Clinical, epidemiological and climatic factors related to the occurrence of cutaneous leishmaniasis in an endemic area in northeastern Brazil.

R S Oliveira,A S Guimarães-E-Silva,C F Aragão,J M T Bezerra,K B A Pimentel,V C S Pinheiro,M N Melo,M L Moura

doi:10.1590/1519-6984.224937

Abstract

Cutaneous leishmaniasis (CL) is a neglected tropical disease with a wide distribution in the Americas. Brazil is an endemic country and present cases in all states. This study aimed to describe the occurrence, the underlying clinical and epidemiological factors, and the correlation of climatic variables with the frequency of reported CL cases in the municipality of Caxias, state of Maranhão, Brazil. This is a retrospective and descriptive epidemiological study based on data extracted from the Brazilian Information System of Diseases Notification, from 2007 to 2017. Maximum and minimum temperature, precipitation, and relative air humidity data were provided by the Brazilian National Institute of Meteorology. A total of 201 reported autochthonous CL cases were analyzed. The predominance of cases was observed in males (70.1%). The age range between 31 and 60 years old was the most affected, with 96 cases (47.9%). Of the total number of registered cases, 38.8% of the affected individuals were engaged in agriculture-related activities. The georeferenced distribution revealed the heterogeneity of disease occurrence, with cases concentrated in the Western and Southern regions of the municipality. An association was detected between relative air humidity (monthly mean) and the number of CL cases per month (p = 0.04). CL continues to be a concerning public health issue in Caxias. In this context, there is a pressing need to strengthen measures of prevention and control of the disease through the network of health services of the municipality, considering local and regional particularities.

Highlights

Cutaneous leishmaniasis (CL) is a non-contagious infectious disease caused by different species of protozoa from the genus Leishmania (Goto and Lindoso, 2012)
The municipality of Caxias, east of Maranhão, is an endemic area for this infection, this is the first study that evaluated in a systematic way the occurrence, distribution and climatic factors associated with the CL in an 11-year historical series
Despite the disease control measures, the results show that the municipality maintains unequal patterns of temporal and spatial distribution of cases

Summary

Introduction

Cutaneous leishmaniasis (CL) is a non-contagious infectious disease caused by different species of protozoa from the genus Leishmania (Goto and Lindoso, 2012). In Brazil, Leishmania (Viannia) braziliensis (Vianna, 1911), Leishmania (Viannia) guyanensis (Floch, 1954), and Leishmania (Leishmania) amazonensis (Lainson and Shaw, 1972) are the most relevant species in medical and public health contexts (Padilha et al, 2010; Akhoundi et al, 2016). The cutaneous form is more frequent and generally presents itself as a single painless ulcerated lesion of raised edges, with granular bottom (Guerra et al, 2015). The disease is a tropical pathology that requires the attention of health services since diagnosis and treatment are difficult, which may allow lesions to evolve disfiguring and disabling forms, impairing the patient’s quality of life and impacting their social life (Bennis et al, 2017)

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