perhaps other countries where Lutzomyia spp. is the main vector of the disease.
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Affiliation(s)
| | - Laiza Bonela Gomes
- Departamento de Medicina Veterinária Preventiva, Escola de Medicina Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Paloma Carla Fonte Boa Carvalho
- Departamento de Medicina Veterinária Preventiva, Escola de Medicina Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | - Camila Stefanie Fonseca Oliveira
- Departamento de Medicina Veterinária Preventiva, Escola de Medicina Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Pedro Lúcio Lithg Pereira
- Departamento de Medicina Veterinária Preventiva, Escola de Medicina Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - João Paulo Amaral Haddad
- Departamento de Medicina Veterinária Preventiva, Escola de Medicina Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, MG, 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] [What about the content of this article? (0)] [Affiliation(s)] [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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17
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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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] [What about the content of this article? (0)] [Affiliation(s)] [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. This article presents the spatial and temporal distribution of visceral leishmaniasis (VL) in Minas Gerais State and identifies the greater risk areas of transmission. This study is both timely and substantive because Minas Gerais is an important Brazilian state in the number of cases of visceral leishmaniasis. The results showed that during the 12-year time series the VL had a heterogeneous spatial and temporal distribution in the state of Minas Gerais. Among the 12 existing mesoregions, six (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 in the state. Among them, the Vale do Rio Doce and Jequitinhonha mesoregions presented a considerable increase in the incidence rates of the disease in the last period. In the other six mesoregions only sporadic cases of the disease were reported during the study period. The results of in this study may contribute to a better understanding the dynamic of the disease in Minas Gerais. Also these findings can provide subsidies to assist the actions of the control program of VL.
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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
- * E-mail:
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Vianna EN, Morais MHF, Almeida ASD, Sabroza PC, Reis IA, Dias ES, Carneiro M. Abundance of Lutzomyia longipalpis in urban households as risk factor of transmission of visceral leishmaniasis. Mem Inst Oswaldo Cruz 2017; 111:302-10. [PMID: 27223866 PMCID: PMC4878299 DOI: 10.1590/0074-02760150366] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 04/09/2016] [Indexed: 11/21/2022] Open
Abstract
Urban occurrence of human and canine visceral leishmaniasis (VL) is linked to households with characteristics conducive to the presence of sand flies. This study proposes an ad hoc classification of households according to the environmental characteristics of receptivity to phlebotominae and an entomological study to validate the proposal. Here we describe the phlebotominae population found in intra- and peridomiciliary environments and analyse the spatiotemporal distribution of the VL vector Lutzomyia longipalpis of households receptive to VL. In the region, 153 households were classified into levels of receptivity to VL followed by entomological surveys in 40 of those properties. Kruskal-Wallis verified the relationship between the households' classification and sand fly abundance and Kernel analysis evaluated L. longipalpis spatial distribution: of the 740 sand flies were captured, 91% were L. longipalpis; 82% were found peridomiciliary whilst the remaining 18% were found intradomiciliary. No statistically significant association was found between sandflies and households levels. L. longipalpis counts were concentrated in areas of high vulnerability and some specific households were responsible for the persistence of the infestation. L. longipalpis prevails over other sand fly species for urban VL transmission. The entomological study may help target the surveillance and vector control strategies to domiciles initiating and/or maintaining VL outbreaks.
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Affiliation(s)
- Elisa Neves Vianna
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | | | - Andréa Sobral de Almeida
- Departamento de Doenças Endêmicas, Escola de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Paulo Chagastelles Sabroza
- Departamento de Doenças Endêmicas, Escola de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - Ilka Afonso Reis
- Departamento de Estatística, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Edelberto Santos Dias
- Laboratório de Leishmanioses, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG, Brasil
| | - Mariângela Carneiro
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
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Morais MHF, Fiuza VDOP, Araújo VEMD, Menezes FCD, Carneiro M. Avaliação das atividades de controle da leishmaniose visceral em Belo Horizonte, Minas Gerais, 2006-2011. Epidemiol Serv Saúde 2015. [DOI: 10.5123/s1679-49742015000300014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Moura AS, Lopes HMRDO, Mourão MVA, Morais MHF. Performance of a rapid diagnostic test for the detection of visceral leishmaniasis in a large urban setting. Rev Soc Bras Med Trop 2014; 46:589-93. [PMID: 24270249 DOI: 10.1590/0037-8682-0145-2013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 10/02/2013] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Rapid diagnostic tests (RDTs) may improve the early detection of visceral leishmaniasis (VL), but their real-world performance requires additional study. Therefore, we evaluated the performance of an rK39-based RDT (Kalazar Detect™) for the detection of VL in an endemic, large urban area. METHODS Data were collected from a registry of rK39 RDT performed at 11 emergency care units in Belo Horizonte, Brazil, and from a national database of reportable communicable diseases of the Sistema de Informação de Agravos de Notificação (SINAN). RESULTS The rapid rK39 test was performed in 476 patients, with 114 (23.9%) positive results. The analysis of rK39 RDT performance was based on 381 (80%) cases reported to the SINAN database, of which 145 (38.1%) were confirmed cases. Estimates for sensitivity and specificity were 72.4% (95% CI: 64.6-79%) and 99.6% (95%CI: 97.6-99.9%), respectively. Positive and negative predictive values were estimated at 99.1% (95%CI: 94.9-99.8%) and 85.5% (95%CI: 80.8-89.1%), respectively. In addition, close agreement between the rK39 RDT and indirect immunofluorescence was observed. CONCLUSIONS In summary, the rK39 RDT showed a high specificity but only moderate sensitivity. In endemic areas for VL, treatment may be considered in cases with clinical manifestations and a positive rK39 RDT, but those with a negative test should be subjected to further investigation.
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Coura-Vital W, Ker HG, Roatt BM, Aguiar-Soares RDO, Leal GGDA, Moreira NDD, Oliveira LAM, de Menezes Machado EM, Morais MHF, Corrêa-Oliveira R, Carneiro M, Reis AB. Evaluation of change in canine diagnosis protocol adopted by the visceral leishmaniasis control program in Brazil and a new proposal for diagnosis. PLoS One 2014; 9:e91009. [PMID: 24608904 PMCID: PMC3946667 DOI: 10.1371/journal.pone.0091009] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 02/06/2014] [Indexed: 11/19/2022] Open
Abstract
The techniques used for diagnosis of canine visceral leishmaniasis (CVL) in Brazil ELISA and IFAT have been extensively questioned because of the accuracy of these tests. A recent change in the diagnosis protocol excluded IFAT and included the Dual-Path Platform (DPP). We evaluated the prevalence and incidence rates of Leishmania spp. before and after the change in the protocol. In addition, based on our results, we propose a new alternative that is less expensive for the screening and confirmation of CVL. Plasma samples were obtained from a serobank from dogs evaluated in a cross-sectional study (1,226 dogs) and in a cohort study of susceptible animals (n = 447), followed for 26 months. Serology testing was performed using ELISA, IFAT, and DPP. The incidence and prevalence of CVL were determined by using the protocol of the Visceral Leishmaniasis Control and Surveillance Program until 2012 (ELISA and IFAT using filter paper) and the protocol used after 2012 (DPP and ELISA using plasma). The prevalence was 6.2% and the incidence was 2.8 per 1,000 dog-months for the protocol used until 2012. For the new diagnosis protocol for CVL resulted in an incidence of 5.4 per 1,000 dog-months and a prevalence of 8.1%. Our results showed that the prevalence and incidence of infection were far greater than suggested by the previously used protocol and that the magnitude of infection in endemic areas has been underestimated. As tests are performed sequentially and euthanasia of dogs is carried out when the serological results are positive in both tests, the sequence does not affect the number of animals to be eliminated by the Control Program. Then we suggest to municipalities with a large demand of exams to use ELISA for screening and DPP for confirmation, since this allows easier performance and reduced cost.
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Affiliation(s)
- Wendel Coura-Vital
- Laboratório de Pesquisas Clínicas, Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, Brazil
- Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCTDT), Salvador, Bahia, Brazil
| | - Henrique Gama Ker
- Laboratório de Pesquisas Clínicas, Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, Brazil
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, Brazil
| | - Bruno Mendes Roatt
- Laboratório de Pesquisas Clínicas, Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, Brazil
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, Brazil
| | - Rodrigo Dian Oliveira Aguiar-Soares
- Laboratório de Pesquisas Clínicas, Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, Brazil
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, Brazil
| | - Gleisiane Gomes de Almeida Leal
- Laboratório de Pesquisas Clínicas, Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, Brazil
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, Brazil
| | - Nádia das Dores Moreira
- Laboratório de Pesquisas Clínicas, Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, Brazil
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, Brazil
| | - Laser Antônio Machado Oliveira
- Laboratório de Pesquisas Clínicas, Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, Brazil
| | - Evandro Marques de Menezes Machado
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, Brazil
| | | | - Rodrigo Corrêa-Oliveira
- Laboratório de Imunologia Celular e Molecular, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCTDT), Salvador, Bahia, Brazil
| | - Mariângela Carneiro
- Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
- Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Alexandre Barbosa Reis
- Laboratório de Pesquisas Clínicas, Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, Brazil
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Morro do Cruzeiro, Ouro Preto, Minas Gerais, Brazil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais (INCTDT), Salvador, Bahia, Brazil
- * E-mail:
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dos Santos Marques LH, Gomes LI, da Rocha ICM, da Silva TAM, Oliveira E, Morais MHF, Rabello A, Carneiro M. Low parasite load estimated by qPCR in a cohort of children living in urban area endemic for visceral leishmaniasis in Brazil. PLoS Negl Trop Dis 2012; 6:e1955. [PMID: 23272263 PMCID: PMC3521664 DOI: 10.1371/journal.pntd.0001955] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 10/28/2012] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND An important issue associated with the control of visceral leishmaniasis is the need to identify and understand the relevance of asymptomatic infection caused by Leishmania infantum. The aim of this study was to follow the course of asymptomatic L. infantum infection in children in an area of Brazil where it is endemic. The children were assessed twice during a 12-month period. METHODOLOGY In this population study, 1875 children, ranging from 6 months to 7 years of age, were assessed. Blood samples were collected on filter papers via finger prick and tested by ELISA (L. infantum soluble antigen and rk39). Seropositives samples (n = 317) and a number of seronegatives samples (n = 242) were subjected to qPCR. After 12 months, blood samples were collected from a subgroup of 199 children and tested for Leishmania spp. to follow the course of infection. PRINCIPAL FINDINGS At baseline qPCR testing identified 82 positive samples. The prevalence rate, as estimated for 1875 children based on the qPCR results, was 13.9%. The qPCR testing of whole blood samples collected from a cohort of children after 12 months (n = 199) yielded the following results: of the 44 (22.1%) children with positive qPCR results at baseline, only 10 (5.0%) remained positive, and 34 (17.1%) became negative; and of the 155 (77.9%) children with negative qPCR results, 131 (65.8%) remained negative, and 24 (12.1%) became positive at the follow-up measurement. The samples with positive findings at baseline (n = 82) had a mean of 56.5 parasites/mL of blood; and at follow-up the mean positive result was 7.8 parasites/mL. CONCLUSIONS The peripheral blood of asymptomatic children had a low and fluctuating quantity of Leishmania DNA and a significant decrease in parasitemia at 1-year follow-up. Quantitative PCR enables adequate monitoring of Leishmania infection.
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Affiliation(s)
- Letícia Helena dos Santos Marques
- Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Luciana Inácia Gomes
- Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
| | - Iara Caixeta Marques da Rocha
- Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Secretaria Municipal de Saúde, Prefeitura de Belo Horizonte, Belo Horizonte, Brazil
| | - Thaís Almeida Marques da Silva
- Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Edward Oliveira
- Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
| | - Maria Helena Franco Morais
- Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Secretaria Municipal de Saúde, Prefeitura de Belo Horizonte, Belo Horizonte, Brazil
| | - Ana Rabello
- Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
| | - Mariângela Carneiro
- Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Pós-graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- * E-mail:
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de Araújo VEM, Morais MHF, Reis IA, Rabello A, Carneiro M. Early clinical manifestations associated with death from visceral leishmaniasis. PLoS Negl Trop Dis 2012; 6:e1511. [PMID: 22347514 PMCID: PMC3274500 DOI: 10.1371/journal.pntd.0001511] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Accepted: 12/21/2011] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In Brazil, lethality from visceral leishmaniasis (VL) is high and few studies have addressed prognostic factors. This historical cohort study was designed to investigate the prognostic factors for death from VL in Belo Horizonte (Brazil). METHODOLOGY The analysis was based on data of the Reportable Disease Information System-SINAN (Brazilian Ministry of Health) relating to the clinical manifestations of the disease. During the study period (2002-2009), the SINAN changed platform from a Windows to a Net-version that differed with respect to some of the parameters collected. Multivariate logistic regression models were performed to identify variables associated with death from VL, and these were included in prognostic score. PRINCIPAL FINDINGS Model 1 (period 2002-2009; 111 deaths from VL and 777 cured patients) included the variables present in both SINAN versions, whereas Model 2 (period 2007-2009; 49 deaths from VL and 327 cured patients) included variables common to both SINAN versions plus the additional variables included in the Net version. In Model 1, the variables significantly associated with a greater risk of death from VL were weakness (OR 2.9; 95%CI 1.3-6.4), Leishmania-HIV co-infection (OR 2.4; 95%CI 1.2-4.8) and age ≥60 years (OR 2.5; 95%CI 1.5-4.3). In Model 2, the variables were bleeding (OR 3.5; 95%CI 1.2-10.3), other associated infections (OR 3.2; 95%CI 1.3-7.8), jaundice (OR 10.1; 95%CI 3.7-27.2) and age ≥60 years (OR 3.1; 95%CI 1.4-7.1). The prognosis score was developed using the variables associated with death from VL of the latest version of the SINAN (Model 2). The predictive performance of which was evaluated by sensitivity (71.4%), specificity (73.7%), positive and negative predictive values (28.9% and 94.5%) and area under the receiver operating characteristic curve (75.6%). CONCLUSIONS Knowledge regarding the factors associated with death from VL may improve clinical management of patients and contribute to lower mortality.
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Affiliation(s)
- Valdelaine Etelvina Miranda de Araújo
- Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias, Pós-graduação em Parasitologia, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Secretaria Municipal de Saúde, Prefeitura de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Helena Franco Morais
- Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias, Pós-graduação em Parasitologia, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Secretaria Municipal de Saúde, Prefeitura de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
| | - Ilka Afonso Reis
- Departamento de Estatística, Instituto de Ciências Exatas, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Rabello
- Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Mariângela Carneiro
- Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias, Pós-graduação em Parasitologia, 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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Coura-Vital W, Marques MJ, Veloso VM, Roatt BM, Aguiar-Soares RDDO, Reis LES, Braga SL, Morais MHF, Reis AB, Carneiro M. Prevalence and factors associated with Leishmania infantum infection of dogs from an urban area of Brazil as identified by molecular methods. PLoS Negl Trop Dis 2011; 5:e1291. [PMID: 21858243 PMCID: PMC3156685 DOI: 10.1371/journal.pntd.0001291] [Citation(s) in RCA: 108] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Accepted: 07/13/2011] [Indexed: 11/19/2022] Open
Abstract
Background Various factors contribute to the urbanization of the visceral leishmaniasis (VL), including the difficulties of implementing control measures relating to the domestic reservoir. The aim of this study was to determine the prevalence of canine visceral leishmaniasis in an urban endemic area in Brazil and the factors associated with Leishmania infantum infection among seronegative and PCR-positive dogs. Methodology A cross-sectional study was conducted in Belo Horizonte, Minas Gerais, Brazil. Blood samples were collected from 1,443 dogs. Serology was carried out by using two enzyme-linked immunosorbent assays (Biomanguinhos/FIOCRUZ/RJ and “in house”), and molecular methods were developed, including PCR-RFLP. To identify the factors associated with early stages of infection, only seronegative (n = 1,213) animals were evaluated. These animals were divided into two groups: PCR-positive (n = 296) and PCR-negative (n = 917) for L. infantum DNA. A comparison of these two groups of dogs taking into consideration the characteristics of the animals and their owners was performed. A mixed logistic regression model was used to identify factors associated with L. infantum infection. Principal Findings Of the 1,443 dogs examined, 230 (15.9%) were seropositive in at least one ELISA, whereas PCR-RFLP revealed that 356 animals (24.7%) were positive for L. infantum DNA. Results indicated that the associated factors with infection were family income<twice the Brazilian minimum salary (OR 2.3; 95%CI 1.4–3.8), knowledge of the owner regarding the vector (OR 1.9; 95%CI 1.1–3.4), the dog staying predominantly in the backyard (OR 2.2; 95%CI 1.1–4.1), and a lack of previous serological examination for VL (OR 1.5; 95%CI 1.1–2.3). Conclusions PCR detected a high prevalence of L. infantum infection in dogs in an area under the Control Program of VL intervention. Socioeconomic variables, dog behavior and the knowledge of the owner regarding the vector were factors associated with canine visceral leishmaniasis (CVL). The absence of previous serological examination conducted by the control program was also associated with L. infantum infection. It is necessary to identify the risk factors associated with CVL to understand the expansion and urbanization of VL. Visceral leishmaniasis (VL) is a disease caused by the parasite Leishmania infantum, and dogs are the most important domestic reservoirs of the agent. During recent decades, VL has expanded to large Brazilian urban centers. In the present work, we have demonstrated by using molecular techniques that the rate of canine infection as detected by serology has been considerably underestimated. Two groups of seronegative dogs (infected and non-infected according to molecular methods) were further evaluated from data obtained through interviews with owners of the animals. The factors associated with Leishmania infection in dogs were a family income of less than two minimum salaries, the knowledge of the owner regarding the vector, the dog spending most of its time in the backyard and the dog never having had a previous serological examination. Awareness regarding the factors associated with canine infection will improve health services and the understanding of the disease's expansion in urban areas.
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Affiliation(s)
- Wendel Coura-Vital
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Núcleo de Pesquisas em Ciências Biológicas, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Marcos José Marques
- Departamento de Ciências Biológicas, Universidade Federal de Alfenas, Alfenas, Minas Gerais, Brazil
| | - Vanja Maria Veloso
- Departamento de Farmácia, Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Bruno Mendes Roatt
- Núcleo de Pesquisas em Ciências Biológicas, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Rodrigo Dian de Oliveira Aguiar-Soares
- Núcleo de Pesquisas em Ciências Biológicas, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Levi Eduardo Soares Reis
- Núcleo de Pesquisas em Ciências Biológicas, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Samuel Leôncio Braga
- Núcleo de Pesquisas em Ciências Biológicas, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Maria Helena Franco Morais
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Gerência Regional de Controle de Zoonoses, Secretaria Municipal de Saúde, Prefeitura de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil
| | - Alexandre Barbosa Reis
- Núcleo de Pesquisas em Ciências Biológicas, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Mariângela Carneiro
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Pós-Graduação em Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- * E-mail:
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Oliveira CDL, Morais MHF, Machado-Coelho GLL. Visceral leishmaniasis in large Brazilian cities: challenges for control. CAD SAUDE PUBLICA 2008; 24:2953-8. [DOI: 10.1590/s0102-311x2008001200026] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2008] [Accepted: 03/10/2008] [Indexed: 11/22/2022] Open
Abstract
The objectives of this article were to discuss the rapid spread of visceral leishmaniasis in urban areas of Brazil and to raise practical questions and perspectives related to control of the disease. Among the proposed methods, the elimination of seropositive dogs is the most controversial and least accepted by society. Its impact on incidence rates varies among studies (positive in some and relatively unimportant in others). Treatment of infected dogs, although widespread in veterinary practice, is based on studies with weak scientific evidence. Insecticide spraying of areas is more acceptable to the population, but is costly and operationally difficult. Intra and inter-urban factors have scarcely been studied and may affect control of the disease. Finally, the article discusses the use of deltamethrin-impregnated dog collars and vaccines, with high expectations for impact on disease transmission, although no product currently available on the market has been fully evaluated, so that further studies are required.
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