Relative risk of visceral leishmaniasis in Brazil: a spatial analysis in urban area

Visceral leishmaniasis (VL) is a vector-borne disease whose factors involved in transmission are poorly understood, especially in more urban and densely populated counties. In Brazil, the VL urbanization is a challenge for the control program. The goals were to identify the greater risk areas for hu...

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Veröffentlicht in:PLoS neglected tropical diseases 2013-11, Vol.7 (11), p.e2540
Hauptverfasser: de Araújo, Valdelaine Etelvina Miranda, Pinheiro, Letícia Cavalari, Almeida, Maria Cristina de Mattos, de Menezes, Fernanda Carvalho, Morais, Maria Helena Franco, Reis, Ilka Afonso, Assunção, Renato Martins, Carneiro, Mariângela
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container_issue 11
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container_title PLoS neglected tropical diseases
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creator de Araújo, Valdelaine Etelvina Miranda
Pinheiro, Letícia Cavalari
Almeida, Maria Cristina de Mattos
de Menezes, Fernanda Carvalho
Morais, Maria Helena Franco
Reis, Ilka Afonso
Assunção, Renato Martins
Carneiro, Mariângela
description Visceral leishmaniasis (VL) is a vector-borne disease whose factors involved in transmission are poorly understood, especially in more urban and densely populated counties. In Brazil, the VL urbanization is a challenge for the control program. The goals were to identify the greater risk areas for human VL and the risk factors involved in transmission. This is an ecological study on the relative risk of human VL. Spatial units of analysis were the coverage areas of the Basic Health Units (146 small-areas) of Belo Horizonte, Minas Gerais State, Brazil. Human VL cases, from 2007 to 2009 (n = 412), were obtained in the Brazilian Reportable Disease Information System. Bayesian approach was used to model the relative risk of VL including potential risk factors involved in transmission (canine infection, socioeconomic and environmental features) and to identify the small-areas of greater risk to human VL. The relative risk of VL was shown to be correlated with income, education, and the number of infected dogs per inhabitants. The estimates of relative risk of VL were higher than 1.0 in 54% of the areas (79/146). The spatial modeling highlighted 14 areas with the highest relative risk of VL and 12 of them are concentrated in the northern region of the city. The spatial analysis used in this study is useful for the identification of small-areas according to risk of human VL and presents operational applicability in control and surveillance program in an urban environment with an unequal spatial distribution of the disease. Thus the frequent monitoring of relative risk of human VL in small-areas is important to direct and prioritize the actions of the control program in urban environment, especially in big cities.
doi_str_mv 10.1371/journal.pntd.0002540
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subjects Brazil - epidemiology
Disease transmission
Distribution
Dogs
Fatalities
Health aspects
Humans
Infections
Information systems
Kala-azar
Leishmaniasis, Visceral - epidemiology
Leishmaniasis, Visceral - transmission
Medical geography
Parasitic diseases
Risk Factors
Socioeconomic factors
Studies
Urban Population
title Relative risk of visceral leishmaniasis in Brazil: a spatial analysis in urban area
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