Hyperendemicity, heterogeneity and spatial overlap of leprosy and cutaneous leishmaniasis in the southern Amazon region of Brazil

Submitted: 26 April 2020
Accepted: 13 July 2020
Published: 29 December 2020
Abstract Views: 1658
PDF: 743
HTML: 27
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Neglected tropical diseases characterized by skin lesions are highly endemic in the state of Mato Grosso, Brazil. We analyzed the spatial distribution of leprosy and Cutaneous Leishmaniasis (CL) and identified the degree of overlap in their distribution. All new cases of leprosy and CL reported between 2008 and 2017 through the national reporting system were included in the study. Scan statistics together with univariate Global and Local Moran's I were employed to identify clusters and spatial autocorrelation for each disease, with the spatial correlation between leprosy and CL measured by bivariate Global and Local Moran's I. Finally, we evaluated the demographic characteristics of the patients. The number of leprosy (N = 28,204) and CL (N = 24,771) cases in Mato Grosso and the highly smoothed detection coefficients indicated hyperendemicity and spatial distribution heterogeneity. Scan statistics demonstrated overlap of high-risk clusters for leprosy (RR = 2.0; P <0.001) and CL (RR = 4.0; P <0.001) in the North and Northeast mesoregions. Global Moran's I revealed a spatial autocorrelation for leprosy (0.228; P = 0.001) and CL (0.311; P = 0.001) and a correlation between them (0.164; P = 0.001). Both diseases were found to be concentrated in urban areas among men aged 31-60 years, of brown-skinned ethnicity and with a low educational level. Our findings indicate a need for developing integrated and spatially as well as socio-demographically targeted public health policies.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Alvar J, Velez ID, Bern C, Herrero M, Desjeux P, Cano J, Jannin J, den Boer M, 2012. Leishmaniasis worldwide and global estimates of its incidence. PLoS One 7:e35671. DOI: https://doi.org/10.1371/journal.pone.0035671
Assunção RM, Barreto SM, Guerra HL, Sakurai E, 1998. Mapas de taxas epidemiológicas: uma abordagem Bayesiana. Cad Saúde Pública 14:713-23. DOI: https://doi.org/10.1590/S0102-311X1998000400013
Aturinde A, Farnaghi M, Pilesjo P, Mansourian A, 2019. Spatial analysis of HIV-TB co-clustering in Uganda. BMC Infect Dis 19:612. DOI: https://doi.org/10.1186/s12879-019-4246-2
Carvalho MS, Câmara G, Cruz OG, Correa V, 2004. Análise de dados de área. In: Druck S, Carvalho MS, Câmara G, Monteiro AMV (ed). Análise Espacial de Dados Geográficos. Brasília: Embrapa.
Costa JML, Saldanha ACR, Melo LS, Silva AR, Ferreira LA, Costa G, Rebêlo JMM, Gama MEA, Barral A, 2009. Cutaneos leishmaniasis (CL) associated with leprosy: a new and emerging clinicoepidemiological entity observed in the northeast of Brazil. Gaz Med Bahia 95-102.
DATASUS, 2020. Department of Informatics of the Unified Health System. Available from: http://tabnet.datasus.gov.br Accessed: March 30, 2020.
de Freitas TP, D'Andrea PS, de Paula DA, Nakazato L, Dutra V, Bonvicino CR, de Almeida Ado B, Boa-Sorte Eda C, Sousa VR, 2012. Natural infection of Leishmania (Viannia) braziliensis in Mus musculus captured in Mato Grosso, Brazil. Vector Borne Zoonotic Dis 12:81-3. DOI: https://doi.org/10.1089/vbz.2010.0268
Engelman D, Fuller LC, Solomon AW, McCarthy JS, Hay RJ, Lammie PJ, Steer AC, 2016. Opportunities for integrated control of neglected tropical diseases that affect the skin. Trends Parasitol 32:843-54. DOI: https://doi.org/10.1016/j.pt.2016.08.005
Golding N, Wilson AL, Moyes CL, Cano J, Pigott DM, Velayudhan R, Brooker SJ, Smith DL, Hay SI, Lindsay SW, 2015. Integrating vector control across diseases. BMC Med 13:249. DOI: https://doi.org/10.1186/s12916-015-0491-4
Instituto Brasileiro de Geografia e Estatística, 2019. Estado de Mato Grosso. Available from: https://cidades.ibge.gov.br/brasil/mt Accessed: September 23, 2019.
Kulldorff M, Nagarwalla N, 1995. Spatial disease clusters: detection and inference. Stat Med 14:799-810. DOI: https://doi.org/10.1002/sim.4780140809
Magalhães MCC, Santos ES, Queiroz ML, Lima ML, Borges RCM, Souza MS, Ramos AN, 2011. Migração e hanseníase em Mato Grosso. Rev Bras Epidemiol 14:386-97. DOI: https://doi.org/10.1590/S1415-790X2011000300004
Martínez DY, Verdonck K, Kaye PM, Adaui V, Polman K, Llanos-Cuentas A, Dujardin J-C, Boelaert M, 2018. Tegumentary leishmaniasis and coinfections other than HIV. PLoS Negl Trop Dis 12:e0006125. DOI: https://doi.org/10.1371/journal.pntd.0006125
Melchior LAK, Brilhante AF, Chiaravalloti-Neto F, 2017. Spatial and temporal distribution of American cutaneous leishmaniasis in Acre state, Brazil. Infect Dis Poverty 6:99. DOI: https://doi.org/10.1186/s40249-017-0311-5
Melo HA, Rossoni DF, Teodoro U, 2017. Spatial distribution of cutaneous leishmaniasis in the state of Paraná, Brazil. PLoS One 12:e0185401. DOI: https://doi.org/10.1371/journal.pone.0185401
Mercadante LM, Santos MASD, Pegas ES, Kadunk BV, 2018. Leprosy and American cutaneous leishmaniasis coinfection. An Bra Dermatol 93:123-5. DOI: https://doi.org/10.1590/abd1806-4841.20186698
Ministério da Saúde, Brasil, 2012. Secretaria de Vigilância em Saúde. Plano integrado de ações estratégicas de eliminação da hanseníase, filariose, esquistossomose e oncocercose como problema de saúde pública, tracoma como causa de cegueira e controle das geohelmintíases: plano de ação 2011-2015. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/plano_integrado_acoes_estrategicas_2011_2015.pdf Accessed: November 7, 2019.
Ministério da Saúde, Brasil, 2016. Secretaria de Vigilância em Saúde. Departamento de Vigilância das Doenças Transmissíveis. Diretrizes para vigilância, atenção e eliminação da hanseníase como problema de saúde pública. Available from: http://portalarquivos2.saude.gov.br/images/pdf/2016/fevereiro/04/diretrizes-eliminacao-hanseniase-4fev16-web.pdf Accessed: January 30, 2020.
Ministério da Saúde, Brasil, 2017. Secretaria de Vigilância em Saúde. Manual de Vigilância da Leishmaniose Tegumentar. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/manual_vigilancia_leishmaniose_tegumentar_americana_2edicao.pdf Accessed: September 9, 2019.
Ministério da Saúde, Brasil, 2018. Secretaria de Vigilância em Saúde. Departamento de Vigilância de Doenças e Agravos não Transmissíveis e Promoção da Saúde. Saúde Brasil 2017: uma análise da situação de saúde e os desafios para o alcance dos objetivos de desenvolvimento sustentável. Doenças negligenciadas no Brasil: vulnerabilidade e desafios. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/saude_brasil_2017.pdf Accessed: November 7, 2019.
Ministério da Saúde, Brasil, 2019. Coeficiente de detecção de casos de leishmaniose tegumentar por 100.000 habitantes. Brasil Grandes regiões e Unidades Federadas. 1990 a 2018. Available from:
Ministério da Saúde, Brasil, 2020. Secretaria de Vigilânica em Saúde. Boletim Epidemiológico de Hanseníase. Available from: https://www.saude.gov.br/images/pdf/2020/janeiro/31/Boletim-hanseniase-2020-web.pdf Accessed: March 20, 2020.
Mitjà O, Marks M, Bertran L, Kollie K, Argaw D, Fahal AH, Fitzpatrick C, Fuller LC, Izquierdo BG, Hay R, Ishii N, Johnson C, Lazarus JV, Meka A, Murdoch M, Ohene S-A, Small P, Steer A, Tabah EN, Tiendrebeogo A, Waller L, Yotsu R, Walker SL, Asiedu K, 2017. Integrated control and management of neglected tropical skin diseases. PLoS Negl Trop Dis 11:e0005136. DOI: https://doi.org/10.1371/journal.pntd.0005136
Moschella SL, Garcia-Albea V, 2016. Differential diagnosis of leprosy. In: Scollard DM, Gillis TP (ed). International Textbook of Leprosy. Available from: https://m3u9w4p9.stackpathcdn.com/sites/default/files/ITL_2_3%20FINAL.pdf Accessed: February 12, 2020.
Phillips DA, Ferreira JA, Ansah D, Teixeira HSA, Kitron U, Filippis T, Alcântara MH, Fairley JK, 2017. A tale of two neglected tropical infections: using GIS to assess the spatial and temporal overlap of schistosomiasis and leprosy in a region of Minas Gerais, Brazil. Mem Inst Oswaldo Cruz 112:275-80. DOI: https://doi.org/10.1590/0074-02760160395
QGIS, 2018. Development Team. Quantum GIS geographic information system. Open source geospatial foundation project, v. 3.4 Madeira. Available from: http://qgis.org Accessed: April 10, 2019.
Ribeiro AL, Missawa NA, Zeilhofer P, 2007. Distribution of phlebotomine sandflies (Diptera: Psychodidae) of medical importance in Mato Grosso State, Brazil. Rev Inst Med Trop Sao Paulo 49:317-21. DOI: https://doi.org/10.1590/S0036-46652007000500008
Rocha ACAA, Junger WL, Cruz WJA, Ignotti E, 2017. The impact of seasonal climate on new case detection rate of leprosy in Brazil (2008–2012). Lepr Rev 88:533-42. DOI: https://doi.org/10.47276/lr.88.4.533
Rodrigues LC, Lockwood D, 2011. Leprosy now: epidemiology, progress, challenges, and research gaps. Lancet Infect Dis 11:464-70. DOI: https://doi.org/10.1016/S1473-3099(11)70006-8
Silva DRX, Ignotti E, Souza-Santos R, Hacon SS, 2010. Hanseníase, condições sociais e desmatamento na Amazônia brasileira. Rev Panam de Salud P 27:268-75. DOI: https://doi.org/10.1590/S1020-49892010000400005
Silva CLM, Fonseca SC, Kawa H, Palmer DOQ, 2017. Spatial distribution of leprosy in Brazil: a literature review. Rev Soc Bras Med Trop 50:439-49. DOI: https://doi.org/10.1590/0037-8682-0170-2016
Standley C, Boyce MR, Klineberg A, Essix G, Katz R, 2018. Organization of oversight for integrated control of neglected tropical diseases within Ministries of Health. PLoS Negl Trop Dis 12:e0006929. DOI: https://doi.org/10.1371/journal.pntd.0006929
Thies SF, Bronzoni RVM, Espinosa MM, Souza CO, Ribeiro ALM, Santos ES, Dias ES, Damazo AS, 2016. Frequency and diversity of phlebotomine sand flies (Diptera: Psychodidae) in Sinop, State of Mato Grosso, Brazil. Rev Soc Bras Med Trop 49:544-52. DOI: https://doi.org/10.1590/0037-8682-0251-2016
Valois EMS, Campos FMC, Ignotti E, 2015. Prevalence of Mycobacterium leprae in the environment: a review. Afr J Microbiol Res 9:2103-10. DOI: https://doi.org/10.5897/AJMR2015.7440
WHO, 2017. Integrating neglected tropical diseases into global gealth and development. World Health Organization, Geneva, Switzerland.
WHO, 2019. Weekly epidemiological record. Global leprosy update, 2018: moving towards a leprosy-free world. Wkly Epidemiol Rec 94:389-412.

How to Cite

de Carvalho, A. G., Guimarães Luz, J. G. ., Leite Dias, J. V. ., Tiwari, A. ., Steinmann, P. ., & Ignotti, E. (2020). Hyperendemicity, heterogeneity and spatial overlap of leprosy and cutaneous leishmaniasis in the southern Amazon region of Brazil. Geospatial Health, 15(2). https://doi.org/10.4081/gh.2020.892

Similar Articles

You may also start an advanced similarity search for this article.