Interaction among environmental and socioeconomic determinants of risk for cutaneous leishmaniasis in Latin America/Interacción entre los determinantes medioambientales y socioeconomicos para el riesgo para leishmaniasis cutánea en América Latina/Interacao entre os determinantes ambientais e socioeconomicos para o risco de leishmaniose cutanea na America Latina

Objective. Determine and characterize areas at potential risk for the occurrence of cutaneous leishmaniasis (CL) in Latin America. Method. Ecological observational study with observation units defined by municipalities with CL transmission during 2014-2018. Environmental and socioeconomic variables...

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Published in:Revista panamericana de salud pública 2021-01, Vol.45
Main Authors: Maia-Elkhoury, Ana Nilce S, Lima, Daniel Magalhaes, Salomon, Oscar Daniel, Buzanovsky, Lia Puppim, Saboya-Diaz, Martha Idalic, Valadas, Samantha Y.O.B, Sanchez-Vazquez, Manuel J
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Language:Spanish
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Summary:Objective. Determine and characterize areas at potential risk for the occurrence of cutaneous leishmaniasis (CL) in Latin America. Method. Ecological observational study with observation units defined by municipalities with CL transmission during 2014-2018. Environmental and socioeconomic variables available for at least 85% of municipalities were combined in a single database, using R software. Principal component analysis was combined with hierarchical cluster analysis for the formation of clusters of municipalities according to their similarity. The V-test was used to define positive or negative association of variables with clusters and separation by natural divisions to determine which contributed more to each cluster. Cases were included to attribute CL risk for each cluster. Results. The study included 4 951 municipalities with CL transmission (36.5% of municipalities in Latin America); seven clusters were defined by their association with 18 environmental and socioeconomic variables. Historical risk of CL is associated positively and in descending order with the Amazonian, Andean, and Savanna clusters; and negatively with the Forest/perennial, Forest/cultivated, and Forest/populated clusters. The Agricultural cluster showed no association with CL cases. Conclusions. The study made it possible to identify and characterize CL risk by clusters of municipalities and to understand the characteristic epidemiological distribution patterns of transmission, providing program managers with better information for intersectoral interventions to control CL. Keywords Leshmaniasis, cutaneous; cluster analysis; Latin America. Objetivo. Determinar y caracterizar areas de riesgo potencial de la ocurrencia de leishmaniasis cutanea (LC) en America Latina (AL). Metodo. Estudio observacional ecologico con unidades de observacion definidas por municipios con transmision de LC entre 2014-2018. Se utilizaron variables medioambientales y socioeconomicas disponibles para al menos 85% de los municipios, combinados en una sola base de datos, a traves del software R. Se combino la metodologia de analisis de componentes principales con un analisis de conglomerados jerarquicos para la formacion de conglomerados de municipios en funcion de su similitud. Se estimo el V-test para definir la asociacion positiva o negativa de las variables con los conglomerados y separacion por divisiones naturales para determinar cuales contribuyeron mas a cada conglomerado. Se incorporaron los casos
ISSN:1020-4989
1680-5348
DOI:10.26633/RPSP.2021.49