Instituto Integrado de Saúde, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil.
Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil.
PLoS One. 2020 Oct 2;15(10):e0240218. doi: 10.1371/journal.pone.0240218. eCollection 2020.
Visceral leishmaniasis (VL) is a neglected vector-borne disease associated with socioeconomic and environmental issues. In Brazil, epidemics of VL have occurred in major cities since 1980. Applied models for medical and epidemiological research have been used to assess the distribution and characteristics of disease endpoints and identify and characterize potential risk factors. This study described the demographic features of VL and modeled the spatio-temporal distribution of human VL cases and their relationship with underlying predicitve factors using generalized additive models. We conducted an ecological study covering an 18-year period from the first report of an autochthonous case of VL in Campo Grande, state of Mato Grosso do Sul, in 2001 to 2018. The urban area of the city has 74 neighborhoods, and they were the units of analysis of our work. Socioeconomic and demographic data available from Brazilian public databases were considered as covariables. A total of 1,855 VL cases were reported during the study period, with an annual mean incidence rate of 13.23 cases per 100,000 population and a cumulative crude incidence of 235.77 per 100,000 population. The results showed the rapid transition from epidemic to endemic and the centrifugal dispersal pattern of the disease. Moreover, the model highlighted that the urban quality of life index, which is calculated based on income, education, housing conditions, and environmental sanitation data, plays a role in VL occurrence. Our findings highlighted the potential for improving spatio-temporal segmentation of control measures and the cost-effectiveness of integrated disease management programs as soon as VL is difficult to control and prevent and has rapid geographical dispersion and increased incidence rates.
内脏利什曼病（VL）是一种被忽视的媒介传播疾病，与社会经济和环境问题有关。在巴西，自 20 世纪 80 年代以来，VL 在主要城市爆发。应用于医学和流行病学研究的模型用于评估疾病终点的分布和特征，并确定和描述潜在的危险因素。本研究描述了 VL 的人口统计学特征，并使用广义加性模型对人类 VL 病例的时空分布及其与潜在预测因素的关系进行建模。我们进行了一项生态研究，涵盖了自 2001 年 Campo Grande 首例本地 VL 病例报告至 2018 年的 18 年期间。该市的市区有 74 个街区，是我们工作的分析单位。考虑了来自巴西公共数据库的社会经济和人口统计数据作为协变量。在研究期间报告了 1855 例 VL 病例，年平均发病率为每 10 万人 13.23 例，累积粗发病率为每 10 万人 235.77 例。结果表明，疾病迅速从流行转为地方病，并呈离心扩散模式。此外，该模型强调了城市生活质量指数的作用，该指数是根据收入、教育、住房条件和环境卫生数据计算的。我们的研究结果强调了改善控制措施的时空分割以及综合疾病管理计划成本效益的潜力，因为一旦 VL 难以控制和预防，并且具有快速的地理扩散和发病率增加，这些措施就变得至关重要。
