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      Espaços de produção da leishmaniose tegumentar americana no estado do Rio de Janeiro, Brasil Translated title: Spaces of production of cutaneous leishmaniasis in the state of Rio de Janeiro, Brazil

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          Abstract

          Resumo O objetivo foi identificar e caracterizar unidades espaciais de relevância epidemiológica no estado do Rio de Janeiro, por meio das maiores concentrações de casos de leishmaniose tegumentar (LT) no período de 1980 a 2012, considerando os conceitos da geografia. Utilizou-se bancos de dados da SUCAM, FUNASA e SINAN. Foi aplicado um método de ajustamento de dados espacialmente referenciados para delimitação das regiões com as maiores concentrações de densidades de casos chamadas circuitos e polos. Estes foram sobrepostos aos mapas de indicadores socioambientais. Do total de casos registrados no período, 87% ocorreram nos municípios localizados nos circuitos e polos resultantes. As variações na ocorrência de casos nos diferentes circuitos e polos não tiveram relação com os indicadores socioambientais. A identificação dos circuitos e polos pode subsidiar o programa estadual da LT para a priorização de estratégias de ações de prevenção e controle e a otimização dos recursos do programa. Essas regiões, mais estáveis que as localidades, permitem operações de vigilância e controle nas localidades com muitos casos e nas demais da área de risco identificada, por terem as mesmas características daquelas já afetadas.

          Translated abstract

          Abstract The scope of this research was to identify and characterize spatial units of epidemiological relevance in the state of Rio de Janeiro, through the highest concentrations of cutaneous leishmaniasis (CL) from 1980 to 2012, considering the geographical aspects. SUCAM, FUNASA and SINAN databases were consulted. A method of adjustment of spatially referenced data for demarcation of the regions with the highest concentrations of cases called circuits and poles was applied. These were superimposed on the socioenvironmental indicator maps. Of the total cases registered in the period, 87% occurred in the municipalities located in the resulting circuits and poles. The variations in the occurrence of cases in the different circuits and poles were not related to the socioenvironmental indicators. The identification of the circuits and poles can subsidize the state CL program of the prioritization of strategies of prevention and control actions and the optimization of the resources of the program. These regions, which are more stable than the localities, allow surveillance and control operations in locations with many cases and in other locations in the identified risk area, because they have the same characteristics as those already affected.

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          Most cited references 13

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          Epidemiological studies of an outbreak of cutaneous leishmaniasis in the Rio Jequitinhonha Valley, Minas Gerais, Brazil.

          We detected an outbreak of American cutaneous leishmaniasis in the Jequitinhonha River Valley, Minas Gerais, Brazil. Clinical and epidemiological aspects were studied for a period of two years. Data include results of physical examinations, Montenegro skin test and serology. In total 72 of the 299 individuals evaluated presented active lesions. Only one case out of these 72 patients showed the mucosal form of the disease. The precarious sanitary conditions, low educational level and low income found in the population studied demonstrated that, as with the other parasitic diseases, cutaneous leishmaniasis occurs with greater frequency in needy populations. A canine serological survey detected 20.3% (30/148) of dogs reactive to the Leishmania antigen. Lutzomyia intermedia was the predominant phlebotomine species and the majority of the specimens (84.9%) were captured in the peridomicile. Four samples from human and three from canine cases were isolated and characterised by PCR and isoenzymes as being Leishmania (Viannia) braziliensis. The peridomiciliary nature of the disease is discussed.
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            A produção do lugar de transmissão da leishmaniose tegumentar: o caso da Localidade Pau da Fome na cidade do Rio de Janeiro, Brasil

            Este trabalho analisa as características de um dos lugares de transmissão de maior relevância da leishmaniose tegumentar na cidade do Rio de Janeiro, Brasil, considerando sua configuração territorial e as relações desta com processos de organização do espaço. Utilizou-se o modelo de análise do processo de ocupação e organização do espaço urbano, em escala local, considerando-se as novas funções adquiridas pelos elementos espaciais expressos por diferentes relações de trabalho, uso do solo e valor da terra. Empregaram-se técnicas de geoprocessamento e de classificação de imagens obtidas por sensoriamento remoto, localização de domicílios e casos de leishmaniose tegumentar, associados a dados qualitativos sobre o processo histórico de ocupação e uso do solo. A análise mostrou áreas com distintas condições de vulnerabilidade, e que mudanças destas condições viabilizaram a produção da epidemia em um determinado período e sua posterior redução. O estudo contribui para o monitoramento da enfermidade em nível local e para a aplicação de medidas eficazes para as ações de vigilância e controle da leishmaniose tegumentar.
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              Spatio-temporal clustering of American Cutaneous Leishmaniasis in a rural municipality of Venezuela.

              American Cutaneous Leishmaniasis (ACL) is an endemic disease in most Latin-American countries and a public health problem. The number of new cases in the world is thought to be about 1.5 million each year. A new epidemiologic pattern has been observed in the last years, in this sense, Geographic Information Systems (GIS) combined with methods of spatial analysis provide powerful new tools for understanding it. To investigate the spatial and temporal features of American Cutaneous Leishmaniasis, in an area known to be endemic. We retrospectively conducted a space-time cluster analysis of incident cases of ACL using cross sectional data recorded from 1348 confirmed cases from 1992 to 2007 in a rural municipality in Venezuela, to test whether the cases were distributed randomly over space and time. We used the space-time permutation scan statistic and GIS. The identified clusters were analyzed for age, sex and job. These allowed us to investigate transmission patterns of ACL without an explicit entomological study. The analysis showed statistically significant space-time clusters of ACL (p-value<0.01). The most likely cluster contained 35.47% of the total cases (n=177) from 1995 to 1998. Four secondary clusters were identified for different periods. There was an indication of ACL cluster spread from the northeast to other points of the municipality. Three transmission patterns (domiciliary, peri-domiciliary and sylvatic environments) were identified along the study area. The transmission of ACL has a spatial and temporal pattern in the studied area which is related to a complex cycle where the environment and other factors have a significant influence. Copyright © 2012 Elsevier B.V. All rights reserved.
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                Author and article information

                Journal
                csc
                Ciência & Saúde Coletiva
                Ciênc. saúde coletiva
                ABRASCO - Associação Brasileira de Saúde Coletiva (Rio de Janeiro, RJ, Brazil )
                1413-8123
                1678-4561
                August 2020
                : 25
                : 8
                : 2961-2971
                Affiliations
                Rio de Janeiro RJ orgnameFiocruz orgdiv1Escola Nacional de Saúde Pública Brazil valdenir@ 123456ensp.fiocruz.br
                Article
                S1413-81232020000902961 S1413-8123(20)02500802961
                10.1590/1413-81232020258.23532018

                This work is licensed under a Creative Commons Attribution 4.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 29, Pages: 11
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