Programa de Residência Multiprofissional em Saúde Coletiva, Secretaria de Saúde do Recife, Recife, PE, Brasil.
Departamento de Saúde Coletiva, Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
Rev Soc Bras Med Trop. 2020;53:e20190373. doi: 10.1590/0037-8682-0373-2019. Epub 2020 Apr 27.
American cutaneous leishmaniasis (ACL) is a public health problem and has been associated with country's territory. We aimed to analyze the spatial dynamics and socioeconomic factors correlated to the incidence of ACL in Pernambuco, Brazil from 2008 to 2017.
A cross-sectional, ecological study was conducted in the Brazilian municipalities. Patient data were obtained from the Health Hazard Notification System (SINAN); indicators and incidence for the total period and for quinquennium were obtained. Socioeconomic factors were analyzed to evaluate the association between the incidence of ACL and presence of bathroom and running water, garbage collection availability, inadequate water supply, sanitation, rural population, per capita income, and vulnerability to poverty. Spatial analysis considered the gross incidence; the Bayesian local empirical method and Moran spatial autocorrelation index were applied using Terra View and QGIS.
The incidence of ACL reduced (0.29/100,000 inhabitants per year). Individuals with ACL were young adults (30.3%), men (60.2%), brown skinned (62.9%), rural residents (70.6%), and less educated (46.7%); had autochthonous transmission (78.8%); developed the cutaneous form (97.2%); had evolution to cure (82.7%); and were diagnosed using the clinical epidemiological criterion (70.5%). ACL occurred in the large part of the state and showed heterogeneous distribution, with persistence of two high priority intervention clusters covering Health Regions I, II, III, IV, and XII.
Spatial analysis and epidemiological indicators complement each other. The combination of these methods can improve the understanding on ACL occurrence, which will help subsidize planning and enhance the quality and effectiveness of healthcare interventions.
美国皮肤利什曼病（ACL）是一个公共卫生问题，与国家领土有关。我们旨在分析巴西伯南布哥州 2008 年至 2017 年 ACL 发病率的空间动态和社会经济因素。
本研究采用了一种横断面、生态学研究方法，在巴西各城市进行了研究。从卫生危害通报系统（SINAN）获取患者数据；获得了总期间和五年期间的指标和发病率。分析了社会经济因素，以评估 ACL 发病率与浴室和自来水、垃圾收集、供水不足、卫生设施、农村人口、人均收入和贫困脆弱性之间的关系。空间分析考虑了总发病率；使用 Terra View 和 QGIS 应用了贝叶斯局部经验方法和 Moran 空间自相关指数。
ACL 的发病率有所下降（0.29/100,000 居民/年）。ACL 患者为年轻成年人（30.3%）、男性（60.2%）、棕色皮肤（62.9%）、农村居民（70.6%）和受教育程度较低（46.7%）；具有本土传播（78.8%）；皮肤形式（97.2%）；治愈（82.7%）；并使用临床流行病学标准进行诊断（70.5%）。ACL 发生在该州的大部分地区，分布不均匀，存在两个高优先干预集群，覆盖了卫生区 I、II、III、IV 和 XII。
空间分析和流行病学指标相互补充。这些方法的结合可以提高对 ACL 发生的认识，从而有助于规划并提高医疗保健干预措施的质量和效果。
