Clinical-epidemiological aspects and prognostic factors associated with death from visceral leishmaniasis between the years 2010 to 2019 in the Central-West region of Brazil.

In Brazil, the fatality rate for visceral leishmaniasis is high, and it is important to investigate its associated factors. The aim of this study was to analyze the clinical-epidemiological profile and prognostic factors associated with death from visceral leishmaniasis (VL) in the Central-West region of Brazil, between 2010 and 2019. A study of series of VL cases was carried out using data obtained from the Sistema de Informação de Agravos de Notificação (SINAN). Multivariate logistic regression was performed to identify variables associated with deaths. Male (64.96%); age group ≤5 years (28.51%); mixed race/color (59.20%); and level of education incomplete primary education (45.16%) were the most affected. The most frequent symptoms were fever (87.65%), weakness (77.56%), enlarged spleen (70.22%) and liver (67.33%), weight loss (67.22%) and pallor (63.41%). Co-infection with HIV was observed in 15.84% of patients. The parasitological diagnosis was positive in 74.17% and the Indirect Immunofluorescence (IIF) in 82.80%. The drug most used for treatment was pentavalent antimony (41.96%). Regarding the evolution of VL, cure was recorded for 82.90% of patients and death from VL in 8.30%. Factors associated with death from VL were: age group ≥20 and <60 (OR 2.95; 95% CI 1.98-4.38) and ≥60 (OR 5.84; 95% CI 3.63-9.38), edema (OR 2.27; 95% CI 1.64-3.13), pallor (OR 1.53; 95% CI 1.06-2.20), infectious condition (OR 1.56; 95% CI 1.12-2.15) and hemorrhagic phenomena (OR 2.87; 95% CI 2.02-4.08). New studies are needed in order to better manage VL control, monitoring, prevention and primary care strategies.

Prevalence and epidemiological aspects of Chikungunya fever in states of the Northeast region of Brazil: A systematic review.

Chikungunya fever is a disease caused by the Chikungunya virus (CHIKV), which is transmitted through the bite of infected female hematophagous mosquitoes of the genus Aedes (Diptera: Culicidae). In the Americas, the first autochthonous cases of the disease were recorded in 2013. A year later, in 2014, the first records of the disease were acquired locally in Brazil, in the states of Bahia and Amapá. The present study aimed to carry out a systematic review of the literature on the prevalence and epidemiological aspects of Chikungunya fever in states of the Northeast region of Brazil, between the years 2018 to 2022. This study was registered in the Open Science Framework (OSF) and in the International Prospective Register of Systemactic Reviews (PROSPERO) and followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The searches were carried out in the scientific electronic databases Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), U. S. National Library of Medicine (PubMed) and Scientific Electronic Library Online (SciELO), using descriptors cataloged in Descritores em Ciências da Saúde (DeCS) and Medical Subject Headings (MeSH) in Portuguese, English and Spanish. Gray literature was also searched by accessing Google Scholar to search for additional publications not captured in the selected electronic databases. Of the 19 studies included in the present systematic review, seven referred to the state of Ceará. Most cases of Chikungunya fever corresponded to the female gender (ranging from 7.5% to 100.0%), to the age group younger than 60 years (84.2%), to literate individuals (93.3%), belonging to the non-white race/color (95.21%) and blacks (100.0%), and residents of the urban area (range from 51.95% to 100.0%). As for laboratory characteristics, most notifications were diagnosed using clinical-epidemiological criteria (ranging from 71.21% to 90.35%). The epidemiological information about Chikungunya fever in the Northeast region of Brazil presented in this systematic review is useful to better understand the characteristics of the disease introduction process in the country. To this end, prevention and control strategies must be adopted, especially in the Northeast, as this region is most responsible for the number of cases of the disease in the country.

Occurrence of human visceral leishmaniasis in the Central-West region of Brazil: A systematic review.

Since the first case of visceral leishmaniasis (VL) recorded in Brazil, in 1913, referring to a patient from Boa Esperança, state of Mato Grosso, Central-West region, epidemics have been observed, with intensified expansion and urbanization from 1980. For a better understanding of the factors associated with VL in the Brazilian Central-West region, the present study aimed to carry out a systematic review on aspects related to the occurrence of VL in this region, which includes the states of Goiás, Mato Grosso, Mato Grosso do Sul and the Distrito Federal. Three thousand and nineteen studies were evaluated, of which twenty published between the years of 2002 and 2020 were included in this systematic review. In the states of Central-West region, it was possible to verify the occurrence of VL related to epidemiological characteristics that included: climatic variables (temperature and precipitation); socioeconomic factors (male gender; age group from zero to 14 years old; deaths from 40 years old, with emphasis from the 60 years and residents of the urban area); urban infrastructure vulnerability indicators (areas with environmental degradation, occupied by low-income population, with precarious hygienic-sanitary conditions; anthropic disturbances and population agglomerations; densely vegetated and vacant lots containing rubble and material decaying organic matter); presence of the vector (Lutzomyia longipalpis and Lu. cruzi), dogs and other animals; in addition to the migratory process. Studies related to regional aspects of VL epidemiology can help in the adoption of strategies for better effectiveness in its control.