ABSTRACT
INTRODUÇÃO: A leishmaniose tegumentar americana faz parte do grupo de doenças parasit¨¢rias que acometem pele e mucosas, e ¨¦ intimamente relacionada a alterações ambientais, comportamentais humanas e demogr¨¢ficas, sendo um grave problema de sa¨²de p¨²blica no Brasil, comprovadamente em Alagoas.MÉTODOS: Foram calculados e avaliados os indicadores epidemiol¨®gicos do manual de leishmaniose tegumentar americana do Minist¨¦rio da Sa¨²de. Optou-se por uma s¨¦rie hist¨®rica de dez anos, com dados coletados no Departamento de Vigilância Epidemiol¨®gica da Secret¨¢ria Estadual de Sa¨²de de Alagoas.RESULTADOS: Constatou-se a notificação de 1.338 novos casos aut¨®ctones, dos quais 1.097 pacientes tinham idade igual ou maior que 10 anos. Quanto ao sexo, 525 pacientes eram do sexo feminino e 811 do sexo masculino. A forma cutânea foi diagnosticada em 969 pacientes, com pico em 2007, quando foram registrados 98,3 por cento dos casos. Realizaram-se 625 intradermorreações de Montenegro, obtendo, no ano de 2008, um valor m¨¢ximo de 99,1 por cento.CONCLUSÃO: Observou-se em Alagoas um coeficiente de detecção de n¨ªvel m¨¦dio, com predom¨ªnio de homens maiores de 10 anos de idade e com a forma cutânea, apresentando uma tend¨ºncia de diminuição no n¨²mero de casos e aumento da proporção no sexo masculino na faixa de idade maior ou igual a 10 anos e nas lesões cutâneas. O conhecimento desse panorama auxilia as tomadas de decisões em sa¨²de p¨²blica no Estado.
INTRODUCTION: Cutaneous leishmaniasis is a severe public health problem in Brazil, particularly in Alagoas State. It is one of the parasitic diseases that affect skin and mucosae, and is closely related to environmental, behavioral and demographic changes.METHODS: The epidemiological indicators of the manual for surveillance of American integumentary leishmaniasis were calculated and evaluated on a ten-year historical series and their data were collected by the Department of Epidemiological Surveillance of the Alagoas State Secretary of Health.RESULTS: A total of 1,338 new indigenous cases were notified: 1,097 patients were 10 years old or older; 525 patients were female and 811 male. Cutaneous leishmaniasis was diagnosed in 969 patients, with a peak in 2007, when 98.3 per cent of the cases were reported; 625 Montenegro skin tests were performed, with a peak of 99.1 per cent in 2008.CONCLUSIONS: In Alagoas, a medium level detection rate was observed, with a prevalence of the cutaneous type in male patients over 10 years old, and a decreasing trend in the case numbers and an increase in the proportion of males in the age group of ¡Ý 10 years old and in the cutaneous lesions. Knowing this panorama supports decision making processes in the public health field within the state.
Subject(s)
Male , Female , Humans , Leishmaniasis, Mucocutaneous/diagnosis , Brazil , Epidemiological Monitoring , Public HealthABSTRACT
The multiplicity of factors involved in the transmission of the American cutaneous leishmaniasis (ACL) constitutes a challenge to its control. Thus, knowledge of such factors may contribute extremely toward redefining the control strategies. The aim of this study was to identify sociodemographic and environmental factors relating to ACL transmission in the State of Alagoas, Brazil. A case-control study with incident cases was conducted. Diagnostic criteria were the presence of compatible skin lesions, laboratory confirmation, and clinical cure after treatment. Two control groups were matched to cases by sex and age: one comprising neighbors and the other from a community-based draw; controls were individuals with no lesion and a negative Montenegro intradermal reaction. Between July 1, 2004 and February 1, 2007, 98 cases and the same number of controls per group were selected. In the multivariate analysis, for both control groups, ACL was associated with absence of a gas stove and forest less than 200 m away; for neighborhood controls with schooling of 4 years or less, family income greater than one minimum salary, birds inside the home, forest-related leisure activities, and rural work or school activities; and for community controls with non-durable wall material in the house, per capita income greater than US$ 28.31, animals inside the house, and absence of dogs and cats around the house. Specific control measures are recommended for areas with similar characteristics: protection for individuals undertaking forest-related leisure activities; distancing houses from forests by more than 200 m; and elimination of bird or other animal-rearing inside homes. General measures of improved housing and living conditions are also recommended.
