Exploring Spatial and Temporal Distribution of Cutaneous Leishmaniasis in the Americas, 2001-2011.
METHODS
Cases reported in the period of 2001-2011 from 14/18 CL endemic countries were included in this study by using two spreadsheet to collect the data. Two indicators were analyzed: CL cases and incidence rate. The local regression method was used to analyze case trends and incidence rates for all the studied period, and for 2011 the spatial distribution of each indicator was analyzed by quartile and stratified into four groups.


RESULTS
From 2001-2011, 636,683 CL cases were reported by 14 countries and with an increase of 30% of the reported cases. The average incidence rate in the Americas was 15.89/100,000 inhabitants. In 2011, 15 countries reported cases in 180 from a total of 292 units of first subnational level. The global incidence rate for all countries was 17.42 cases per 100,000 inhabitants; while in 180 administrative units at the first subnational level, the average incidence rate was 57.52/100,000 inhabitants. Nicaragua and Panama had the highest incidence but more cases occurred in Brazil and Colombia. Spatial distribution was heterogeneous for each indicator, and when analyzed in different administrative level. The results showed different distribution patterns, illustrating the limitation of the use of individual indicators and the need to classify higher-risk areas in order to prioritize the actions. This study shows the epidemiological patterns using secondary data and the importance of using multiple indicators to define and characterize smaller territorial units for surveillance and control of leishmaniasis.
Communicable Diseases and Health Analysis, Pan American Health Organization, Duque de Caxias, Rio de Janeiro, Brazil.
Ana Nilce Silveira
http://orcid.org/0000-0001-5369-5860
AN
Maia-Elkhoury
Communicable Diseases and Health Analysis, Pan American Health Organization, Washington, District of Columbia, United States of America.
Zaida
Z
E Yadón
Communicable Diseases and Health Analysis, Pan American Health Organization, Washington, District of Columbia, United States of America.
Martha
M
Idali Saboyá Díaz
Ministry of Social Development and Against Hungry, Brasilia, Federal District, Brazil.
Francisca
F
de Fátima de Araújo Lucena
Communicable Diseases and Health Analysis, Pan American Health Organization, Washington, District of Columbia, United States of America.
Luis
L
Gerardo Castellanos
Pan American Foot-and-Mouth Disease Center-PANAFTOSA/PAHO, Duque de Caxias, Rio de Janeiro, Brazil.
Manuel
M
J Sanchez-Vazquez
D000569:Americas / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D019353:Endemic Diseases; D014943:Global Health; D006801:Humans; D015994:Incidence; D016773:Leishmaniasis, Cutaneous / Q000453:epidemiology* / Q000469:parasitology; D009527:Nicaragua / Q000453:epidemiology; D010176:Panama / Q000453:epidemiology; D062211:Spatio-Temporal Analysis; D013997:Time Factors