ANÁLISE DA DISTRIBUIÇÃO ESPACIAL DA LEISHMANIOSE TEGUMENTAR AMERICANA NO MARANHÃO

Abstract

American Cutaneous Leishmaniasis (ACL) is a prevalent disease in Brazil, especially in the state of Maranhão. This disease is caused by protozoa transmitted by vectors of the order Diptera and results in skin and mucous membrane lesions. The increase in the incidence of ACL and the emergence of urban outbreaks constitute a challenge to public health in the country. In order to address this challenge, two studies were conducted in the state of Maranhão, resulting in two manuscripts. The first manuscript consisted of a scoping review, whose objective was to evaluate preexisting epidemiological studies and identify deficiencies that require progress. This analysis revealed the lack of studies on the risk factors associated with ACL in the state, as well as the insufficiency of geographic analyses aimed at understanding the dynamics of the disease and its relationship with the environment in endemic areas. The epidemiological profile of ACL indicated that most of those affected belong to the age group of 20 to 39 years, being predominantly male, of mixed ethnicity, and whose main occupation is agriculture. Therefore, it is imperative to conduct analytical research on risk factors and geographic analyses in order to gain an understanding of ATL in Maranhão. The second manuscript aimed to understand the situation of ATL in the region during the period from 2017 to 2022, addressing the geographic distribution and characteristics of the cases. The methods employed involved the collection of sociodemographic and clinical-epidemiological data, the creation of maps for spatial visualization, the calculation of incidence, the analysis of temporal trends and the application of the Moran Index to investigate spatial correlations. During the study period, 8,212 cases of American Cutaneous Leishmaniasis (ACL) were identified, with an incidence of 19.12 cases per 100,000 inhabitants. Most of the affected individuals were men aged between 20 and 39 years, of mixed race and with a low level of education, with skin lesions being the most common manifestation. Clinical and laboratory diagnosis prevailed, most cases were locally acquired and resulted in cure. Santa Inês showed the greatest increase in incidence (24.59 per 10,000 inhabitants), while Tufilândia recorded the lowest incidence (0.66 per 10,000 inhabitants). The maps demonstrated the change in geographic distribution, mainly in the east of the state in 2021 and 2022. We conclude that studies related to ecoepidemiology and spatial modeling are essential for understanding the geographic and environmental influences on the expansion of the disease.