Leishmaniose visceral: comportamento epidemiológico e distribuição temporo-espacial em área endêmica do Tocantins

Abstract

Visceral leishmaniasis (VL) is a chronic infectious and parasitic disease, which has high morbidity and wide geographical distribution. The disease is of great importance in Palmas- TO, which is a major transmission area in the state of Tocantins, and is considered priority to the development of strategies aimed at controlling this zoonosis. The objective of this study was to increase knowledge about the epidemiology of VL in the city, from January 2002 to December 2013 in order to provide data that can support the planning of care, prevention and control of disease. Therefore, it wascarried out an epidemiological study of descriptive and quantitative, from the new autochthonous human cases of VL located in the urban part of the host district, registered in the System Notification Diseases Information (SINAN), and the positive cases evolved to death, registered in the Mortality System (SIM) during the study period. The variables inherent to the individual were analyzed, the location and time of occurrence of the event, with positive cases georeferenced and built thematic maps from the epidemiological stratification and satellite images. The monthly averages of VL cases and rainfall were evaluated to verify the occurrence of a possible pattern of seasonal distribution. There was a significant reduction in the number of cases of the disease over the time series studied, although Palmas is still considered an intense transmission place, with a clearly urban profile of transmission, with a greater clustering of cases in South Palmas Region and greater dispersion of the disease in 2003, possibly due to the formation of the lake in Lajeado HPP. It was found that the reduction in the incidence rate did not follow a drop in mortality, suggesting a late diagnosis and the need for intensification of active search of suspected cases for the early detection, timely treatment and reduce mortality from this cause. The greatest risk of being affected by the disease was observed in the peripheral areas of the city, densely inhabited by a population of low education, predominantly male, the grayish-brown, and the children under 10 years of age the most affected, showing an epidemiological framework conducive to infection and environmental vulnerability.