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- Title
Magnitude of visceral leishmaniasis and HIV coinfection and association with social determinants of health in the Northeast region of Brazil: a retrospective, spatiotemporal model (2010–2018).
- Authors
dos Reis, Erica Santos; Ribeiro, Caíque Jordan Nunes; dos Santos, Allan Dantas; da Conceição Araújo, Damião; Bezerra-Santos, Márcio; da Silva, Eliete Rodrigues; Santos, Rogério Silva; Paz, Wandklebson Silva; Ramos, Rosália Elen Santos; dos Santos, Priscila Lima; Lipscomb, Michael Wheeler; de Araújo, Karina Conceição Gomes M.; de Moura, Tatiana Rodrigues
- Abstract
The Northeast region of Brazil (NRB) includes the states with the highest prevalence of visceral leishmaniasis (VL), as well as those with significant increases in HIV cases. This study aims to analyze the spatiotemporal patterns of VL-HIV coinfection and its association with the social determinants of health (SDH) in the NRB. Time trend analysis and Bayesian spatial statistical inferences, Moran's autocorrelation, and retrospective space–time scanning were performed. Spatial regression modelling was used to build an explanatory model for the occurrence of VL-HIV coinfection within NRB. A total of 1550 cases of VL-HIV coinfection were confirmed. We observed a higher prevalence among males (1232; 83%), individuals aged from 20 to 59 years (850; 54.8%), non-white skin color (1,422; 91.7%), and with low education (550; 35.48%). NRB showed an increasing and significant trend in the detection rate of coinfection (APC, 5.3; 95% CI, 1.4 to 9.4). The states of Maranhão and Piauí comprised the high-risk cluster. The SDH that most correlated with the occurrence of coinfection were poor housing, low income, and low education. VL-HIV is dispersed in the NRB but chiefly affects states with greater social vulnerability. Taken together, these findings reinforce the necessity to implement surveillance strategies that will contribute to the reduction of cases in these populations.
- Subjects
BRAZIL; MARANHAO (Brazil); VISCERAL leishmaniasis; LEISHMANIASIS; SOCIAL determinants of health; MIXED infections; LOW-income housing; HIV; HUMAN skin color; INFERENTIAL statistics
- Publication
Parasitology Research, 2022, Vol 121, Issue 3, p1021
- ISSN
0932-0113
- Publication type
Article
- DOI
10.1007/s00436-022-07450-6