Abstract
BackgroundAcre 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.MethodsThis 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 SaTScan™ 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.ResultsAcre 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.ConclusionsAcre 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.
Highlights
Acre has reported the highest incidence of American cutaneous leishmaniasis (ACL) in Brazil in recent years
The meso-region of the Acre Valley reported the highest rate of incidence, as a result of the high incidences reported in the micro-regions of Brasiléia and Sena Madureira
Regarding the age group most affected in Sena Madureira (5 to 39 years old), it is probable that this micro-region is undergoing a transition to a situation similar to that which is occurring in Brasiléia, with exposure to the vector coming ever closer to the dwellings, i.e., in the intra/peri-domiciliary environment
Summary
Acre has reported the highest incidence of American cutaneous leishmaniasis (ACL) in Brazil in recent years. American cutaneous leishmaniasis (ACL) is a metaxenic disease widespread throughout the world. It is caused by the infection of various species of protozoa of the genus Leishmania. Brazil is one of 10 countries (alongside Afghanistan, Algeria, Colombia, Iran, Syria, Ethiopia, Northern Sudan, Costa Rica, and Peru) that has the greatest numbers of cases notified, accounting altogether for 70–75% of the global incidence of the disease [1]. The state of Acre, with 5 689 new cases notified in that period, accounted for the highest rate of incidence (11.1 cases/10 000 inhabitant-years); this rate was 1.6 times that of Mato
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