Caracterização epidemiológica e distribuição espaço temporal da Leishmaniose Visceral no Município de Três Lagoas, Estado de Mato Grosso do Sul, 2000 – 2009

Abstract

The Visceral Leishmaniasis (VL) is a relevant disease in the world today, once high percentages of incidence and of lethal occurrences have been registered in different developing countries. In Brazil, VL has spread and become urbanized. In Três Lagoas, Mato Grosso do Sul State, it is greatly disseminated bringing about a situation in which the disease is spreading intensively. Objectives. To undertake a descriptive study of the occurrences of the autochthonous VL cases in the municipality of Três Lagoas at east region of the Mato Grosso do Sul State , between 2000 and 2009, and to recorded the phlebotomine species in the area of transmission. Methods. Secondary data of spatial and temporal distribution and personal characteristics were analyzed from the recorded autochthonous VL cases notified to the epidemiological surveillance service of the Municipality Health Secretary and SINAN. Information about canine visceral leishmaniasis and phlebotomines was obtained from data of examination and elimination of positive dogs and entomological captures, respectively, undertaken by Centro de Controle de Zoonoses. The following indicators were analyzed: percentage of incidence and death cases; the variables: age group, gender, area of residence and also the relationship between human cases and canine cases from 2000 to 2009. Results. The VL presented heterogeneous spatial and temporal distribution with both isolates and clustered cases. There was synchronicity in the occurrence of the disease in others municipalities of Mato Grosso do Sul State, with irregular cyclilality at intervals from two to three years. A total of 424 human cases of VL (388 georeferenced) and 45 deaths were registered. All age groups and both sexes were affected, without any particular profession. It is present in most urban areas and is characterized as a disease of an epidemiologic profile of transmissions urban, once most cases (96.9%) were registered in urban areas. Most of the human cases were registered in 2002 (122) with the highest percentage of incidence (148.74 cases/100,000 inhabitants), when a serious epidemic situation was registered. Out of the 388 human cases of VL included in the analysis of spatial distribution, 46% came from the easthern regional of the city and 33% from the southern regional. There was a positive correlation between human and canine cases (p<0.001) and vector density (p<0.005). The phlebotomine fauna consisted of fourteen species, with L. longipalpis predominating (84.37%) both in the peri and intradomiciliary surrounds. Conclusions. VL presented a close relation with the remaining of vegetation fragments intertwined by inhabited and neighborhoods, the constant migrations and deforesting elapsing of the urban expansion and of the constant clearing of empty lots and green areas, besides the lack of basic infrastructure in the area of sanitation, low socioeconomic conditions, especially in the suburbs, contribute to the maintenance of the transmission cycle of the disease in Três Lagoas.