title: Canine visceral leishmaniasis in an urban setting of Southeastern Brazil: an ecological study involving spatial analysis.
abstract: BACKGROUND
  The physical characteristics of the environment influence the composition, distribution and behavior of the vectors and mammalian hosts involved in the transmission of visceral leishmaniasis (VL), thereby affecting the epidemiology of the disease. In Brazil, urbanization of human VL is a recent phenomenon and represents an issue of particular concern to local health authorities. The present study aimed to establish the degree of spatial dependency between canine and human VL in the municipality of Divinópolis, Minas Gerais, Brazil, and to identify priority risk areas in which stricter control measures should be implemented.
  
  
  METHODS
  The selected canine population comprised 3,652 dogs distributed within 11 strata and 1,247 urban blocks. Serum samples were collected between March 2013 and February 2014. Serodiagnosis of dogs was performed using the enzyme-linked immunosorbent assay and the indirect fluorescent-antibody test. The blocks sampled for canine VL and the addresses of the 16 confirmed cases of human VL notified in Divinópolis during the period 2007-2013 were georeferenced. Spatial analysis of the data was performed using Kernel density estimation, Ripley's bivariate K-function and directional distribution methods.
  
  
  RESULTS
  The overall prevalence of seropositive animals was 4.63% (range 3.95-5.31) (n =169) and varied in different strata between 0.9 (range 0.0-1.91) and 8.73% (range 5.65-11.81). A positive spatial dependency was detected between human and canine VL in which the occurrence of human cases of the disease tended to concentrate in locations that were close to areas with a higher incidence of canine VL. The priority risk area could be clearly distinguished from Kernel density estimation and standard deviational ellipse plots in which the human VL ellipse was totally enclosed within the canine VL ellipse.
  
  
  CONCLUSIONS
  The results presented herein will enable the Municipal Health Office of Divinópolis to devise a more effective management plan for human VL in which specific strategies would be applied to areas presenting different levels of risk. This spatial evaluation of leishmaniasis model could be applied in other urban areas of Brazil.
authors.affiliation: Centro de Pesquisas René Rachou, FIOCRUZ, Avenida Augusto de Lima 1715, Barro Preto, 30190-002, Belo Horizonte, MG, Brazil. rafaelgtn@hotmail.com.|Universidade Federal de São João del Rei, Campus Dona Lindu, Av. Sebastião Gonçalves Coelho 400, Chanadour, Chanadour, 35501-296, Divinópolis, MG, Brazil. rafaelgtn@hotmail.com.
authors.forename: Rafael Gonçalves
authors.initials: RG
authors.lastname: Teixeira-Neto
authors.affiliation: Universidade Federal de São João del Rei, Campus Dona Lindu, Av. Sebastião Gonçalves Coelho 400, Chanadour, Chanadour, 35501-296, Divinópolis, MG, Brazil. silvaedu@ufsj.edu.br.
authors.forename: Eduardo Sérgio
authors.initials: ES
authors.lastname: da Silva
authors.affiliation: Universidade Federal de São João del Rei, Campus Dona Lindu, Av. Sebastião Gonçalves Coelho 400, Chanadour, Chanadour, 35501-296, Divinópolis, MG, Brazil. renataaparecidanascimento@yahoo.com.br.
authors.forename: Renata Aparecida
authors.initials: RA
authors.lastname: Nascimento
authors.affiliation: Escola Nacional de Saúde Pública, FIOCRUZ, Rua Leopoldo Bulhões 1480, Manguinhos, 21041-210, Rio de Janeiro, RJ, Brazil. viniciusbelo4@hotmail.com.|Universidade Federal de Juiz de Fora, Campus Governador Valadares, Rua Israel Pinheiro 2000, 35020-220, Governador Valadares, MG, Brazil. viniciusbelo4@hotmail.com.
authors.forename: Vinícius Silva
authors.initials: VS
authors.lastname: Belo
authors.affiliation: Universidade Federal de São João del Rei, Campus Dona Lindu, Av. Sebastião Gonçalves Coelho 400, Chanadour, Chanadour, 35501-296, Divinópolis, MG, Brazil. claudia.dlorenzo@gmail.com.
authors.forename: Cláudia di Lorenzo
authors.initials: Cd
authors.lastname: de Oliveira
authors.affiliation: Centro de Pesquisas René Rachou, FIOCRUZ, Avenida Augusto de Lima 1715, Barro Preto, 30190-002, Belo Horizonte, MG, Brazil. leticia.pinheiro@cpqrr.fiocruz.br.
authors.forename: Letícia Cavalari
authors.initials: LC
authors.lastname: Pinheiro
authors.affiliation: Centro de Pesquisas René Rachou, FIOCRUZ, Avenida Augusto de Lima 1715, Barro Preto, 30190-002, Belo Horizonte, MG, Brazil. gontijo@cpqrr.fiocruz.br.
authors.forename: Célia Maria Ferreira
authors.initials: CM
authors.lastname: Gontijo
mesh_terms: D000818:Animals; D001938:Brazil / Q000453:epidemiology; D002947:Cities; D004283:Dog Diseases / Q000453:epidemiology / Q000469:parasitology*; D004285:Dogs; D007898:Leishmaniasis, Visceral / Q000453:epidemiology / Q000662:veterinary*; D016036:Seroepidemiologic Studies