Abstract
ABSTRACTOBJECTIVETo propose a new operational unit in the locality scale capable of subsidizing the construction of an information system to control the transmission of tegumentary leishmaniasis at this scale, in a region of high endemicity of the Atlantic Forest.METHODSWe examined the adequacy of data and instruments in an area of high endemicity in the Atlantic Forest located in the South of the State of Rio de Janeiro from 1990 to 2012. The study proposed an operational unit called Local Surveillance Unit to make all used databases compatible by adjusting census sectors. This enabled the overlap and comparison of information in different periods.RESULTSThe spreading process of the transmission of tegumentary leishmaniasis in the Baía da Ilha Grande region does not depend on great population movements, and can occur in areas with population growth or decrease. The data information system allowed the adequate identification and characterization of the place of residence. We identified relevant characteristics of the place of transmission, such as self-limited in time and not associated with recent deforestation. The results also highlight the lack of synchronicity in the case production in territorial units involved in the endemic-epidemic process, noting that this process is in constant motion.CONCLUSIONSThe transmission process seems more connected to the presence and movement of rodents that move continuously in the region than to the local density of vectors or the permanence of infected dogs at home. New control strategies targeted at the foci of transmission must be considered. The construction of a new operational unit, called Local Surveillance Unit, was instrumental in the endemic-epidemic process analysis.
Highlights
The spreading process of the transmission of tegumentary leishmaniasis in the Baía da Ilha Grande region does not depend on great population movements, and can occur in areas with population growth or decrease
The results highlight the lack of synchronicity in the case production in territorial units involved in the endemic-epidemic process, noting that this process is in constant motion
Brazil has seen a sharp increase in cases of tegumentary leishmaniasis (TL) in the last decades[13,14]
Summary
Brazil has seen a sharp increase in cases of tegumentary leishmaniasis (TL) in the last decades[13,14]. An outbreak investigation in Rio de Janeiro, RJ, in 1974 recorded the same epidemiological characteristics described in foci studies with transmission patterns at home and the surrounding areas. The investigation enabled the identification of other behavior of this endemic disease: the simultaneous production of discontinuous outbreaks, as a true network of interrelated foci, and their tendency to dissemination through the progressive incorporation of new locales to the endemic area with active transmission10,b. The information component of the National Program of Tegumentary Leishmaniasis Control was the production of standardized reports with operational indicators, which consolidated the data only per State. The program had as main objectives the early diagnosis with proper treatment of human cases and the reduction of human-vector contact by the application of insecticide and measures of individual protection[12]
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