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A tale of two neglected tropical infections: using GIS to assess the spatial and temporal overlap of schistosomiasis and leprosy in a region of Minas Gerais, Brazil.

Phillips, David Alexander; Ferreira, José Antonio; Ansah, Deidra; Teixeira, Herica Sa; Kitron, Uriel; Filippis, Thelma de; Alcântara, Marcelo H de; Fairley, Jessica K.
Mem Inst Oswaldo Cruz; 112(4): 275-280, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28327791

BACKGROUND:

Despite public health efforts to reduce the global burden of leprosy, gaps remain in the knowledge surrounding transmission of infection. Helminth co-infections have been associated with a shift towards the lepromatous end of the disease spectrum, potentially increasing transmission in co-endemic areas.

OBJECTIVES:

Using this biologically plausible association, we conducted a geographic information systems (GIS) study to investigate the spatial associations of schistosomiasis and leprosy in an endemic area of Minas Gerais (MG), Brazil.

METHODS:

Data on new cases of Mycobacterium leprae and Schistosoma mansoni infections from 2007-2014 were retrieved from the Brazilian national notifiable diseases information system for seven municipalities in and surrounding Vespasiano, MG. A total of 139 cases of leprosy and 200 cases of schistosomiasis were mapped to a municipality level. For one municipality, cases were mapped to a neighborhood level and a stratified analysis was conducted to identify spatial associations.

FINDINGS:

A relative risk of 6.80 [95% confidence interval (CI) 1.46 - 31.64] of leprosy was found in neighborhoods with schistosomiasis. Incidence rates of leprosy increased with corresponding incidence rates of schistosomiasis, and the temporal trends of both infections were similar.

CONCLUSIONS:

The associations found in this project support the hypothesis that helminth infections may influence the transmission of leprosy in co-endemic areas.
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