title: Risk factors for Leishmania chagasi infection in an endemic area in Raposa, State of Maranhão, Brazil.
abstract: BACKGROUND
  Infection with Leishmania chagasi is the most common clinical presentation for visceral leishmaniaisis in endemic areas. The municipality of Raposa is an endemic area in State of Maranhão, Brazil, and have had registration cases of visceral leishmaniasis disease. For this reason, a cross-sectional study was conducted to evaluate the risk factors for infection with L. chagasi detected by Montenegro skin test.
  
  
  METHODS
  The sample comprised 96% of the inhabitants of the villages of Maresia, Pantoja, and Marisol located in the municipality of Raposa, corresponding to 1,359 subjects. Data were collected using a questionnaire. Univariate and multivariate logistic regression models were applied to evaluate the association between the variables studied and infection of L. chagasi.
  
  
  RESULTS
  The variables associated with infection upon nonadjusted analysis were a straw roof, mud walls, floors of beaten earth, presence of sand flies inside or outside of the dwelling, and bathing outdoors. Adjusted analysis showed that the presence of sand flies inside/outside the dwelling was a risk factor, and age younger than 10 years was a protective factor against asymptomatic infection.
  
  
  CONCLUSIONS
  The results highlight the extent to which precarious living conditions of the population strengthen the epidemiological chain of visceral leishmaniasis.
authors.affiliation: Departamento de Enfermagem, Universidade Federal do Maranhão, São Luis, MA, Brasil.
authors.forename: Charlene Barreto
authors.initials: CB
authors.lastname: Ponte
authors.forename: Natália Coelho
authors.initials: NC
authors.lastname: Souza
authors.forename: Maria Neuza
authors.initials: MN
authors.lastname: Cavalcante
authors.forename: Aldina Maria Prado
authors.initials: AM
authors.lastname: Barral
authors.forename: Dorlene Maria Cardoso de
authors.initials: DM
authors.lastname: Aquino
authors.forename: Arlene de Jesus Mendes
authors.initials: Ade J
authors.lastname: Caldas
mesh_terms: D000818:Animals; D001938:Brazil / Q000453:epidemiology; D002645:Chickens; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004285:Dogs; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007428:Intradermal Tests; D007898:Leishmaniasis, Visceral / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D012307:Risk Factors; D014505:Urban Population