Spaces of production of cutaneous leishmaniasis in the state of Rio de Janeiro, Brazil

Abstract The scope of this research was to identify and characterize spatial units of epidemiological relevance in the state of Rio de Janeiro, through the highest concentrations of cutaneous leishmaniasis (CL) from 1980 to 2012, considering the geographical aspects. SUCAM, FUNASA and SINAN databases were consulted. A method of adjustment of spatially referenced data for demarcation of the regions with the highest concentrations of cases called circuits and poles was applied. These were superimposed on the socioenvironmental indicator maps. Of the total cases registered in the period, 87% occurred in the municipalities located in the resulting circuits and poles. The variations in the occurrence of cases in the different circuits and poles were not related to the socioenvironmental indicators. The identification of the circuits and poles can subsidize the state CL program of the prioritization of strategies of prevention and control actions and the optimization of the resources of the program. These regions, which are more stable than the localities, allow surveillance and control operations in locations with many cases and in other locations in the identified risk area, because they have the same characteristics as those already affected.

摘要：本研究旨在结合地理特征，依托1980年至2012年巴西里约热内卢州皮肤利什曼病（cutaneous leishmaniasis, CL）的最高发病聚集情况，识别并表征该州内具有流行病学意义的空间单元。本研究查阅了SUCAM、FUNASA及SINAN数据库，采用空间参考数据校正方法，对以“聚集循环圈（circuits）”与“发病极点（poles）”命名的高发病聚集区域进行划定，并将上述区域叠加至社会环境指标地图开展分析。研究期内登记的全部病例中，87%均分布于上述聚集循环圈与发病极点覆盖的市镇范围内。不同聚集循环圈与发病极点间的病例发病差异，与社会环境指标并无关联。上述聚集循环圈与发病极点的识别结果，可为里约热内卢州皮肤利什曼病防控项目提供防控策略优先级排序依据，助力优化项目资源配置。相较于零散行政区域，上述区域特征更为稳定，可针对病例高发区域及已划定风险区内的其他点位开展监测与防控工作，因其与已受影响区域具有相同的流行特征。