Acute Chagas disease in Brazil from 2001 to 2018: A nationwide spatiotemporal analysis.

Autor: Santos EF; Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil., Silva ÂAO; Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil., Leony LM; Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil., Freitas NEM; Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil., Daltro RT; Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil., Regis-Silva CG; Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil., Del-Rei RP; Faculty of Technology and Sciences of Bahia, Salvador, Bahia, Brazil., Souza WV; Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Pernambuco, Brazil., Ostermayer AL; Chagas Disease Study Center, Federal University of Goiás, Goiânia, Goiás, Brazil., Costa VM; General Coordination of Zoonosis and Vector Diseases, Secretariat of Health Surveillance (SVS), Brazilian Ministry of Health, Brasília, Federal District, Brazil., Silva RA; General Coordination of Zoonosis and Vector Diseases, Secretariat of Health Surveillance (SVS), Brazilian Ministry of Health, Brasília, Federal District, Brazil., Ramos AN Jr; Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil., Sousa AS; Federal University of Rio de Janeiro, School of Medicine, Department of Internal Medicine, Rio de Janeiro, Rio de Janeiro, Brazil.; Laboratory of Clinical Research on Chagas Disease, Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.; Chagas Disease Translational Research Program (Fio-Chagas), Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil., Gomes YM; Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Pernambuco, Brazil.; Chagas Disease Translational Research Program (Fio-Chagas), Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil., Santos FLN; Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.; Chagas Disease Translational Research Program (Fio-Chagas), Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil.
Jazyk: angličtina
Zdroj: PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2020 Aug 03; Vol. 14 (8), pp. e0008445. Date of Electronic Publication: 2020 Aug 03 (Print Publication: 2020).
DOI: 10.1371/journal.pntd.0008445
Abstrakt: Background: In Brazil, acute Chagas disease (ACD) surveillance involves mandatory notification, which allows for population-based epidemiological studies. We conducted a nationwide population-based ecological analysis of the spatiotemporal patterns of ACD notifications in Brazil using secondary surveillance data obtained from the Notifiable Diseases Information System (SINAN) maintained by Brazilian Ministry of Health.
Methodology/principal Findings: In this nationwide population-based ecological all cases of ACD reported in Brazil between 2001 and 2018 were included. Epidemiological characteristics and time trends were analyzed through joinpoint regression models and spatial distribution using microregions as the unit of analysis. A total of 5,184 cases of ACD were recorded during the period under study. The annual incidence rate in Brazil was 0.16 per 100,000 inhabitants/year. Three statistically significant changes in time trends were identified: a rapid increase prior to 2005 (Period 1), a stable drop from 2005 to 2009 (Period 2), followed by another increasing trend after 2009 (Period 3). Higher frequencies were noted in males and females in the North (all three periods) and in females in Northeast (Periods 1 and 2) macroregions, as well as in individuals aged between 20-64 years in the Northeast, and children, adolescents and the elderly in the North macroregion. Vectorial transmission was the main route reported during Period 1, while oral transmission was found to increase significantly in the North during the other periods. Spatiotemporal distribution was heterogeneous in Brazil over time. Despite regional differences, over time cases of ACD decreased significantly nationwide. An increasing trend was noted in the North (especially after 2007), and significant decreases occurred after 2008 among all microregions other than those in the North, especially those in the Northeast and Central-West macroregions.
Conclusions/significance: In light of the newly identified epidemiological profile of CD transmission in Brazil, we emphasize the need for strategically integrated entomological and health surveillance actions.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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