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. 2019 Mar;24(3):348-355.
doi: 10.1111/tmi.13196. Epub 2019 Jan 28.

The role of deforestation on American cutaneous leishmaniasis incidence: spatial-temporal distribution, environmental and socioeconomic factors associated in the Brazilian Amazon

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Free article

The role of deforestation on American cutaneous leishmaniasis incidence: spatial-temporal distribution, environmental and socioeconomic factors associated in the Brazilian Amazon

Maria Gabriela de Almeida Rodrigues et al. Trop Med Int Health. 2019 Mar.
Free article

Abstract

Objective: To analyse the temporal and spatial distribution as well as the environmental and socioeconomic factors associated with cutaneous leishmaniasis incidence in the state of Amazonas, Brazil from 2007 to 2015.

Methods: Spatial and temporal distribution was evaluated from sequential thematic maps of the mean incidence rates of the disease. A negative binomial regression analysis was performed to evaluate the association of the factors studied with the mean incidence rate of ACL.

Results: The average proportion of deforestation was negatively associated with the average incidence rate of cutaneous leishmaniasis in municipalities (β = -2.178; P = 0.019; 95%CI -3.996, -0.361), and the health system performance index (effectiveness) (β = -0.852; P = 0.008; 95%CI -1.481, -0.225). Conversely, the municipal human development index (MHDI) was a factor positively related to the average incidence among the municipalities (β = 7.728; P = 0.003; 95%CI 2.716, 12.738).

Conclusion: Our study shows the important impact of socioeconomic and environmental factors on ACL incidence in the Amazonas State.

Objectif: Analyser la distribution temporelle et spatiale ainsi que les facteurs environnementaux et socioéconomiques associés à l'incidence de la leishmaniose cutanée dans l'Etat de l'Amazonas, au Brésil, de 2007 à 2015. MÉTHODES: La distribution spatiale et temporelle a été évaluée à partir de cartes thématiques séquentielles des taux d'incidence moyens de la maladie. Une analyse de régression binomiale négative a été réalisée pour évaluer l'association des facteurs étudiés avec le taux d'incidence moyen de la LCA. RÉSULTATS: La proportion moyenne de déforestation était négativement associée au taux d'incidence moyen de la leishmaniose cutanée dans les municipalités (β = -2,178; p = 0,019; IC95%: -3,996 à -0,361) et à l'indice de performance du système de santé (efficacité) (β = -0,852; p = 0,008; IC95%: -1,481 à -0,225). Par contre, l'indice de développement humain municipal (IDHM) était un facteur positivement lié à l'incidence moyenne dans les municipalités (β = 7,728; p = 0,003; IC95%: 2,716 à 12,738).

Conclusion: Notre étude montre l'impact important des facteurs socioéconomiques et environnementaux sur l'incidence de la LCA dans l'Etat d'Amazonas.

Keywords: American cutaneous leishmaniasis; dynamique de la transmission; environment; environnement; facteurs socioéconomiques; leishmaniose cutanée américaine; socioeconomic factors; transmission dynamics.

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