Cutaneous leishmaniasis in protected environmental areas in the Eastern Amazon: the case of São Félix do Xingu, Pará, Brazil.

INTRODUCTION: Cutaneous Leishmaniasis is a disease transmitted to men and animals by infected female phlebotomine sandflies and is considered a great environmental and public health problem in the Amazon region. Thus, the study aimed to analyze the spatial distribution of this disease in São Félix do Xingu, in the state of Pará, Brazil, and its relationship with epidemiological and environmental variables, in the period from 2012 to 2016. METHODOLOGY: The data used were from the Information System of the Pará State Secretariat of Health, the National Institute for Space Research and the Brazilian Institute of Geography and Statistics. The statistical and spatial analysis of the variables were done using non-parametric chi-square statistical test, kernel interpolation technique and the Bivariate Global Moran Index. RESULTS: The municipality had 183 confirmed cases, non-homogeneously distributed in 5 administrative districts. The individuals most affected were adult males with brown skin, an elementary level of education and rural area residents. In the case series, a direct relationship was observed between the increase of the number of cases and deforestation in the study area. The spatial analysis showed different types of land use and cover related to case clusters in the municipality. Additionally, there was a presence of cases in protected areas and a great epidemiological silence in indigenous lands. CONCLUSIONS: Thus, this disease is a large and complex public health problem in the municipality, related to social and environmental risk factors.

Cutaneous leishmaniasis: Spatial distribution and environmental risk factors in the state of Pará, Brazilian Eastern Amazon.

INTRODUCTION: Cutaneous leishmaniasis is an infectious disease transmitted by phlebotomine sandflies and is considered a great environmental and public health problem. Thus, this work presents initial results of the analyses about the relationship between the spatial distribution of this disease and its environmental risk factors in three municipalities, in the state of Pará, Brazil, from 2012 to 2016. METHODOLOGY: It was used data from the Ministry of Health, the National Institute for Space Research and the Brazilian Institute of Geography and Statistics. The statistical and spacial analysis of the variables were done using G-test goodness-of-fit, kernel interpolation technique and the Bivariate Global Moran Index (I). RESULTS: The analyses showed that the most affected individuals were males, adults, low schooling, residents in rural areas and small farmers. The disease spatial distribution was not homogeneous in the municipalities and it was associated to different relationships between the land use and occupation and the notificated cases density, with direct spatial autocorrelation. CONCLUSIONS: The deforestation was the most significant risk factor linked to the cases occurrence in all the studied area. We emphasize the need of intensification of epidemiological and environmental surveillance actions in the studied areas.