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. 2017 Jun 7;6(1):99.
doi: 10.1186/s40249-017-0311-5.

Spatial and temporal distribution of American cutaneous leishmaniasis in Acre state, Brazil

Affiliations

Spatial and temporal distribution of American cutaneous leishmaniasis in Acre state, Brazil

Leonardo Augusto Kohara Melchior et al. Infect Dis Poverty. .

Abstract

Background: Acre has reported the highest incidence of American cutaneous leishmaniasis (ACL) in Brazil in recent years. The present study seeks to identify high and low risk agglomerations of ACL in space and space-time during the period from 2007 to 2013 in Acre, and also to characterize the occurrence of the disease in time and according to sociodemographic variables.

Methods: This is an ecological study, the study population of which consisted of autochthonous ACL cases notified in the municipalities of Acre by an epidemiological surveillance system. Scan statistics of SaTScanTM software were used to identify spatial and space-time clusters. In addition, the cases were characterized by sex, age, home situation (in a rural or urban area), and temporal tendency.

Results: Acre reported an incidence rate of 12.4 cases per 10 000 inhabitant-years in the study period, with the rates varied greatly (standard deviation of 21.8) among their 22 municipalities. One agglomeration of high risk and three of low risk were detected in space and space-time. Four of the five micro-regions of Acre presented a stationary temporal tendency. The profile of transmission varied according to the micro-region. Generally speaking, the disease occurred more often among young people, those of male gender, and those living in rural areas.

Conclusions: Acre has stood out within the Brazilian national context due to its high rates of ACL incidence in the central region of the Acre Valley. The high rates in the micro-region of Brasiléia are related to the disease's intra/peridomiciliary occurrence, and it would seem that the municipality of Sena Madureira is approaching a transmission pattern similar to that of Brasiléia. In other micro-regions, the profile of the disease's transmission is mainly related to the forest/sylvatic cycle of ACL.

Keywords: Acre; Brazil; Cutaneous leishmaniasis; Geographical information system; Scan statistics; Spatial analysis.

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Figures

Fig. 1
Fig. 1
Map of the study area of Acre and its municipalities and territorial divisions in meso- and micro-regions
Fig. 2
Fig. 2
Locations of the detected clusters of ACL cases, based on the a) space-time analysis and b) purely spatial analysis, Acre state, 2007 – 2013
Fig. 3
Fig. 3
Distribution of ACL incidence in the micro-regions of Acre by sex and age group, 2007 – 2013

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