Inequalities of visceral leishmaniasis case-fatality in Brazil: A multilevel modeling considering space, time, individual and contextual factors

Detalhes bibliográficos
Autor(a) principal: Cota, Gláucia Fernandes
Data de Publicação: 2021
Outros Autores: Erber, Astrid Christine, Schernhammer, Eva, Simões, Taynãna Cesar
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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spelling 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
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Public Library of Science
publisher.none.fl_str_mv Public Library of Science
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv https://www.arca.fiocruz.br/bitstream/icict/51660/1/license.txt
https://www.arca.fiocruz.br/bitstream/icict/51660/2/Inequalities%20of%20visceral%20leishmaniasis%20case-fatality%20in%20Brazil.pdf
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repository.name.fl_str_mv Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)
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