Feline sporotrichosis: social vulnerability and prioritization of geographic areas in Guarulhos, SP, Brazil

Abstract

Over the past two decades, many Brazilian cities have been reporting an increasing incidence and spread of feline sporotrichosis. The disease is neglected, and little is known about the causal processes underlying its epidemic occurrence. This study characterized the spatiotemporal dynamics of feline sporotrichosis in Guarulhos. Moreover, we proposed and tested a causal explanation for its occurrence and zoonotic transmission, giving a key role to social vulnerability. A direct acyclic graph represented the causal explanation, while Bayesian spatial models supported its test as well as the attribution of a risk-based priority index to the census tracts of the city. Between 2011 and 2017, the disease grew exponentially and the spatial spread increased. The model findings showed a dose-response pattern between an index of social vulnerability and the incidence of feline sporotrichosis. This pattern was not strictly monotonic, so some census tracts received a higher priority index than others with higher vulnerability. According to our causal explanation, there will not be effective prevention of feline and zoonotic sporotrichosis as long as social inequities continue imposing precarious livelihoods.