Análise epidemiológica dos casos humanos de leishmaniose tegumentar americana, Minas Gerais, 2007 a 2013

Abstract

In Minas Gerais, American Cutaneous Leishmaniasis (ACL) is distributed under different epidemiological profiles and patterns of transmission. The delineation of spatial circuits of production, defined by the Ministry of Health (MS) for three years, provide subsidies for specific prophylactic measures, which are of great epidemiological relevance. The objective of this study was to evaluate the epidemiological distribution of ACL cases throughout the state of Minas Gerais in the period between 2007-2013 and the spatial circuits of production, for three years from 2007 to 2011, listing the cases of ACL by population density with social and environmental variables and land use. We conducted a retrospective observational epidemiological study to characterize the epidemiological distribution of cases. National secondary data of ACL cases were obtained from System for Notifiable Diseases (SINAN), Demographic Census 2010 and Agricultural Census 2006, both data from the Brazilian Institute of Geography and Statistics (IBGE), in addition to sub-index data Index miner Social Responsibility (IMRS) and the Municipal Development FIRJAN Index (IFDM), to assess the relationship of cases of ACL by population density with social and environmental factors and land use by multivariate principal component analysis (PCA). Between 2007-2013 there were 9,107 new cases of ATL in Minas Gerais, average detection rate of 6.6 cases per 100,000 population and density of cases of 2.2 cases per square kilometer. The Mesoregions North of Minas Gerais, the metropolitan area of Belo Horizonte and Vale do Rio Doce had higher concentration of cases. Three spatial circuits of production were identified for the period 2007 to 2011. These areas concentrate municipalities that in general presented cases density above 10 cases per square kilometer. A downward trend in cases over the period was evaluated with transmission and expansion peaks of the disease among the municipalities in the 2010-2011 biennium. There were more reported cases from January to March and in December. Male individuals, aged between 30-59 years, the cutaneous form, laboratory diagnosis and low education presented a higher frequency. The countryside was predominant in the overall evaluation of the state and in the spatial circuits of production except for the circuit 1. For the PCA, we identified for the three circuits a strong association between the cases of ACL by population density for farming, natural pasture forest natural, useless land and rural population, and a weak association with planted pasture. The IFDM and the sub-indices of IMRS represented by illiteracy rate and per capita income showed no relevance in the PCA system. In general, the major land use, population density and environmental variables, and basic sanitation are relevant to the occurrence of ACL in the spatial circuits of production