Abstract
BackgroundVisceral leishmaniasis is a serious public health problem in Brazil, and control of this disease constitutes a major challenge. The purpose of this study was to assess the existing spatial and temporal relationships between cases of canine visceral leishmaniasis (CanL) and human visceral leishmaniasis (HVL) recorded in Belo Horizonte, State of Minas Gerais, from 2006 to 2013.MethodsData provided by the Belo Horizonte Health Services regarding the disease control routine were analyzed in order to perform a retrospective observational and ecological study. Information regarding the incidence rate of HVL and canine seroprevalence was examined in relation to control actions performed atthe 148 coverage areas of healthcare centers for the period between 2006 and 2013. A time series analysis was performed using the Gretl 1.9.12 software followed by the assessment of the existing increasing or declining trend and seasonality in the occurrence of CanL and HVL. Autoregressive integrated moving average (ARIMA) models were adjusted, intervention analysis was performed, vector autoregressive models were developed, and Granger causality was used for testing temporal relationships between variables. The hot spot analysis tool was used for cluster identification through Getis-OrdGi statistics. The ArcGis for desktop 10.2.1 software was used for spatial analysis.ResultsWe identified 866 HVL cases in Belo Horizonte between 2006 and 2013. The mean proportion of canine seroprevalence (PCP) was 7.31% and the mean proportion of monitored hosts (PMH) was 6.73%.HVL and PCP showed a decreasing trend, while PMH increased over time (P<0.05). Vector Autoregressive (VAR) and Granger analysis showed a temporal relation between CanL and HVL cases. Maps illustrating the spatial distribution of cases and obituaries of HVL and CanL cases also showed an apparent association between the occurrence of leishmaniasis in humans, and data about canine cases recorded in the previous years.ConclusionsCases of HVL were preceded by PMH and PCP cases. Similar results were observed for intraspecific cases (i.e. between PCP and other canine cases and between HVL and other HVL cases), which indicated the existence of favorable environmental conditions for the transmission and spread of L. infantum in Belo Horizonte.
Highlights
Visceral leishmaniasis is a serious public health problem in Brazil, and control of this disease constitutes a major challenge
People living in conditions of social vulnerability are more susceptible to the development of clinical signs [2,3,4,5,6], which may account for the fact that leishmaniasis has been identified in 98 countries, most cases of human visceral leishmaniasis (HVL) are found in Brazil, Bangladesh, Ethiopia, India, Sudan and South Sudan [2]
Using the Augmented Dickey-Fuller (ADF) test, we identified that the series of HVL, Proportion of canine seroprevalence (PCP) and proportion of monitored hosts (PMH) are non-stationary, which became stationary after adding the first difference to the original series
Summary
Visceral leishmaniasis is a serious public health problem in Brazil, and control of this disease constitutes a major challenge. Considering the impact of leishmaniasis in the country, development of novel ways to control VL, and assessment and improvement of current approaches is required. This improvement depends on the epidemiological characteristics of the disease such as spatial and temporal distribution, and association between variables. These parameters are important because they help to understand the health-disease process and the implementation of educational, prophylactic, and targeted control measures, as well as the implementation of monitoring and surveillance practices
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