title: Spatiotemporal analysis of reported cases of acute Chagas disease in the State of Pernambuco, Brazil, from 2002 to 2013.
abstract: BACKGROUND
  Control strategies to eliminate the transmission of Chagas disease by insect vectors have significantly decreased the number of reported acute cases in Brazil. However, data regarding the incidence and distribution of acute Chagas disease cases in the State of Pernambuco are unavailable in the literature.
  
  
  METHODS
  A geographical information system was used to delineate the spatiotemporal distribution profile of the cases from 2002 to 2013 in 185 municipalities of Pernambuco based on the municipality where notification occurred. The results were presented in digital maps generated by the TerraView software (INPE).
  
  
  RESULTS
  A total of 302 cases of acute disease were recorded in 37.8% of the municipalities, for a total of 0.13 cases per 1,000,000 inhabitants per year. Out of the 302 cases, 99.3% were reported between 2002 and 2006. The most affected municipalities were Carnaubeira da Penha, Mirandiba and Terra Nova. The risk maps showed a significant decrease in the number of notifications and a concentration of cases in the Midwest region.
  
  
  CONCLUSIONS
  This study highlights a significant decrease in new cases of acute Chagas disease in Pernambuco starting in 2006 when Brazil received an international certification for the interruption of vectorial transmission by Triatoma infestans. However, control strategies should still be encouraged because other triatomine species can also transmit the parasite; moreover, other transmission modes must not be neglected.
authors.affiliation: Serviço de Referência em Doença de Chagas, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Pernambuco, Brazil.
authors.forename: Fred Luciano Neves
authors.initials: FL
authors.lastname: Santos
authors.affiliation: Serviço de Referência em Doença de Chagas, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Pernambuco, Brazil.
authors.forename: Virginia Maria Barros de
authors.initials: VM
authors.lastname: Lorena
authors.affiliation: Departamento de Saúde Coletiva, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Pernambuco, Brazil.
authors.forename: Wayner Vieira de
authors.initials: WV
authors.lastname: Souza
authors.affiliation: Serviço de Referência em Doença de Chagas, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Pernambuco, Brazil.
authors.forename: Yara de Miranda
authors.initials: Yde M
authors.lastname: Gomes
mesh_terms: D000208:Acute Disease; D000328:Adult; D000818:Animals; D001938:Brazil / Q000453:epidemiology; D014355:Chagas Disease / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D062211:Spatio-Temporal Analysis; D055815:Young Adult