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3100-12-31
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SPATIO-TEMPORAL DYNAMICS OF VISCERAL LEISHMANIASIS IN BRAZIL: A NONLINEAR REGRESSION ANALYSIS
Author
Bruhn, Fábio Raphael Pascoti
Werneck, Guilherme Loureiro
Barbosa, David Soeiro
Câmara, Daniel Cardoso Portela
Simões, Taynãna César
Buzanovsky, Lia Puppim
Duarte, Anna Gabryela Sousa
Melo, Saulo Nascimento de
Cardoso, Diogo Tavares
Donato, Lucas Edel
Maia-Elkhoury, Ana Nilce Silveira
Belo, Vinícius Silva
Werneck, Guilherme Loureiro
Barbosa, David Soeiro
Câmara, Daniel Cardoso Portela
Simões, Taynãna César
Buzanovsky, Lia Puppim
Duarte, Anna Gabryela Sousa
Melo, Saulo Nascimento de
Cardoso, Diogo Tavares
Donato, Lucas Edel
Maia-Elkhoury, Ana Nilce Silveira
Belo, Vinícius Silva
Affilliation
Universidade Federal de Pelotas. Departamento de Veterinária Preventiva. Laboratório de Epidemiologia Veterinária. Capão do Leão, RS, Brazil.
Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brazil.
Universidade Federal de Minas Gerais. Instituto de Ciências Biológicas. Departamento de Parasitologia. Belo Horizonte, MG, Brazil.
Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Rene Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brazil.
Organização Pan-Americana da Saúde. Rio de Janeiro, RJ, Brazil.
Universidade Federal de São João del-Rei. Divinópolis, MG, Brazil.
Universidade Federal de São João del-Rei. Divinópolis, MG, Brazil.
Universidade Federal de Minas Gerais. Instituto de Ciências Biológicas. Departamento de Parasitologia. Belo Horizonte, MG, Brazil.
Ministério da Saúde. Brasília, DF, Brazil.
Organização Pan-Americana da Saúde. Rio de Janeiro, RJ, Brazil.
Universidade Federal de São João del-Rei. Divinópolis, MG, Brazil.
Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brazil.
Universidade Federal de Minas Gerais. Instituto de Ciências Biológicas. Departamento de Parasitologia. Belo Horizonte, MG, Brazil.
Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Rene Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brazil.
Organização Pan-Americana da Saúde. Rio de Janeiro, RJ, Brazil.
Universidade Federal de São João del-Rei. Divinópolis, MG, Brazil.
Universidade Federal de São João del-Rei. Divinópolis, MG, Brazil.
Universidade Federal de Minas Gerais. Instituto de Ciências Biológicas. Departamento de Parasitologia. Belo Horizonte, MG, Brazil.
Ministério da Saúde. Brasília, DF, Brazil.
Organização Pan-Americana da Saúde. Rio de Janeiro, RJ, Brazil.
Universidade Federal de São João del-Rei. Divinópolis, MG, Brazil.
Abstract
Aims: This study describes the spatio-temporal dynamics of new visceral leishmaniasis (VL) cases notified in Brazil between 2001 and 2020.
Methods and results: Data on the occurrence of the disease were obtained by means of the Notifiable Diseases Information System of the Brazilian Ministry of Health. Joinpoint, temporal generalized additive models and conditional autoregressive (CAR) models were used to analyse the temporal evolution of the rates in Brazil, states and regions. Spatio-temporal generalized additive and CAR models were used to identify the distribution of annual risks of VL occurrence in the Brazilian territory in relation to variation in the spatial average. There were 63,966 VL cases in the target period (3.198 cases/year), corresponding to a mean incidence rate of 1.68 cases/100,000 inhabitants. Of these, 4451 resulted in deaths, which gives a mean mortality rate of 0.12 deaths/100,000 inhabitants and a case fatality of 6.96%. The highest incidence rate was found in the North region, followed closely by the Northeast region, which presented the second and first highest mortality rates, respectively. For all of Brazil, and in the Northeast region, there were stability in the incidence rates, while the other regions showed an increasing trend in different time segments in the period: Central-West up to 2011, North up to 2008, Southeast up to 2004, and South up to 2010. On the other hand, all regions experienced a reduction in incidence rate during the last years of the series. The Northeast region had the highest number of municipalities with statistically significant elevated relative risks. The spatio-temporal analysis showed the highest risk area predominantly in the Northeast region in the beginning of the time series. From 2002 to 2018, this area expanded to the interior of the country.
Conclusions: The present study has shown that VL has expanded in Brazil. However, the North and Northeast regions continue to have the highest incidence, and the risk of infection has decreased in recent years.
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