Temporal and spatial analysis of visceral leishmaniasis in Brazil, by age group and sex: an ecological study, 2013–2022

Abstract

Objective: The aim of the study was to analyze the temporal trend and spatial distribution of the incidence rate of visceral leishmaniasis by age and sex across Brazilian states, macro-regions, and nationally, from 2013 to 2022. Methods: Ecological study with temporal and spatial analyses of cases recorded in Brazil’s national disease notification system, using Prais-Winsten regression and global and local Moran indices. Results: A total of 31,453 visceral leishmaniasis cases were recorded in Brazil in the period (mean incidence of 1.68 per 100,000). A statistically significant decreasing trend was observed in Brazil (annual percent change [APC]: -3.25, 95% confidence interval [95%CI] -5.65; -0.79), particularly among women (APC -4.12, 95%CI -6.68; -1.49) and children and adolescents (APC -5.17; 95%CI -8.59; -1.62). An increase was observed among women in Santa Catarina (APC 9.03; 95%CI 6.49; 11.64), in adults in Rio Grande do Sul (APC 7.39; 95%CI 3.47; 11.45) and Santa Catarina (APC 6.48; 95%CI 1.89; 11.27) and in older adults in Paraíba (APC 2.13; 95%CI 0.46; 3.84). Spatial analysis revealed high-risk municipality clusters in the Northeast, North, Midwest, and Southeast, with the highest incidence rate in children and adolescents. Conclusions: demographic factors such as age range (especially children and adolescents) and sex were associated with a high risk of visceral leishmaniasis, indicating a need for targeted control measures in Brazil.