Dados do Trabalho

Título

AMERICAN TEGUMENTARY LEISHMANIASIS CORRELATED WITH ENVIRONMENTAL DEGRADATION AND SOCIAL VULNERABILITY IN BAHIA STATE, BRAZIL

Introdução

American Tegumentary Leishmaniasis (ATL) is a neglected tropical disease caused by protozoa of the genus Leishmania, affecting the skin and mucous membranes. With a wide distribution in the Americas, it exhibits distribution patterns closely associated with the environment in which the exposed population resides.

Objetivo (s)

To analyze the evolution of ATL cases in Bahia from 2001 to 2022, associating it with socio-environmental indexes.

Material e Métodos

Confirmed ATL cases by year of diagnosis and estimated population were obtained from the Brazilian Health Information System for each of the 417 Bahia municipalities. This was used for calculating incidences (ATL-INC), discrete Poisson model spatial scanning analysis (DPMSSA), and application of uni and bivariate Local Index of Spatial Autocorrelation (LISA and BiLISA). Two composite indices were used to evaluate the correlation with ATL-INC: Social Vulnerability Index (IVS) and Environmental Degradation Index (IDA). IVS for the years 2000 and 2010 were obtained from the Institute for Applied Economic Research (IPEA). IDA for the years 2006 and 2017 was calculated using variables from the IBGE Agricultural Census.

Resultados e Conclusão

The majority of municipalities in Bahia (86%) had cases of ATL. The largest LTA-INC were observed in Presidente Tancredo Neves (42,155.87/100000 inhabitants) and Taperoá (16,614.95/100000 inhabitants). Retrospective DPMSSA revealed significant clusters between 2012-2022. Temporal DPMSSA identified one cluster with 14.7/100000 annual cases with a relative risk of 136.18 between 2012 to 2022). Spatio-temporal DPMSSA identified three clusters of high incidences presenting a higher than expected risk for regions such as Valença, Santo Antônio de Jesus, Senhor do Bonfim and Jacobina (2012-2022), and Ribeira do Pombal (2014-2015). LISA showed a positive spatial correlation for both study periods (pseudo P-Value < 0.05). BiLISA between IVS and ATL-INC showed 11 clusters of positive spatial correlation between 2001-2011 and significant spatial correlations between IDA and ATL-INC, were verified in 11 high-high clusters in 2001-2011 and 14 high-high clusters in 2012-2022 (pseudo P-Value < 0.05). Results indicate a relationship between low socioeconomic indices and agricultural activities on high incidence of ATL, as well as persistence of disease in affected regions.   

Palavras Chave

Leishmania; Socioeconomic and environmental Indexes; Spatial Analysis.