American tegumentary leishmaniasis in the population of the city of Rio Branco, Acre, Brazil: a 2007­2015 time series analysis

American tegumentary leishmaniasis (ATL) is a public health problem in the State of Acre. This study analyses the incidence of all forms of ATL time series in the human population from 2007 to 2015. This time series ecological study investigated the incidence of all forms of ATL in the city of Rio Branco, Acre, Brazil. Data on the number of cases of all forms of ATL diagnosed from 2007 to 2015 were collected from the secondary Health Surveillance Board database, Rio Branco City Health Department. Prais­Winsten regression was used to analyze the trends in ATL incidence. Subsequently, the annual percent change (APC) was estimated. The incidence of disease remained stationary during the studied period, except in the age group from 15 to 19 years old with an increase in the annual variation percentage (APC: 6,48%; IC95%: 1,67; 11,53) and a decline between 20 and 34 years old (APC: -15,41%; IC95%: -18,57; -12,13) and 35 and 49 years old (APC: -8,52%; IC95%: -14,63; -1,97). There was a higher frequency of cases between 2007 and 2015 in the cutaneous form, entry of new cases, evolution to cure, and diagnosis by clinical-laboratory procedures. In conclusion, there was a high disease incidence during the studied period. Additionally, an increase in the ATL incidence in the younger age group and a decrease in the ATL incidence in the middle age groups were observed.

Epidemiological aspects of American cutaneous leishmaniasis (ACL) in an endemic area of forest extractivist culture in western Brazilian Amazonia

ABSTRACT The study sought to analyze clinical and epidemiological aspects of cutaneous leishmaniasis (CL) in Xapuri, Acre, Brazil. Data from 2008 to 2014 registered in the notification records of the disease of the Information System of the Complaints of Notification (SINAN), and the data of the Information Department of the Unified Health System (DATASUS) available from 2007 to 2013 were used and analyzed in the light of the statistics of the temporal series by the Prais-Winsten method and chi-squared test. A total of 906 cases were registered with 60.2% occurring in men and 39.7% in women. The groups from 0 to 4 years of age (48.0%) and from 5 to 19 years of age (23.3%) were the most affected. Regarding the clinical forms, 77.7% presented CL and 22.3% mucocutaneous leishmaniasis (MCL). Among the 896 cases with information on the diagnostic methods used, Montenegro’s skin test predominated (66.4%), with a positive result of 95.8% for CL and 99.3% for MCL. Treatment with N-methylglucamine antimony was performed in 99.4% of the cases, but discontinuously used in the majority of patients. This study presents information which may be used as a tool for the epidemiological surveillance and control of the disease in Xapuri, a region which depends essentially on forest resources and ecological tourism.