Magnitude da coinfecção leishmaniose visceral e HIV e determinantes sociais da saúde na região nordeste do Brasil: uma modelagem espaço-temporal retrospectiva (2010-2018)
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFS |
Texto Completo: | https://ri.ufs.br/jspui/handle/riufs/14568 |
Resumo: | Visceral leishmaniasis (VL) is a neglected tropical disease, endemic in Brazil, mainly in the Northeast region, where approximately 50% of cases has been reported. Individuals immunocompromised with the human immunodeficiency virus and or acquired immunodeficiency syndrome (HIV/AIDS) are more susceptible to the VL infection. In addition, patients co-infected with LV-HIV do not respond satisfactorily to the treatment and it significantly raises the chances of recurrences and deaths. The geographical overlap of VL and HIV contributed to an increase in the number of co-infected in the Northeast region, whose epidemiological scenario is influenced by the social determinants of health (SDH), as it is a region with important socioeconomic disparities. Therefore, the objective of this study was to analyze the spatiotemporal distribution patterns and the social determinants of health associated with VL-HIV co-infection in the Northeast region of Brazil. We conducted an ecological and time-series study using spatial analysis techniques and included all confirmed cases of VL-HIV in 1,794 municipalities from the Northeast region, between 2010 and 2018. Data were obtained from the Health Information System of Notification (SINAN). Time trends were analyzed using segmented linear regression models. The inferences of spatial statistics were performed through local empirical Bayesian analysis, Moran's global and local indexes. Additionally, we used the spatiotemporal scanning statistic to identify high-risk spatiotemporal clusters for VL-HIV, and the spatial models (simultaneous autoregressive regression - SAR and conditional autoregressive regression - CAR) to select variables associated with the occurrence of VL-HIV. We identified a total of 1,550 cases of VL-HIV in the Northeast. Interestingly, coinfection was more prevalent among men (83%), in aged 20-59 years (54.8%), inf non-white skin color (91.74 %), in low education level group (35.48%) and in residents from urban areas (80.19%). We observed increasing time trends in the VL-HIV detection rate in the state of Maranhão, and high-risk clusters were also detected in the states of Maranhão and Piauí. The annual incidence in these states was 1.3/100,000, in the period between 2014 and 2017 (Relative Risk-RR = 6.34). Considering the SDH, we observed significative correlation with the co-infection among precarious housing (C=0,62; E=0,07; p<0,001), low income (C= 0,67; E=0,09; p<0,01) and low educational level (C= 0,70; E= 0,10; p<0,02). Taken together, our data demonstrate that the VL-HIV co-infection is increasing in the Northeast of Brazil, and is, therefore, an important problem for the public health, since both diseases have raised in number of cases in the same region and mainly affect the poorest population. VL-HIV presents itself in a dispersed way in the Northeast and reaches states in conditions of social vulnerability more frequently, so it is necessary to reinforce the importance of implementing specific surveillance strategies, especially in high-risk areas, which can contribute to the reduction of cases in these populations. |
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Reis, Erica Santos dosMoura, Tatiana Rodrigues de2021-09-06T11:46:18Z2021-09-06T11:46:18Z2021-02-11REIS, Erica Santos dos. Magnitude da coinfecção leishmaniose visceral e HIV e determinantes sociais da saúde na região Nordeste do Brasil: uma modelagem espaço-temporal retrospectiva (2010-2018). 2021. 86 f. Dissertação (Mestrado em Biologia Parasitária) – Universidade Federal de Sergipe, São Cristóvão, SE, 2021.https://ri.ufs.br/jspui/handle/riufs/14568Visceral leishmaniasis (VL) is a neglected tropical disease, endemic in Brazil, mainly in the Northeast region, where approximately 50% of cases has been reported. Individuals immunocompromised with the human immunodeficiency virus and or acquired immunodeficiency syndrome (HIV/AIDS) are more susceptible to the VL infection. In addition, patients co-infected with LV-HIV do not respond satisfactorily to the treatment and it significantly raises the chances of recurrences and deaths. The geographical overlap of VL and HIV contributed to an increase in the number of co-infected in the Northeast region, whose epidemiological scenario is influenced by the social determinants of health (SDH), as it is a region with important socioeconomic disparities. Therefore, the objective of this study was to analyze the spatiotemporal distribution patterns and the social determinants of health associated with VL-HIV co-infection in the Northeast region of Brazil. We conducted an ecological and time-series study using spatial analysis techniques and included all confirmed cases of VL-HIV in 1,794 municipalities from the Northeast region, between 2010 and 2018. Data were obtained from the Health Information System of Notification (SINAN). Time trends were analyzed using segmented linear regression models. The inferences of spatial statistics were performed through local empirical Bayesian analysis, Moran's global and local indexes. Additionally, we used the spatiotemporal scanning statistic to identify high-risk spatiotemporal clusters for VL-HIV, and the spatial models (simultaneous autoregressive regression - SAR and conditional autoregressive regression - CAR) to select variables associated with the occurrence of VL-HIV. We identified a total of 1,550 cases of VL-HIV in the Northeast. Interestingly, coinfection was more prevalent among men (83%), in aged 20-59 years (54.8%), inf non-white skin color (91.74 %), in low education level group (35.48%) and in residents from urban areas (80.19%). We observed increasing time trends in the VL-HIV detection rate in the state of Maranhão, and high-risk clusters were also detected in the states of Maranhão and Piauí. The annual incidence in these states was 1.3/100,000, in the period between 2014 and 2017 (Relative Risk-RR = 6.34). Considering the SDH, we observed significative correlation with the co-infection among precarious housing (C=0,62; E=0,07; p<0,001), low income (C= 0,67; E=0,09; p<0,01) and low educational level (C= 0,70; E= 0,10; p<0,02). Taken together, our data demonstrate that the VL-HIV co-infection is increasing in the Northeast of Brazil, and is, therefore, an important problem for the public health, since both diseases have raised in number of cases in the same region and mainly affect the poorest population. VL-HIV presents itself in a dispersed way in the Northeast and reaches states in conditions of social vulnerability more frequently, so it is necessary to reinforce the importance of implementing specific surveillance strategies, especially in high-risk areas, which can contribute to the reduction of cases in these populations.A leishmaniose visceral (LV) é uma doença tropical negligenciada, endêmica no Brasil, principalmente na região Nordeste, onde ocorrem aproximadamente 50% dos casos. Indivíduos imunocomprometidos com o vírus da imunodeficiência humana e ou síndrome da imunodeficiência adquirida (HIV/AIDS) se tornam mais suscetíveis à doença. Adicionalmente, pacientes coinfectados com LV-HIV não respondem satisfatoriamente ao tratamento e as chances de recidivas e óbitos aumentam significativamente. A sobreposição geográfica de LV e HIV contribuiu com aumento no número de coinfectados na região Nordeste, cujo cenário epidemiológico é influenciado pelos determinantes sociais de saúde (DSS), pois se trata de uma região com importantes disparidades socioeconômicas. Destarte, o objetivo deste trabalho foi analisar os padrões de distribuição espaço-temporal e os determinantes sociais da saúde associados à coinfecção LV-HIV no Nordeste brasileiro. Trata-se de um estudo ecológico e de série temporal que utilizou técnicas de análise espacial e incluiu todos os casos confirmados de LV-HIV nos 1.794 municípios do Nordeste, no período de 2010 a 2018. Os dados foram obtidos do Sistema de Informação de Agravos de Notificação (SINAN). As tendências temporais foram analisadas através de modelos de regressão linear segmentada. As inferências da estatística espacial foram realizadas através da análise bayesiana empírica local, dos índices global e local de Moran. A estatística de varredura espaço-temporal foi utilizada para identificar aglomerados espaço-temporais de alto risco para a LV-HIV, os modelos espaciais (simultaneous autoregressive regression – SAR e conditional autoregressive regression – CAR) foram utilizados para selecionar variáveis associadas à ocorrência de LV-HIV. O total de 1.550 casos de LV-HIV foram confirmados no Nordeste, sendo mais prevalente entre os homens (83%), na faixa etária de 20-59 anos (54,8%), de cor de pele não branca (91,74%), de baixa escolaridade (35,48%) e residentes de zona urbana (80,19%). Tendência temporal crescente da taxa de detecção LV HIV foi observada no Maranhão e aglomerados de alto risco também foram detectados nesse mesmo estado e no Piauí. A incidência anual nesses estados no período 2014-2017 foi de 1,3/100.000 e o Risco Relativo (RR) = 6,34. Entre os DSS, os que mais se correlacionam com a ocorrência da coinfecção são: moradia precária (C=0,62; E=0,07; p<0,001), baixa renda (C= 0,67; E=0,09; p<0,01) e pouca escolaridade (C= 0,70; E= 0,10; p<0,02). A coinfecção da LV-HIV é um problema crescente e importante para saúde publica, visto que ambas as infecções têm aumentado em número de casos na mesma região e acomete principalmente a população mais pobre. A LV-HIV se apresenta de maneira dispersa no Nordeste e atinge com maior frequência os estados em condição de vulnerabilidade social, desse modo é necessário reforçar a importância de implementar estratégias específicas de vigilância, sobretudo nas regiões de alto risco, que possam contribuir com a redução de casos nestas populações.Fundação de Apoio a Pesquisa e à Inovação Tecnológica do Estado de Sergipe - FAPITEC/SESão Cristóvão, SEporLeishmaniose visceralHIV (Vírus)EpidemiologiaCoinfecçãoAnálise espacial (Estatística)Determinantes sociais de saúde (DSS)CoinfecçãoSpatial analysisEpidemiologySocial determinants of health (SDH)Visceral leishmaniasisCoinfectionCIENCIAS BIOLOGICAS::PARASITOLOGIAMagnitude da coinfecção leishmaniose visceral e HIV e determinantes sociais da saúde na região nordeste do Brasil: uma modelagem espaço-temporal retrospectiva (2010-2018)Magnitude of visceral leishmaniasis and HIV coinfection and association with social determinants of health in the Northeast region of Brazil: a retrospective spatiotemporal modeling (2010-2018)info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisPós-Graduação em Biologia ParasitáriaUniversidade Federal de Sergipereponame:Repositório Institucional da UFSinstname:Universidade Federal de Sergipe (UFS)instacron:UFSinfo:eu-repo/semantics/openAccessLICENSElicense.txtlicense.txttext/plain; charset=utf-81475https://ri.ufs.br/jspui/bitstream/riufs/14568/1/license.txt098cbbf65c2c15e1fb2e49c5d306a44cMD51ORIGINALERICA_SANTOS_REIS.pdfERICA_SANTOS_REIS.pdfapplication/pdf2387089https://ri.ufs.br/jspui/bitstream/riufs/14568/2/ERICA_SANTOS_REIS.pdf473212dc6a0163b5169678fa57a4a188MD52TEXTERICA_SANTOS_REIS.pdf.txtERICA_SANTOS_REIS.pdf.txtExtracted texttext/plain191650https://ri.ufs.br/jspui/bitstream/riufs/14568/3/ERICA_SANTOS_REIS.pdf.txt732b8421cfb582fd42bc1bdfcd263264MD53THUMBNAILERICA_SANTOS_REIS.pdf.jpgERICA_SANTOS_REIS.pdf.jpgGenerated Thumbnailimage/jpeg1267https://ri.ufs.br/jspui/bitstream/riufs/14568/4/ERICA_SANTOS_REIS.pdf.jpg22525861a41db22a455ed2c69d21358fMD54riufs/145682021-09-06 08:46:18.848oai:ufs.br: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Repositório InstitucionalPUBhttps://ri.ufs.br/oai/requestrepositorio@academico.ufs.bropendoar:2021-09-06T11:46:18Repositório Institucional da UFS - Universidade Federal de Sergipe (UFS)false |
dc.title.pt_BR.fl_str_mv |
Magnitude da coinfecção leishmaniose visceral e HIV e determinantes sociais da saúde na região nordeste do Brasil: uma modelagem espaço-temporal retrospectiva (2010-2018) |
dc.title.alternative.eng.fl_str_mv |
Magnitude of visceral leishmaniasis and HIV coinfection and association with social determinants of health in the Northeast region of Brazil: a retrospective spatiotemporal modeling (2010-2018) |
title |
Magnitude da coinfecção leishmaniose visceral e HIV e determinantes sociais da saúde na região nordeste do Brasil: uma modelagem espaço-temporal retrospectiva (2010-2018) |
spellingShingle |
Magnitude da coinfecção leishmaniose visceral e HIV e determinantes sociais da saúde na região nordeste do Brasil: uma modelagem espaço-temporal retrospectiva (2010-2018) Reis, Erica Santos dos Leishmaniose visceral HIV (Vírus) Epidemiologia Coinfecção Análise espacial (Estatística) Determinantes sociais de saúde (DSS) Coinfecção Spatial analysis Epidemiology Social determinants of health (SDH) Visceral leishmaniasis Coinfection CIENCIAS BIOLOGICAS::PARASITOLOGIA |
title_short |
Magnitude da coinfecção leishmaniose visceral e HIV e determinantes sociais da saúde na região nordeste do Brasil: uma modelagem espaço-temporal retrospectiva (2010-2018) |
title_full |
Magnitude da coinfecção leishmaniose visceral e HIV e determinantes sociais da saúde na região nordeste do Brasil: uma modelagem espaço-temporal retrospectiva (2010-2018) |
title_fullStr |
Magnitude da coinfecção leishmaniose visceral e HIV e determinantes sociais da saúde na região nordeste do Brasil: uma modelagem espaço-temporal retrospectiva (2010-2018) |
title_full_unstemmed |
Magnitude da coinfecção leishmaniose visceral e HIV e determinantes sociais da saúde na região nordeste do Brasil: uma modelagem espaço-temporal retrospectiva (2010-2018) |
title_sort |
Magnitude da coinfecção leishmaniose visceral e HIV e determinantes sociais da saúde na região nordeste do Brasil: uma modelagem espaço-temporal retrospectiva (2010-2018) |
author |
Reis, Erica Santos dos |
author_facet |
Reis, Erica Santos dos |
author_role |
author |
dc.contributor.author.fl_str_mv |
Reis, Erica Santos dos |
dc.contributor.advisor1.fl_str_mv |
Moura, Tatiana Rodrigues de |
contributor_str_mv |
Moura, Tatiana Rodrigues de |
dc.subject.por.fl_str_mv |
Leishmaniose visceral HIV (Vírus) Epidemiologia Coinfecção Análise espacial (Estatística) Determinantes sociais de saúde (DSS) Coinfecção |
topic |
Leishmaniose visceral HIV (Vírus) Epidemiologia Coinfecção Análise espacial (Estatística) Determinantes sociais de saúde (DSS) Coinfecção Spatial analysis Epidemiology Social determinants of health (SDH) Visceral leishmaniasis Coinfection CIENCIAS BIOLOGICAS::PARASITOLOGIA |
dc.subject.eng.fl_str_mv |
Spatial analysis Epidemiology Social determinants of health (SDH) Visceral leishmaniasis Coinfection |
dc.subject.cnpq.fl_str_mv |
CIENCIAS BIOLOGICAS::PARASITOLOGIA |
description |
Visceral leishmaniasis (VL) is a neglected tropical disease, endemic in Brazil, mainly in the Northeast region, where approximately 50% of cases has been reported. Individuals immunocompromised with the human immunodeficiency virus and or acquired immunodeficiency syndrome (HIV/AIDS) are more susceptible to the VL infection. In addition, patients co-infected with LV-HIV do not respond satisfactorily to the treatment and it significantly raises the chances of recurrences and deaths. The geographical overlap of VL and HIV contributed to an increase in the number of co-infected in the Northeast region, whose epidemiological scenario is influenced by the social determinants of health (SDH), as it is a region with important socioeconomic disparities. Therefore, the objective of this study was to analyze the spatiotemporal distribution patterns and the social determinants of health associated with VL-HIV co-infection in the Northeast region of Brazil. We conducted an ecological and time-series study using spatial analysis techniques and included all confirmed cases of VL-HIV in 1,794 municipalities from the Northeast region, between 2010 and 2018. Data were obtained from the Health Information System of Notification (SINAN). Time trends were analyzed using segmented linear regression models. The inferences of spatial statistics were performed through local empirical Bayesian analysis, Moran's global and local indexes. Additionally, we used the spatiotemporal scanning statistic to identify high-risk spatiotemporal clusters for VL-HIV, and the spatial models (simultaneous autoregressive regression - SAR and conditional autoregressive regression - CAR) to select variables associated with the occurrence of VL-HIV. We identified a total of 1,550 cases of VL-HIV in the Northeast. Interestingly, coinfection was more prevalent among men (83%), in aged 20-59 years (54.8%), inf non-white skin color (91.74 %), in low education level group (35.48%) and in residents from urban areas (80.19%). We observed increasing time trends in the VL-HIV detection rate in the state of Maranhão, and high-risk clusters were also detected in the states of Maranhão and Piauí. The annual incidence in these states was 1.3/100,000, in the period between 2014 and 2017 (Relative Risk-RR = 6.34). Considering the SDH, we observed significative correlation with the co-infection among precarious housing (C=0,62; E=0,07; p<0,001), low income (C= 0,67; E=0,09; p<0,01) and low educational level (C= 0,70; E= 0,10; p<0,02). Taken together, our data demonstrate that the VL-HIV co-infection is increasing in the Northeast of Brazil, and is, therefore, an important problem for the public health, since both diseases have raised in number of cases in the same region and mainly affect the poorest population. VL-HIV presents itself in a dispersed way in the Northeast and reaches states in conditions of social vulnerability more frequently, so it is necessary to reinforce the importance of implementing specific surveillance strategies, especially in high-risk areas, which can contribute to the reduction of cases in these populations. |
publishDate |
2021 |
dc.date.accessioned.fl_str_mv |
2021-09-06T11:46:18Z |
dc.date.available.fl_str_mv |
2021-09-06T11:46:18Z |
dc.date.issued.fl_str_mv |
2021-02-11 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/masterThesis |
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masterThesis |
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dc.identifier.citation.fl_str_mv |
REIS, Erica Santos dos. Magnitude da coinfecção leishmaniose visceral e HIV e determinantes sociais da saúde na região Nordeste do Brasil: uma modelagem espaço-temporal retrospectiva (2010-2018). 2021. 86 f. Dissertação (Mestrado em Biologia Parasitária) – Universidade Federal de Sergipe, São Cristóvão, SE, 2021. |
dc.identifier.uri.fl_str_mv |
https://ri.ufs.br/jspui/handle/riufs/14568 |
identifier_str_mv |
REIS, Erica Santos dos. Magnitude da coinfecção leishmaniose visceral e HIV e determinantes sociais da saúde na região Nordeste do Brasil: uma modelagem espaço-temporal retrospectiva (2010-2018). 2021. 86 f. Dissertação (Mestrado em Biologia Parasitária) – Universidade Federal de Sergipe, São Cristóvão, SE, 2021. |
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https://ri.ufs.br/jspui/handle/riufs/14568 |
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