Epidemiological and environmental aspects of visceral leishmaniasis in children under 15 years of age between 2007 and 2012 in the city of araguaína, State of Tocantins, Brazil

Abstract

Introduction: Visceral leishmaniasis (VL) stands out as a zoonosis observed on four continents and also in urban expansion zones in several regions of Brazil. Methods: A cross-sectional epidemiological study of VL cases in children under 15 years of age in the period from 2007 to 2012. Clinical data were gathered from medical reports; meteorological data were obtained at the Meteorological Measurement Department of UFT. Environmental variables were divided into two periods, rainy and dry. Results: The study revealed no difference by gender (p=0.67) among the 821 patients. However, the most affected age group was between one and fi ve years of age (58.6%; p<0.01); the highest prevalence of the disease (99.03%; p<0.01) occurred in urban zones; and the most affected ethnic group (85.5%; p<0.01) was mixed race. The highest incidence coeffi cients in this population occurred in 2007 and 2008 (578.39/100,000 inhabitants; 18.5/100,000 inhabitants, respectively), whereas the highest lethality coeffi cients occurred in 2008 and 2011 (0.85/100 deaths). There was no signifi cant correlation between average rainfall and the number of VL cases. The correlation between temperature and number of VL cases was negative (r = -0.4039; p<0.01). Conclusions: In Araguaína, visceral leishmaniasis in children under 15 years is an urban-based endemic disease distributed across all districts of the city wherein temperature as an environmental factor, a higher prevalence in mixed race children between one and fi ve years of age, and a high incidence coeffi cient all strongly contribute to child mortality.