economic costs and spatial distribution analysis in an Endemic Northeastern City, Brazil

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Spatial distribution of leprosy in India: an ecological study

CITATION: Grantz, Kyra H., et al. 2018. Spatial distribution of leprosy in India : an ecological study. Infectious Diseases of Poverty, 7:20, doi:10.1186/s40249-018-0402-y.The original publication is available at https://idpjournal.biomedcentral.comBackground: As leprosy elimination becomes an increasingly realistic goal, it is essential to determine the factors that contribute to its persistence. We evaluate social and economic factors as predictors of leprosy annual new case detection rates within India, where the majority of leprosy cases occur. Methods: We used correlation and linear mixed effect regressions to assess whether poverty, illiteracy, nighttime satellite radiance (an index of development), and other covariates can explain district-wise annual new case detection rate and Grade 2 disability diagnoses. Results: We find only weak evidence of an association between poverty and annual new case detection rates at the district level, though illiteracy and satellite radiance are statistically significant predictors of leprosy at the district level. We find no evidence of rapid decline over the period 2008–2015 in either new case detection or new Grade 2 disability. Conclusions: Our findings suggest a somewhat higher rate of leprosy detection, on average, in poorer districts; the overall effect is weak. The divide between leprosy case detection and true incidence of clinical leprosy complicates these results, particularly given that the detection rate is likely disproportionately lower in impoverished settings. Additional information is needed to distinguish the determinants of leprosy case detection and transmission during the elimination epoch.https://idpjournal.biomedcentral.com/articles/10.1186/s40249-018-0402-yPublisher's versio

Estudo da infecção e morbidade da doença de Chagas no município de João Costa: Parque Nacional Serra da Capivara, Piauí, Brasil Study of the infection and morbidity of Chagas' disease in municipality of João Costa: National Park Serra da Capivara, Piauí, Brazil

Com o objetivo de investigar aspectos da infecção e morbidade da doença de Chagas no município de João Costa, Piauí, Brasil, realizamos pesquisa sorológica para detectar Ig G anti-T. cruzi em 2.080 moradores através dos testes de imunofluorescência indireta, hemaglutinação indireta e ELISA. Em seguida, 189 pacientes soropositivos e 141 soronegativos foram avaliados pelo exame clínico e eletrocardiograma (ECG), enquanto a parasitemia foi pesquisada em 106 chagásicos pelo xenodiagnóstico indireto e teste da reação polimerásica em cadeia (PCR). A soropositividade total para Ig G anti-T.cruzi foi de 9,8%, com variação de 0,5% em menores de 10 anos a 39,4% em maiores de 59 anos, independentemente do sexo. O percentual de ECG alterados foi de 41,3% entre os chagásicos e de 15,6% entre os não-chagásicos (p < 0,05). A positividade do teste da PCR foi de 74,5% e a do xenodiagnóstico de 15,1% (p < 0,05). Apesar da elevada prevalência da infecção na população investigada, o baixo valor nos menores de 10 anos pode ser indicador de redução da transmissão por triatomíneos. A alta proporção de participação do componente etiológico exclusivamente chagásico na prevalência da cardiopatia indica a gravidade da doença de Chagas na região estudada.<br>In order to investigate aspects of the infection and morbidity of Chagas' disease in the municipality of João Costa, Piauí State, Brazil, we carried out a serological survey to detect anti-Trypanosoma cruzi antibodies in 2,080 individuals, by indirect immunofluorescence, indirect hemagglutination and ELISA. A total of 189 seropositive and 141 seronegative patients were evaluated by anamnesis, physical exam and electrocardiogram (EKG). The parasitaemia of 106 chagasic patients was evaluated by indirect xenodiagnosis and PCR (polymerase chain reaction). The total seropositivity was 9.8%, with intervals of 0.5% in patients younger than 10 years old, and 39.4% among patients older than 59 years old, independently of the sex. The PCR and xenodiagnosis were positive, respectively in 74.5% and 15.1% of the seropositive patients (p < 0.05). The rate of abnormal EKG was 41.3% in chagasic and 15.6% in non-chagasic patients (p < 0.05). In spite of the high prevalence of infection in the investigated population, the low rate of seropositivity among children is indicative of a possible decrease of the active transmission mediated by triatomines. The high proportion of the chagasic component on the cardiopathy prevalence is indicative of the high morbidity of Chagas' disease in the studied region