title: An analysis of the spatiotemporal distribution of American cutaneous leishmaniasis in counties located along road and railway corridors in the State of Maranhão, Brazil.
abstract: BACKGROUND
  The incidence of American cutaneous leishmaniasis (ACL) is increasing in Latin America, especially in Brazil, where 256,587 cases were confirmed in the last decade.
  
  
  METHODS
  This study used a Bayesian model to examine the spatial and temporal distribution of ACL cases between 2000 and 2009 in 61 counties of State of Maranhão located along the three main road and railway corridors.
  
  
  RESULTS
  During the study period, 13,818 cases of ACL were recorded. There was a significant decrease in the incidence of ACL in the ten study years. The recorded incidence rate ranged from 7.36 to 241.45 per 100,000 inhabitants. The relative risk increased in 77% of the counties, decreased in 18% and was maintained in only five counties.
  
  
  CONCLUSIONS
  Although there was a decreased incidence of the disease, ACL was present in all of the examined municipalities, thus maintaining the risk of contracting this illness.
authors.affiliation: Coordenação de VISA de Portos, Aeroportos e Fronteiras, Agência Nacional de Vigilância Sanitária, São Luis, MA, Brazil.
authors.forename: Vicente Silva
authors.initials: VS
authors.lastname: Gonçalves Neto
authors.forename: Allan Kardec Duailibe
authors.initials: AK
authors.lastname: Barros Filho
authors.forename: Alcione Miranda dos
authors.initials: AM
authors.lastname: Santos
authors.forename: Margarida Paula Carreira de Sá
authors.initials: MP
authors.lastname: Prazeres
authors.forename: Ana Célia Rolim
authors.initials: AC
authors.lastname: Bezerril
authors.forename: Alexandre Vitor de Lima
authors.initials: AV
authors.lastname: Fonseca
authors.forename: José Manuel Macário
authors.initials: JM
authors.lastname: Rebêlo
mesh_terms: D001938:Brazil / Q000453:epidemiology; D004812:Epidemiologic Methods; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000453:epidemiology*; D012424:Rural Population