Temponi Andrea Oliveira Dias, Brito Mariana Gontijo de, Ferraz Marcela Lencine, Diniz Soraia de Araújo, Silva Marcos Xavier, Cunha Tarcísio Neves da
Secretaria de Estado de Saúde de Minas Gerais, Belo Horizonte, Brasil.
Escola de Veterinária, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
Cad Saude Publica. 2018 Feb 19;34(2):e00165716. doi: 10.1590/0102-311X00165716.
The aim of this study was to explain the association between social-environmental factors and major land uses and the occurrence of cases of American tegumentary leishmaniasis (ATL) in the spatial circuits of production in Minas Gerais State, Brazil. This was an analytical-type ecological study based on secondary data on ATL divided by three-year period from 2007 to 2011, in which the analytical units were municipalities belonging to the spatial circuits. Two distinct stages were performed. The first was the elaboration of thematic maps with identification of the circuits. In the second, a new indicator, ATL cases by population density, was associated with social-environmental indicators and major land uses, submitted to multivariate principal components analysis (PCA). During the periods studied, three circuits were identified, distributed in the major regions of Northern Minas Gerais, Rio Doce Valley, and Greater Metropolitan Belo Horizonte. There was a strong association between ATL by population density and temporary crops, natural pasture, natural forest, unusable lands, and rural population, and a weak association with planted pasture. The association of cases with the major land uses variable in different agricultural profiles shows the occupational nature of ATL, associated mainly with rural workers. The association of the disease with environmental variables and deficient basic sanitation also proved relevant in the transmission profile in spatial circuits of production in Minas Gerais.
本研究旨在解释巴西米纳斯吉拉斯州生产空间回路中社会环境因素、主要土地利用与美洲皮肤利什曼病(ATL)病例发生之间的关联。这是一项基于2007年至2011年按三年期划分的ATL二手数据的分析型生态研究,其中分析单位是属于这些空间回路的市镇。研究分两个不同阶段进行。第一阶段是绘制主题地图并识别这些回路。第二阶段,一个新指标——按人口密度计算的ATL病例数,与社会环境指标和主要土地利用相关联,并进行多元主成分分析(PCA)。在研究期间,识别出了三个回路,分布在米纳斯吉拉斯州北部的主要地区、多西河河谷和大贝洛奥里藏特都会区。按人口密度计算的ATL病例数与临时作物、天然牧场、天然森林、无法使用的土地和农村人口之间存在很强的关联,与人工种植牧场的关联较弱。不同农业概况下病例数与主要土地利用变量之间的关联表明了ATL的职业性质,主要与农村工人有关。在米纳斯吉拉斯州生产空间回路的传播概况中,该疾病与环境变量和基本卫生设施不足之间的关联也被证明是相关的。