Miranda Claudia do Socorro Carvalho, de Souza Bruna Costa, Figueiredo Eric Renato Lima, de Melo Neto João Simão, da Silva Hilton Pereira, da Silva Marcos Valerio Santos, Althoff Sérgio Luiz, Filgueiras Tainara Carvalho Garcia Miranda, Miranda Debora do Socorro Carvalho, Gonçalves Nelson Veiga
Laboratory of Epidemiology and Geoprocessing of Amazon, University of the State of Pará (UEPA), Belém 66050-540, Brazil.
Programa de Pós-Graduação em Saúde Coletiva na Amazônia, Federal University of Pará (UFPA), Belém 66075-110, Brazil.
Trop Med Infect Dis. 2024 Mar 21;9(3):66. doi: 10.3390/tropicalmed9030066.
Human Visceral Leishmaniasis is an endemic public health problem in the Amazon. This article analyzed the spatial distribution of this disease and its relationship with socioeconomic, environmental and public health policy variables in four mesoregions of the state of Pará, from 2011 to 2022. This ecological study used secondary data obtained from official Brazilian agencies. Spatial analysis was performed using the Flow, Kernel and Global Moran bivariate techniques expressed in thematic maps. In the mesoregions studied, 2685 cases of the disease were confirmed, with the highest number of cases in Southeast Pará state. The epidemiological profile followed the national pattern of occurrence of the disease, with a higher number of cases in children below school age. Spatial dependence was observed between the prevalence of the disease and socio-economic indicators. The most intense movement of patients was towards the Belém Metropolitan mesoregion. The disease showed an inhomogeneous pattern of distribution of cases, with a direct relationship between areas with cases and deforestation associated with different anthropic activities. There is a socio-environmental production of the disease that goes beyond the border limits of the mesoregions, and its establishment is related to the unsustainable development model implemented in the region.
人类内脏利什曼病是亚马逊地区的一个地方性公共卫生问题。本文分析了2011年至2022年期间帕拉州四个中观区域内该疾病的空间分布及其与社会经济、环境和公共卫生政策变量的关系。这项生态研究使用了从巴西官方机构获得的二手数据。使用专题地图中表示的流量、核密度和全局莫兰双变量技术进行空间分析。在所研究的中观区域内,共确诊2685例该疾病病例,其中帕拉州东南部的病例数最多。该疾病的流行病学特征遵循全国疾病发生模式,学龄以下儿童的病例数较多。观察到该疾病的患病率与社会经济指标之间存在空间依赖性。患者最密集的流动方向是贝伦大都会中观区域。该疾病呈现出病例分布不均匀的模式,病例所在地区与不同人类活动相关的森林砍伐之间存在直接关系。该疾病存在一种超越中观区域边界限制的社会环境产生方式,其形成与该地区实施的不可持续发展模式有关。