Iraci Duarte de Lima|Ádila Lorena Morais Lima|Carolina de Oliveira Mendes-Aguiar|José F. V. Coutinho|Mary E. Wilson|Richard D. Pearson|José W. Queiroz|Selma M. B. Jerônimo
Changing demographics of visceral leishmaniasis in northeast Brazil: Lessons for the future
Centro Universitário do Rio Grande do Norte|Universidade Federal do Rio Grande do Norte|Centro Universitário do Rio Grande do Norte|Universidade Federal do Rio Grande do Norte|Universidade Federal do Rio Grande do Norte|Centro Universitário do Rio Grande do Norte|Centro Universitário do Rio Grande do Norte|Universidade Federal do Rio Grande do Norte|University of Iowa|University of Virginia|Centro Universitário do Rio Grande do Norte|Universidade Federal do Rio Grande do Norte|Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais|Centro Universitário do Rio Grande do Norte|Universidade Federal do Rio Grande do Norte|Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais
background visceral leishmaniasis vl caused leishmania infantum became disease urban areas brazil last 30 years increase asymptomatic l infantum infection areas methodologyprincipal findings retrospective study human vl performed state rio grande norte brazil period 19902014 data divided fivetime periods vl cases data sex age nutritional status childhood vaccination collected geographic information system tools statistical models used analyze dispersion human vl mean annual incidence vl 46 cases100000 inhabitants total 3252 cases reported lethality rate 64 time annual incidence vl decreased 04 years p00001 59 p 00001 age groups increased ages 2039 p0001 40 years p00001 vl occurred often males 2 25 p00001 decreased incidence vl children associated improved nutritional status childhood immunizations including measles poliomyelitis bcg hepatitis b human vl correlated temporally geographically canine l infantum infection p 0002 r2 0438 rainfall lutzomyia longipalpis density r 0762 overall incidence vl decreased vlaids increased especially 20102014 vl frequently found areas lacked urban infrastructure detected lack garbage collection sewers whereas hiv infection associated higher levels schooling evidence higher socioeconomic status conclusionsignificance demographics vl northeastern brazil changed disease incidence decreased children increased adults associated improvements nutrition socioeconomic status immunization rates concurrent vlaids poses serious challenge future