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. 2018 Sep 10;11(1):503.
doi: 10.1186/s13071-018-3084-1.

Dispersion of Lutzomyia longipalpis and expansion of visceral leishmaniasis in São Paulo State, Brazil: identification of associated factors through survival analysis

Agda M Oliveira  1 , Rossana V M López  2 , Margareth R Dibo  3 , Lilian A C Rodas  4 , Marluci M Guirado  5 , Francisco Chiaravalloti-Neto  6
Affiliations

Dispersion of Lutzomyia longipalpis and expansion of visceral leishmaniasis in São Paulo State, Brazil: identification of associated factors through survival analysis

Agda M Oliveira et al. Parasit Vectors. .

Abstract

Background: In Brazil, visceral leishmaniasis (VL) is a serious public health problem because of its magnitude, geographical expansion and potential harms caused by illnesses, including death. However, VL is largely ignored in discussions of tropical disease priorities. Thus, this study aimed to identify factors associated with the expansion of VL and the dispersion of its vector, Lutzomyia longipalpis, in the municipalities of the State of São Paulo, Brazil.

Methods: Information about the date of vector detection and the confirmation of autochthonous VL occurrence in humans and canines in São Paulo were obtained between 1997 and 2014. Survival curves were calculated by the Kaplan-Meier and the Cox multiple regression models was used.

Results: The presence of the Marechal Rondon highway showed the highest positive association with vector dispersion and canine and human VL expansion. The monthly maximum and minimum temperature averages recorded in the municipalities during the study period were also positively associated with these events. The presence of transverse highways was positively associated with the presence of the vector; the border with the State of Mato Grosso do Sul, the presence of a prison, microregion headquarters, and the presence of the Tietê River were positively associated with the occurrence of canine cases, while only the presence of prison was positively associated with the occurrence of human cases. The construction of the Bolivia-Brazil gas pipeline was not associated with any events.

Conclusions: Survival analysis enabled the identification of factors associated with vector dispersion and VL expansion, thus the results of this study may be useful to the improvement of VL surveillance and control activities in the State of São Paulo and throughout Brazil.

Keywords: Brazil; Neglected tropical disease; Survival analysis; Visceral leishmaniasis.

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Conflict of interest statement

Ethics approval and consent to participate

The present study was approved by the Research Ethics Committee of the School of Public Health at the University of São Paulo (Protocol number: 257.511; April 26, 2013).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Location of the states of São Paulo (study area), Minas Gerais and Mato Grosso do Sul in Brazil and South America (a and b); mesoregions, municipalities, the Marechal Rondon Highway, and the Tietê River in the State of SP, with an emphasis on Araçatuba, the municipality to first report the detection of Lu. longipalpis and presence of VL cases in SP (c); microregions of the State of SP (d)
Fig. 2
Fig. 2
Survival curves and Lu. longipalpis. Emergence of Lu. longipalpis and the two associated categorical variables (the Marechal Rondon highway and transverse highways) from 1997 to 2014. Data for the municipalities of São Paulo, Brazil
Fig. 3
Fig. 3
Survival curves and canine cases of VL. Emergence of canine cases of VL and the five associated categorical variables (the Marechal Rondon highway, Mato Grosso do Sul border, presence of a prison, microregion headquarters and the Tietê River) from 1998 to 2014. Data for the municipalities of São Paulo, Brazil
Fig. 4
Fig. 4
Survival curves and human cases of VL. Emergence of human cases of VL and the two associated categorical variables (the Marechal Rondon highway and presence of a prison) from 1999 to 2014. Data for the municipalities of São Paulo, Brazil
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