Inequalities of visceral leishmaniasis case-fatality in Brazil: A multilevel modeling considering space, time, individual and contextual factors
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
Texto Completo: | https://www.arca.fiocruz.br/handle/icict/51660 |
Resumo: | Pesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias. Instituto René Rachou. Fundação Oswaldo Cruz. Belo Horizonte, MG, Brazil. |
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Cota, Gláucia FernandesErber, Astrid ChristineSchernhammer, EvaSimões, Taynãna Cesar2022-03-09T17:11:15Z2022-03-09T17:11:15Z2021COTA,Gláucia Fernandes et al. Inequalities of visceral leishmaniasis case-fatality in Brazil: A multilevel modeling considering space, time, individual and contextual factors. PLoS Negl Trop Dis., v. 15, n. 7, e0009567, 2021. doi: 10.1371/journal.pntd.0009567.1935-2735https://www.arca.fiocruz.br/handle/icict/5166010.1371/journal.pntd.0009567engPublic Library of ScienceInequalities of visceral leishmaniasis case-fatality in Brazil: A multilevel modeling considering space, time, individual and contextual factorsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlePesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias. Instituto René Rachou. Fundação Oswaldo Cruz. Belo Horizonte, MG, Brazil.Department of Epidemiology.Center for Public Health. Medical University of Vienna. Vienna, Austria.Department of Epidemiology.Center for Public Health. Medical University of Vienna. Vienna, Austria.Pesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias. Instituto René Rachou. Fundação Oswaldo Cruz. Belo Horizonte, MG, Brazil.Background: In Brazil, case-fatality from visceral leishmaniasis (VL) is high and characterized by wide differences between the various political-economic units, the federated units (FUs). This study was designed to investigate the association between factors at the both FU and individual levels with the risk of dying from VL, after analysing the temporal trend and the spatial dependency for VL case-fatality. Methodology: The analysis was based on individual and aggregated data of the Reportable Disease Information System-SINAN (Brazilian Ministry of Health). The temporal and spatial distributions of the VL case-fatality between 2007 and 2017 (27 FUs as unit of analysis) were considered together with the individual characteristics and many other variables at the FU level (socioeconomic, demographic, access to health and epidemiological indicators) in a mixed effects models or multilevel modeling, assuming a binomial outcome distribution (death from VL). Findings: A linear increasing temporal tendency (4%/year) for VL case-fatality was observed between 2007 and 2017. There was no similarity between the case-fatality rates of neighboring FUs (non-significant spatial term), although these rates were heterogeneous in this spatial scale of analysis. In addition to the known individual risk factors age, female gender, disease's severity, bacterial co-infection and disease duration, low level schooling and unavailability of emergency beds and health professionals (the last two only in univariate analysis) were identified as possibly related to VL death risk. Lower VL incidence was also associated to VL case-fatality, suggesting that unfamiliarity with the disease may delay appropriate medical management: VL patients with fatal outcome were notified and had VL treatment started 6 and 3 days later, respectively, in relation to VL cured patients. Access to garbage collection, marker of social and economic development, seems to be protective against the risk of dying from VL. Part of the observed VL case-fatality variability in Brazil could not be explained by the studied variables, suggesting that factors linked to the intra FU environment may be involved. Conclusions: This study aimed to identify epidemiological conditions and others related to access to the health system possibly linked to VL case-fatality, pointing out new prognostic determinants subject to intervention.info:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83082https://www.arca.fiocruz.br/bitstream/icict/51660/1/license.txt9193a7c197bc67acd023525e72a03240MD51ORIGINALInequalities of visceral leishmaniasis case-fatality in Brazil.pdfInequalities of visceral leishmaniasis case-fatality in Brazil.pdfapplication/pdf9904852https://www.arca.fiocruz.br/bitstream/icict/51660/2/Inequalities%20of%20visceral%20leishmaniasis%20case-fatality%20in%20Brazil.pdf951e82e1ebc8b1cf09fda228d420548eMD52icict/516602022-03-09 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dc.title.pt_BR.fl_str_mv |
Inequalities of visceral leishmaniasis case-fatality in Brazil: A multilevel modeling considering space, time, individual and contextual factors |
title |
Inequalities of visceral leishmaniasis case-fatality in Brazil: A multilevel modeling considering space, time, individual and contextual factors |
spellingShingle |
Inequalities of visceral leishmaniasis case-fatality in Brazil: A multilevel modeling considering space, time, individual and contextual factors Cota, Gláucia Fernandes |
title_short |
Inequalities of visceral leishmaniasis case-fatality in Brazil: A multilevel modeling considering space, time, individual and contextual factors |
title_full |
Inequalities of visceral leishmaniasis case-fatality in Brazil: A multilevel modeling considering space, time, individual and contextual factors |
title_fullStr |
Inequalities of visceral leishmaniasis case-fatality in Brazil: A multilevel modeling considering space, time, individual and contextual factors |
title_full_unstemmed |
Inequalities of visceral leishmaniasis case-fatality in Brazil: A multilevel modeling considering space, time, individual and contextual factors |
title_sort |
Inequalities of visceral leishmaniasis case-fatality in Brazil: A multilevel modeling considering space, time, individual and contextual factors |
author |
Cota, Gláucia Fernandes |
author_facet |
Cota, Gláucia Fernandes Erber, Astrid Christine Schernhammer, Eva Simões, Taynãna Cesar |
author_role |
author |
author2 |
Erber, Astrid Christine Schernhammer, Eva Simões, Taynãna Cesar |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Cota, Gláucia Fernandes Erber, Astrid Christine Schernhammer, Eva Simões, Taynãna Cesar |
description |
Pesquisa Clínica e Políticas Públicas em Doenças Infecto-Parasitárias. Instituto René Rachou. Fundação Oswaldo Cruz. Belo Horizonte, MG, Brazil. |
publishDate |
2021 |
dc.date.issued.fl_str_mv |
2021 |
dc.date.accessioned.fl_str_mv |
2022-03-09T17:11:15Z |
dc.date.available.fl_str_mv |
2022-03-09T17:11:15Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
COTA,Gláucia Fernandes et al. Inequalities of visceral leishmaniasis case-fatality in Brazil: A multilevel modeling considering space, time, individual and contextual factors. PLoS Negl Trop Dis., v. 15, n. 7, e0009567, 2021. doi: 10.1371/journal.pntd.0009567. |
dc.identifier.uri.fl_str_mv |
https://www.arca.fiocruz.br/handle/icict/51660 |
dc.identifier.issn.pt_BR.fl_str_mv |
1935-2735 |
dc.identifier.doi.none.fl_str_mv |
10.1371/journal.pntd.0009567 |
identifier_str_mv |
COTA,Gláucia Fernandes et al. Inequalities of visceral leishmaniasis case-fatality in Brazil: A multilevel modeling considering space, time, individual and contextual factors. PLoS Negl Trop Dis., v. 15, n. 7, e0009567, 2021. doi: 10.1371/journal.pntd.0009567. 1935-2735 10.1371/journal.pntd.0009567 |
url |
https://www.arca.fiocruz.br/handle/icict/51660 |
dc.language.iso.fl_str_mv |
eng |
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eng |
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info:eu-repo/semantics/openAccess |
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openAccess |
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Public Library of Science |
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Public Library of Science |
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reponame:Repositório Institucional da FIOCRUZ (ARCA) instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
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Fundação Oswaldo Cruz (FIOCRUZ) |
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FIOCRUZ |
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FIOCRUZ |
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