Epidemiological patterns related to deaths caused by visceral leishmaniasis in the southern Amazon region of Brazil

• DOI: 10.1093/trstmh/trac110
• Publication Date: 2022-12-08T15:26:07Z
• Authors: Amanda G Carvalho; André Luiz M Kuhn; João Victor L Dias; João Gabriel G Luz
• Keywords: Spatial Analysis; 03 medical and health sciences; Delayed Diagnosis; 0302 clinical medicine; Humans; Leishmaniasis, Visceral; Brazil; 3. Good health

We analysed the spatial and spatiotemporal patterns of visceral leishmaniasis (VL) mortality at municipality level in an endemic state southern Amazon region Brazil. Individual-level factors associated with death due to VL were also investigated.All cases deaths reported between 2007 2018 included. The global local bivariate Moran's index assessed space-time autocorrelation smoothed triennial mortality. Kulldorff's scan statistics investigated clusters. A multivariable logistic regression explored sociodemographic, diagnostic clinical variables VL.We observed overall lethality 0.14 cases/100 000 inhabitants 11.2%, respectively. total 14% municipalities registered least one VL-related death. In southeastern mesoregion state, we detected high-risk (relative risk [RR] 14.14; p<0.001) (RR 15.91; clusters for Bivariate analysis suggested a high Death by was age ≥48 y (odds ratio [OR] 7.2 [95% confidence interval {CI} 3.4 15.3]), displacement notification (OR 3.3 CI 1.5 7.2]) occurrence oedema 2.8 1.3 6.1]) bleeding 5.8 2.6 12.8]).VL has heterogeneous distribution. death-related suggest late diagnosis as underlying cause