Cerveira Rodrigo Arcoverde, Ferreira Luan Oliveira, Oliveira Edwiges de Fátima de, Felipe Hanna Katharine Dos Santos, Almeida Marcelli Carolini Alves, Lima Sandra Souza, Ribeiro Karla Tereza Silva
Biomedical School, Universidade Federal do Pará, Belém, PA, Brazil.
Medical School, Universidade Federal do Pará, Belém, PA, Brazil.
Rev Bras Epidemiol. 2020;23:e200041. doi: 10.1590/1980-549720200041. Epub 2020 Jun 1.
Brazil has registered more than 62,000 confirmed cases of leptospirosis between 2001 and 2017, with more than 2,000 cases confirmed in the State of Pará. Despite a large number of cases, no study has been conducted to trace the spatio-temporal profile of the disease.
Confirmed cases of leptospirosis from 2001 to 2017 from the state of Pará were the basis for this space-time study. The database of the Department of Informatics of the Ministry of Health was used to access data on leptospirosis. The spatio-temporal analysis was performed in the SaTScan software for the detection of clusters, and maps were generated in the QGIS software.
The municipalities of Belém and Santarém were among the ones with the highest incidence rates of leptospirosis for the whole study period. Increased number of cases in Soure, Inhangapi, São João da Ponta and Magalhães Barata, Ponta de Pedras, Breves, Bragança, Castanhal, and São Domingos do Capim were identified in different time periods. Santarém and Belém are the main foci of leptospirosis because they are the most urbanized and densely populated municipalities in the State. The cases found in smaller municipalities may be associated with periods of more frequent rainfall and circulation of Leptospira sp. in marsupials and cattle, in the northeastern part of the State.
Further studies are needed to help identify the risk factors that contribute to the occurrence of leptospirosis in the State of Pará, particularly in areas with lower population density.
2001年至2017年间，巴西登记的钩端螺旋体病确诊病例超过62000例，其中帕拉州确诊病例超过2000例。尽管病例数量众多，但尚未开展研究来追踪该疾病的时空分布情况。
本时空研究以2001年至2017年帕拉州钩端螺旋体病确诊病例为基础。利用卫生部信息司的数据库获取钩端螺旋体病数据。在SaTScan软件中进行时空分析以检测聚集性，并在QGIS软件中生成地图。
在整个研究期间，贝伦市和圣塔伦市是钩端螺旋体病发病率最高的城市之一。在不同时间段，索雷、因汉加皮、圣若昂达蓬塔、马加良斯巴拉塔、蓬塔德佩德拉斯、布雷维斯、布拉干萨、卡斯塔尼亚尔和圣多明戈斯杜卡平的病例数有所增加。圣塔伦和贝伦是钩端螺旋体病的主要疫源地，因为它们是该州城市化程度最高、人口最密集的城市。在较小城市发现的病例可能与该州东北部降雨更频繁以及钩端螺旋体在有袋动物和牛群中的传播有关。
需要进一步开展研究，以帮助确定导致帕拉州钩端螺旋体病发生的风险因素，特别是在人口密度较低的地区。
