Spatio-temporal relative risks and priority areas for visceral leishmaniasis control in Brazil, between 2001 and 2020

•There is a spatial concentration of cases of visceral leishmaniasis (VL) in brazil.•The disease, however, expanded territorially in brazil in the 21st century.•The number of priority municipalities for control actions showed an upward trend.•Spatio-temporal clusters of high-risk were higher in the...

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Published in:Acta tropica 2023-06, Vol.242, p.106912-106912, Article 106912
Main Authors: de Melo, Saulo Nascimento, Barbosa, David Soeiro, Bruhn, Fábio Raphael Pascoti, Câmara, Daniel Cardoso Portela, Simões, Taynãna César, Buzanovsky, Lia Puppim, Duarte, Anna Gabryela Sousa, Maia-Elkhoury, Ana Nilce Silveira, Cardoso, Diogo Tavares, Donato, Lucas Edel, Werneck, Guilherme Loureiro, Belo, Vinícius Silva
Format: Article
Language:English
Subjects:
Brazil - epidemiology
Brazilian municipalities
Humans
Incidence
Leishmaniasis, Visceral - epidemiology
Leishmaniasis, Visceral - prevention & control
Risk
Risk areas
Spatial Analysis
Spatio-temporal
Spatio-Temporal Analysis
Visceral leishmaniasis
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Summary:•There is a spatial concentration of cases of visceral leishmaniasis (VL) in brazil.•The disease, however, expanded territorially in brazil in the 21st century.•The number of priority municipalities for control actions showed an upward trend.•Spatio-temporal clusters of high-risk were higher in the north and northeast regions.•The identified risk areas should be prioritized for VL control actions. Visceral leishmaniasis (VL) is a pressing public health problem in Brazil. The proper implementation of disease control programs in priority areas is a challenge for healthcare managers. The present study aimed to analyze the spatio-temporal distribution and identify high risk areas of VL occurrence in the Brazilian territory. We analyzed data regarding new cases with confirmed diagnosis of VL in Brazilian municipalities, from 2001 to 2020, extracted from the Brazilian Information System for Notifiable Diseases. The Local Index of Spatial Autocorrelation (LISA) was used to identify contiguous areas with high incidence rates in different periods of the temporal series. Clusters of high spatio-temporal relative risks were identified using the scan statistics. The accumulated incidence rate in the analyzed period was 33.53 cases per 100,000 inhabitants. The number of municipalities that reported cases showed an upward trend from 2001 onward, although there was a decrease in 2019 and 2020. According to LISA, the number of municipalities considered a priority increased in Brazil and in most states. Priority municipalities were predominantly concentrated in the states of Tocantins, Maranhão, Piauí, and Mato Grosso do Sul, in addition to more specific areas of Pará, Ceará, Piauí, Alagoas, Pernambuco, Bahia, São Paulo, Minas Gerais, and Roraima. The spatio-temporal clusters of high-risk areas varied throughout the time series and were relatively higher in the North and Northeast regions. Recent high-risk areas were found in Roraima and municipalities in northeastern states. VL expanded territorially in Brazil in the 21st century. However, there is still a considerable spatial concentration of cases. The areas identified in the present study should be prioritized for disease control actions. [Display omitted]
ISSN:0001-706X
1873-6254
DOI:10.1016/j.actatropica.2023.106912