Abstract
The Northeast region of Brazil (NRB) includes the states with the highest prevalence of visceral leishmaniasis (VL), as well as those with significant increases in HIV cases. This study aims to analyze the spatiotemporal patterns of VL-HIV coinfection and its association with the social determinants of health (SDH) in the NRB. Time trend analysis and Bayesian spatial statistical inferences, Moran’s autocorrelation, and retrospective space–time scanning were performed. Spatial regression modelling was used to build an explanatory model for the occurrence of VL-HIV coinfection within NRB. A total of 1550 cases of VL-HIV coinfection were confirmed. We observed a higher prevalence among males (1232; 83%), individuals aged from 20 to 59 years (850; 54.8%), non-white skin color (1,422; 91.7%), and with low education (550; 35.48%). NRB showed an increasing and significant trend in the detection rate of coinfection (APC, 5.3; 95% CI, 1.4 to 9.4). The states of Maranhão and Piauí comprised the high-risk cluster. The SDH that most correlated with the occurrence of coinfection were poor housing, low income, and low education. VL-HIV is dispersed in the NRB but chiefly affects states with greater social vulnerability. Taken together, these findings reinforce the necessity to implement surveillance strategies that will contribute to the reduction of cases in these populations.
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Data availability
The datasets analyzed during the current study consisted of all confirmed cases of LV-HIV in the public domain. Data recorded in the Sistema de Informação de Agravos de Notificação (SINAN) that support the results of this study are available from http://www2.datasus.gov.br/. For the construction of the spatial analysis maps, we used the cartographic base of the state of Sergipe, available in the electronic database of the Instituto Brasileiro de Geografia e Estatística (IBGE) (https://www.ibge.gov.br).
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Funding
This work was supported by the Fundação de Apoio a Pesquisa e à Inovação Tecnológica do Estado de Sergipe (FAPITC/SE) (EDITAL FAPITEC/SE/FUNTEC/CAPES N° 07/2018). The funding helped in the conception of the study and collection and analysis of the data.
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ESR, CJNR, and TRM conceptualized the study design, data curation, investigation, methodology, software, writing (review and editing), project administration, writing—original draft. ESR, CJNR, ERS, RSS, and TRM wrote the manuscript. ADS, DMCA, MBS, conceptualization, data curation, methodology, software, writing—review and editing. PLS, KCGA, WSP, RESR, validation, writing—review and editing. All authors reviewed the manuscript and approved all content and participated in the implementation of the study and analysis and interpretation of the data, drafting the article or critically revising it for important intellectual content, and final approval of the version submitted.
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dos Reis, E.S., Ribeiro, C.J.N., dos Santos, A.D. et al. Magnitude of visceral leishmaniasis and HIV coinfection and association with social determinants of health in the Northeast region of Brazil: a retrospective, spatiotemporal model (2010–2018). Parasitol Res 121, 1021–1031 (2022). https://doi.org/10.1007/s00436-022-07450-6
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DOI: https://doi.org/10.1007/s00436-022-07450-6