The urban spread of visceral leishmaniasis: clues from spatial analysis.
BACKGROUND
The pattern of spread of visceral leishmaniasis in Brazilian cities is poorly understood.


METHODS
We used geographic information systems and spatial statistics to evaluate the distribution of 1061 cases of visceral leishmaniasis in Teresina, Brazil, in 1993 through 1996.


RESULTS
A locally weighted (LOESS) regression model, which was fit as a smoothed function of spatial coordinates, demonstrated large-scale variation, with high incidence rates in peripheral neighborhoods that bordered forest land and pastures. Moran's I indicated small-scale variation and clustering up to 300 m, roughly the flight range of the sand fly vector.


CONCLUSIONS
Spatial analytical techniques can identify high-risk areas for targeting control interventions.
Werneck
Guilherme L
GL
Department of Immunology and Infectious Disease, Harvard School of Public Health, Boston, MA, USA.
Costa
Carlos H N
CH
Walker
Alexander M
AM
David
John R
JR
Wand
Matthew
M
Maguire
James H
JH
D001938:Brazil / Q000453:epidemiology; D016000:Cluster Analysis; D006801:Humans; D015994:Incidence; D007256:Information Systems; D007898:Leishmaniasis, Visceral / Q000453:epidemiology*; D012044:Regression Analysis; D014505:Urban Population