Visceral leishmaniasis in Barcarena mining town, Pará State, Brazil: evolution from 2004 to 2008 and bases for epidemiological surveillance

Abstract

This study describes the epidemiological profile of human visceral leishmaniasis (HVL) in Barcarena, Pará State, Brazil and circuits of production of disease cases (CPCs). Autochthonous cases were analyzed and reported in the Notifiable Diseases Information System from 2004 to 2008, with the aim of identifying the CPCs by Kernel estimator of intensity and categorizing problems. There were 201 new cases of HVL, with annual reduction of coefficient of incidence/100 inhabitants: 76.8; 82.3; 55.2; 27.0; 25.6 (p < 0.0001) and only one death in 2007. December (23) January (24) and May (26) had the highest number of notifications in that period. Children under 5 years of age, males, in rural areas, were hardest hit, but the annual rate of new cases between young and old people (< 5 and > 60) has decreased during this period. The reaction tests of indirect imunoflourescence confirmed most cases of HVL (90%). CPCs have appeared in the central and northern regions of Barcarena where the risk of transmission increases in the rainy season. Brown boys, under 5 years of age from rural areas represent the epidemiological profile of HVL in the city and they are the priority cases for surveillance and prevention actions. The reduction of morbidity and low mortality by HVL in Barcarena can be attributed to the good quality of care assistance and the local structural changes operated from 2005. Inserted locations in identified CPCs are: Santa Maria, Bacuri, Araticu, Aipi and peri-urban area where training programs for health professionals and preventive actions are recommend to HVL.