Spatial and spatiotemporal dynamics of visceral leishmaniasis in an endemic North-eastern region of Brazil

Submitted: 5 April 2020
Accepted: 2 July 2020
Published: 11 January 2021
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Visceral Leishmaniasis (VL) is a neglected disease with increasing incidence in Brazil, particularly in the North-eastern. The aim of this study was to analyze the spatial and spatiotemporal dynamics of VL in an endemic region of North-eastern Brazil, between 2009 and 2017. Using spatial analysis techniques, an ecological and time series study was made regarding VL cases in Sergipe filed as notifiable disease events. With data from the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística, IBGE), a digital population and cartographic baseline was established. Segmented linear regression was used to examine the temporal trends. The statistical analysis methods of Global and Local Moran' I, local Bayesian empirical methodology and spatial-temporal scanning were used to produce thematic maps. High instances were found among adults, males, urban residents, non-Whites and persons with low levels of education. A decrease in the recovery rate and an increase in the proportion of urban cases and lethality was found. A heterogeneous VL distribution with spatiotemporal agglomeration on the seaside of the state was seen in Sergipe. To better manage the disease, new research is encouraged together with development of public health strategies. Further, improving health care networks, especially primary care, is suggested as this approach has a key role in health promotion, prevention and monitoring of the most prevalent diseases.



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Anselin L. Exploring Spatial Data with GeoDaTM: A Workbook, 2005. 1. ed. Urbana: Center for Spatially Integrated Social Science, 36 pp.
Antunes JLF; Cardoso MRA, 2015. Using time series analysis in epidemiological studies. Epidemiol Serv Saúde 24:565–576. DOI:
Assunção, RM, Barreto SM, Guerra HL, Sakurai E, 1998. Mapas de taxas epidemiológicas: uma abordagem Bayesiana. Cad Saúde Pública 14:713–723. DOI:
Barbosa DS, Belo VS, Rangel MES, Werneck GL, 2013. Spatial analysis for identification of priority areas for surveillance and control in a visceral leishmaniasis endemic area in Brazil. Science 131:56–62. DOI:
Bezerra JMT, de Araújo VEM, Barbosa DS, Martins-Melo FR, Werneck GL, Carneiro M, 2016. Burden of leishmaniasis in Brazil and federated units, 1990-2016: Findings from Global Burden of Disease Study. PLoS Negl Trop Dis 12: e0006697. DOI:
Boaz R, Corberán-Vallet A, Lawson A, de Ferreira-Lima FE, Donato LE, Alves RV, et al., 2019. Integration of animal health and public health surveillance sources to exhaustively inform the risk of zoonosis: An application to visceral leishmaniasis data in Brazil. Spat Spatiotemporal Epidemiol 29:177–85. DOI:
Boelaert M, Meheus F, Sanchez A, Singh SP, Vanlerberghe V, Picado A, Meessen B, Sundar S, 2009.The poorest of the poor: A poverty appraisal of households affected by visceral leishmaniasis in Bihar, India. Trop Med Int Health 14:639–644. DOI:
Campos RNS, Tunon GIL, Cunha LCS, Magalhaes LS, Moraes J, Ramalho D, Lima S, Pacheco J, Lipscomb M, Jesus AR, Almeida RP, 2017. Epidemiological aspects and spatial distribution of human and canine visceral leishmaniasis in an endemic area in northeastern Brazil. Geospatial Healt 12:67-73. DOI:
Cavalcante FRA, Cavalcante KKS, Florencio CMGD, Moreno JO, Correia FGS, Alencar CH, 2019. Human visceral leishmaniasis: epidemiological, temporal and spacial aspects in Northeast Brazil, 2003-2017. Rev Inst Med Trop São Paulo 62:e12. DOI:
Costa de Albuquerque MA, Dias DM, Vieira LT, Lima CA, Silva AM, 2017. Mortality trends for Neglected Tropical Diseases in the State of Sergipe, Brazil, 1980-2013. Infect Dis Poverty 8:6-20. DOI:
Costa DNCC, Bermudi PMM, Rodas LAC, Nunes CM, Hiramoto RM, Tolezano JE, Cipriano RS, Cardoso GCD, Codeço CT, Neto FC, 2018. Human visceral leishmaniasis and relationship with vector and canine control measures. Rev Saúde Pública 52:1–11. DOI:
da Rocha ICM, dos Santos LHM, Coura-Vital W, da Cunha GMR, Magalhães FC, da Silva TAM, Morais MHF, Oliveira E, Reis IA, Carneiro M, 2018. Effectiveness of the Brazilian Visceral Leishmaniasis Surveillance and Control Programme in reducing the prevalence and incidence of Leishmania infantum infection. Parasit Vectors 12:11-586. DOI:
DATASUS, 2019. Department of Informatics of the Unified Health Systems. Available from:
de Souza CDF, Rocha VS, Santos NF, Leal TC, de Paiva JPS, Oliveira CCC, Martins-Filho PRS, Magalhães MAFM, Cuevas LE, Santos VS, 2019. Spatial clustering, social vulnerability and risk of leprosy in an endemic area in Northeast Brazil: an ecological study. J Eur Acad Dermatol Venereol 33:1581–1590. DOI:
dos Santos AD, Lima ACR, Santos MB, Alves JAB, Góes MAO, Nunes MAP, Sá SLCS, de Araújo KCGM, 2019. Spatial analysis for the identification of risk areas for schistosomiasis mansoni in the State of Sergipe, Brazil, 2005-2014. Rev Soc Bras Med Trop 49:608-615. DOI:
Góes MAO, Melo CMD, Jeraldo VDLS, 2012. Série temporal da leishmaniose visceral em Aracaju, estado de Sergipe, Brasil (1999 a 2008): aspectos humanos e caninos. Rev Bras Epidemiol15:298-307. DOI:
Góes MAO, Jeraldo VDLS, 2013. Características clínicas e epidemiológicas dos pacientes internados com leishmaniose visceral em hospital de referência. Rev Soc Bras Clin Med 11:227-231.
Góes MAO, Jeraldo VLS, Oliveira AS, 2014. Urbanização da leishmaniose visceral: aspectos clínicos e epidemiológicos em Aracaju, Sergipe, Brasil. Rev Bras Med Fam Comunidade 9:119-126. DOI:
Gontijo CMF, Melo MN, 2004. Leishmaniose Visceral no Brasil. Rev Bras Epidemiol 7:7-12. DOI:
Hailu T, Yimer M, Mulu W, Abera B, 2016. Challenges in visceral leishmaniasis control and elimination in the developing countries: A review. J Vector Borne Dis 53:193–198.
IBGE, 2019. Instituto Brasileiro de Geografia e Estatística. Avaliable from: Accessed: Sep 7, 2019.
Kulldorff MA, 1997. Spatial scan statistic. Commun Stat Theory Methods, 26:1481–1496. DOI:
Lane VM, 2016. Análise epidemiológica da Leishmaniose visceral humana no Brasil: contribuição as políticas de controle. Repositório UNB, Brasília, 25 pp.
Lima ID, Lima ALM, Mendes-Aguiar CO, Coutinho JFV, Wilson ME, Pearson RD, Queiroz JW, Jeronimo SMB, 2018. Changing demographics of visceral leishmaniasis in northeast Brazil: Lessons for the future. PLoS Negl Trop Dis 12:e0006164. DOI:
Lima SVMA, dos Santos AD, Duque AM, Góes MAO, Peixoto MVS, Araújo DC, Ribeiro CJN, Santos MB, de Araújo KCGM, Nunes MAP, 2019. Spatial and temporal analysis of tuberculosis in an area of social inequality in Northeast Brazil. BMC Public Health 19:1–9. DOI:
Mendes CS, Coelho AB, Féres JG, de Souza EC, da Cunha DA., 2016. The impact of climate change on leishmaniasis in Brazil. Ciência & Saúde Coletiva 21:263-272. DOI:
Ministry of Health, 2019. Guide to Health Surveillance. 3. ed. Brasília: Ministério da Saúde.
Ministry of Health, 2017. Ministério da Saúde. Leishmaniose Visceral. Secretaria de Vigilância em Saúde. Departamento de Vigilância Epidemiológica. Coordenação Geral de Doenças Transmissíveis. Outubro, 2017.
Nunes BEBR, Leal TC, de Paiva JPS, da Silva LF, do Carmo RF, Machado MF, Araujo MDP, Santos VS, de Souza CD, 2020. Social determinants of mortality due to visceral leishmaniasis in Brazil (2001-2015): an ecological study. Rev Soc Bras Med Trop 53:e20190262. DOI:
Romero GAS, Boelaert M, 2010. Control of visceral leishmaniasis in Latin America - A systematic review. PLoS Negl Trop Dis 4:e584. DOI:
Santos GO, de Jesus NPS, Cerqueira-Braz JV, Santos VS, de Lemos LMD, de Santos GO, 2019. Prevalence of HIV and associated factors among visceral leishmaniasis cases in an endemic area of Northeast Brazil. Rev Soc Bras Med Trop 52: e20180257. DOI:
Santos MA, Rodrigues SLC, Nascimento ALF, Rodrigues JS, Góes MAO, 2018. Leishmaniose Visceral: Características clínico-epidemiológicas de casos e óbitos no estado de Sergipe. Rev Epidemiol Controle Infecç 8:428-434. DOI:
Sena IVDO, 2015. Fatores associados ao óbito por leishmaniose visceral em hospital público de referência no estado do Piauí. Acervo FIOCRUZ 616.9364098122, 52 pp.
Sousa JMS, Ramalho WM, Melo MA, 2018. Demographic and clinical characterization of human visceral leishmaniasis in the State of Pernambuco, Brazil between 2006 and 2015.Rev Soc Bras Med Trop 51:622-630. DOI:
Sousa S, Hachmann CM, Winck, CA, 2018. Leishmaniose visceral canina: revisão de literatura. Unincor 6:1-12.
Toledo CRS, Almeida AS, Chaves SAM, Sabroza P, Toledo LM, Caldas JP, 2017. Vulnerability to the transmission of human visceral leishmaniasis in a Brazilian urban area. Rev Saúde Pública 1:49-51. DOI:
Werneck GL, 2016. Controle da leishmaniose visceral no Brasil: o fim de um ciclo? Cad Saúde Pública 32:1-2. DOI:
World Health Organization, 2015. Working to overcome the global impact of neglected tropical diseases: first WHO report on neglected tropical diseases. Geneva: World Health Organization.

How to Cite

Almeida, Ândria S., Ribeiro, C. J. N., Carlini, C. C., Santos, R. S., dos Santos, A. D., Tavares, D. S., de Araújo, K. C. G. M., Moura, T. R. de, & Santos, P. L. dos. (2021). Spatial and spatiotemporal dynamics of visceral leishmaniasis in an endemic North-eastern region of Brazil. Geospatial Health, 15(2).

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