Spatial-temporal distribution of visceral leishmaniasis in Rio de Janeiro, Brazil, 2001-2020: expansion and challenges.

Autor:	Vasconcelos AO; Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil., Bedoya-Pacheco SJ; Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro, CEP: 21041-210, RJ, Brazil., Cunha E Silva RR; Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil., Magalhães MAFM; Instituto de Comunicação e Informação Científica e Técnológica em Saúde, Fundação Oswaldo Cruz, Av. Brasil 4365, Pavilhão Haity Moussatché, Manguinhos, Rio de Janeiro, CEP 21040-900, RJ, Brazil., de Sá TPSO; Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil., Dias CMG; Secretaria de Estado de Saúde do Rio de Janeiro, Rua México 128 sala 420, Rio de Janeiro, CEP: 20031-142, RJ, Brazil., Meneguete PS; Secretaria de Estado de Saúde do Rio de Janeiro, Rua México 128 sala 420, Rio de Janeiro, CEP: 20031-142, RJ, Brazil., de Almeida PMP; Secretaria de Estado de Saúde do Rio de Janeiro, Rua México 128 sala 420, Rio de Janeiro, CEP: 20031-142, RJ, Brazil., Pimentel MIF; Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, CEP: 21040-900, RJ, Brazil.; Instituto de Comunicação e Informação Científica e Técnológica em Saúde, Fundação Oswaldo Cruz, Av. Brasil 4365, Pavilhão Haity Moussatché, Manguinhos, Rio de Janeiro, CEP 21040-900, RJ, Brazil.
Jazyk:	angličtina
Zdroj:	Transactions of the Royal Society of Tropical Medicine and Hygiene [Trans R Soc Trop Med Hyg] 2024 Jul 05; Vol. 118 (7), pp. 448-457.
DOI:	10.1093/trstmh/trae009
Abstrakt:	Background: Visceral leishmaniasis results from complex interactions among humans, dogs and environment. Brazil accounts for 97% of cases in the Americas. Methods: Twenty years (2001-2020) of the endemic disease in the state of Rio de Janeiro were studied. Incidence, lethality, sociodemographic and clinical characteristics were investigated, complemented with spatial methodologies (kernel and clusters). Results: Ninety-seven human cases and 625 dogs were reported. Of the 92 cities, 22 were human endemic areas. The state had a low incidence level (0.6 per 100 000). Lethality was higher compared with the Brazilian average. More than 90% of infections occurred in urban areas. Most cases (66%) occurred in men. The predominant age groups were 0-4 y (28.7%) and 20-39 y (32.9%). Fever (89.5%), splenomegaly (83.2%) and hepatomegaly (76.8%) were the main clinical manifestations. Spatial analysis showed a displacement of the human endemic: in the first decade (2001-2010), cases were concentrated in the Metropolitan region, and in the second decade (2011-2020) in the Médio Paraíba region of the state. Most of the endemic area (56.4%) had canine infections without reported human cases. Conclusions: Disorderly urbanisation and precarious living conditions favour the transmission of the disease. Changes in the environment and migratory processes contribute to its expansion. (© The Author(s) 2024. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)
Databáze:	MEDLINE
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