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

IF 1.9 4区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Transactions of The Royal Society of Tropical Medicine and Hygiene Pub Date : 2024-07-05 DOI:10.1093/trstmh/trae009

Alex de O Vasconcelos, Sandro J Bedoya-Pacheco, Rafael R Cunha E Silva, Mônica de A F M Magalhães, Tayana P S O de Sá, Cristina M G Dias, Patrícia S Meneguete, Paula M P de Almeida, Maria Inês F Pimentel

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Abstract

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.

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2001-2020 年巴西里约热内卢内脏利什曼病的时空分布：扩展与挑战。

背景：人、狗和环境之间复杂的相互作用导致了内脏利什曼病。巴西的病例占美洲病例的 97%：方法：对里约热内卢州 20 年（2001-2020 年）的地方病进行了研究。调查了发病率、致死率、社会人口和临床特征，并辅以空间方法（内核和群组）：结果：共报告了 97 例人类病例和 625 条狗。在 92 个城市中，22 个是人类流行区。该州的发病率较低（0.6/100 000）。死亡率高于巴西的平均水平。90%以上的感染病例发生在城市地区。大多数病例（66%）发生在男性身上。主要年龄组为 0-4 岁（28.7%）和 20-39 岁（32.9%）。发热（89.5%）、脾脏肿大（83.2%）和肝脏肿大（76.8%）是主要的临床表现。空间分析显示了人类流行病的转移：在第一个十年（2001-2010 年），病例集中在大都会地区，而在第二个十年（2011-2020 年），病例集中在该州的梅迪奥帕拉伊巴地区。大部分流行区（56.4%）都有犬类感染病例，但没有人类病例报告：结论：无序的城市化和不稳定的生活条件有利于疾病的传播。环境的变化和迁徙过程助长了该疾病的蔓延。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transactions of The Royal Society of Tropical Medicine and Hygiene 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.00

自引率

9.10%

发文量

115

审稿时长

4-8 weeks

期刊介绍： Transactions of the Royal Society of Tropical Medicine and Hygiene publishes authoritative and impactful original, peer-reviewed articles and reviews on all aspects of tropical medicine.