Profile of American tegumentary leishmaniasis in transmission areas in the state of Minas Gerais, Brazil, from 2007 to 2017

Abstract

Background: American tegumentary leishmaniasis (ATL) is a widespread anthropozoonosis caused by protozoa of the genus Leishmania and is considered a serious public health problem. The aim of this study was to provide a descriptive analysis of confirmed ATL cases and evaluate the spatial distribution of ATL in high-risk transmission areas from the state of Minas Gerais, Brazil.

Methods: An ecological, analytical, and retrospective study of the confirmed cases of ATL in Minas Gerais from 2007 to 2017 was conducted. To characterize these cases, multiple correspondence analysis and georeferencing of the ATL prevalence rates in the municipalities were conducted based on variables obtained at Sistema Nacional de Agravos de Notificação and Instituto Brasileiro de Geografia e Estatística databases.

Results: There were 13,025 confirmed cases of ATL from 74.4% (635) municipalities of Minas Gerais, corresponding to a prevalence rate of 66.5 cases for every 100,000 inhabitants. Males aged 20 to 59 years and individuals who attended elementary school were most affected with ATL. Multiple correspondence analysis presented an accumulated qui-squared value of 44.74%, proving that there was a relationship between the variables, including ethnicity, age, pregnancy status, zone of infection, and number of cases.

Conclusion: We confirmed that ATL is endemic to Minas Gerais, and there is high risk of infection within the municipalities due to a high rate of parasite transmission. The occurrence of infection in children, pregnant women, and the indigenous population demonstrates the need for the government to expand social policies aimed at vulnerable groups.

Keywords: Cutaneous leishmaniasis; Epidemiology; Public health; Zoonoses.

Fig. 1

Distribution of the ATL confirmed cases in Minas Gerais, Brazil from 2007 to 2017

Fig. 2

Control diagram according to the monthly average frequency of ATL cases in Minas Gerais, from 2007 to 2017

Fig. 3

Graphic of the Multiple Correspondence Analyses of the epidemiological of the ATL cases occurred between 2007 and 2017 in Minas Gerais, Brazil. Low: municipalities with low number of cases; Mode: municipalities with moderate number of cases; High: municipalities with high number of cases; N_Ana: not illiterate; Y_Ana: illiterate; N_HS: do not have high school degree; Y_HS: have high school degree; N_GD: do not have graduate degree; Y_GD: have graduate degree; N_Preg: not pregnant; Y_Preg: pregnant; N_Age0: not age 0 (younger than 1-year-old); Y_Age0: age 0 (younger than 1-year-old); N_Age1: not age 1 (1–14 year-old); Y_Age1: age 1 (1–14 years old); N_Age2: not age 2 (15–19 years old); Y_Age2: age 2 (15–19 years old); N_Age3: not age 3 (20–59 years old); Y_Age3: age 3 (20–59 years old); N_Age4: not age 4 (60 years old or older); Y_Age4: age 4 (60 years old or older); N_Cl_ep: not evaluated using clinical-epidemiological criteria; Y_Cl_ep: evaluated using clinical-epidemiological criteria; N_Bla: not black patients; Y_Bla: black patients; N_Yel: not yellow patients; Y_Yel: yellow patients; N_Bro: not brown patients; Y_Bro: brown patients; N_Ind: not Indian patients; Y_Ind: Indian patients; N_Fem: not female patients; Y_Fem: female patients; N_Per: not peri urban area; Y_Per: peri urban area; N_Ru: not rural area; Y_Ru: rural area