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Visceral leishmaniasis on the rise in Brazil, study finds

A PLOS Neglected Tropical Diseases press release



IMAGE:  "This is a female Phlebotomus sp. sand fly, a vector of the parasite responsible for Leishmaniasis. " view more 

Credit: WHO, Public Domain, 2012

The parasitic disease leishmaniasis is spread to humans through the bites of sandflies, and is endemic in a number of countries, including Brazil. Despite control efforts, the incidence of visceral leishmaniasis -- the most severe form of the disease -- rose in Brazil between 1990 and 2016, researchers have reported in PLOS Neglected Tropical Diseases.

Leishmaniasis can be classified into two clinical forms--visceral (VL) and tegumentary, which encompasses both cutaneous and mucocutaneous leishmaniasis (CML). The World Health Organization estimates that there are 400,000 new cases of VL and 1 million new cases of CML around the globe each year. In the Americas, 96% of cases occur in Brazil, where the fatality rate of VL is 7.4%.

In the new work, Juliana Bezerra, of the Universidade Federal de Minas Gerais, Brazil, and colleagues analyzed the burden of VL and CML using data from the Global Burden of Disease (GBD) study. Since 1990, GBD has quantified and compared the magnitude of health loss due to diseases around the world. The researchers relied on GBD data for Brazil and all of its 27 federated units.

Overall, the age-standardized rate of leishmaniasis in Brazil decreased 48.5% from 1990 to 2016, and the disability-adjusted life years--a measure of health loss--increased by 83.6%. However, that decrease was mostly due to a drop in the rate of CML; the incidence rate of VL increased by 52.9% during the same time period, and an even higher increase was seen in children under the age of 1. Additionally, different regions of Brazil saw different burdens of disease, with rates increasing the Northeast and Southeast but decreasing in the Northern states.

"Understanding the burden of these diseases and their regional differences is of great relevance for the establishment of adequate and region-specific surveillance and control measures," the authors say. In addition, it can help in the rational use of available resources and in decision making aimed at reducing the transmission of the parasite and the burden of this disabling and potentially lethal disease."


Peer-reviewed / Data review

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Citation: Bezerra JMT, de Araújo VEM, Barbosa DS, Martins-Melo FR, Werneck GL, et al. (2018) Burden of leishmaniasis in Brazil and federated units, 1990-2016: Findings from Global Burden of Disease Study 2016. PLOS Neglected Tropical Diseases 12(9): e0006697.

Funding: The GBD 2016 Brazilian database and methods are funded by Bill & Melinda Gates Foundation and by the Brazilian Ministry of Health through the agreement of the Secretariat of Health Surveillance and the Federal University of Minas Gerais - Health Process nº. 25000.479735 / 2017-40 TED 125/2017. Juliana Maria Trindade Bezerra is grateful for PNPD/Capes (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior)/Post-Graduation Program in Parasitology/Universidade Federal de Minas Gerais for the Postdoctoral fellowship. Francisco Rogerlândio Martins-Melo was funded by a postdoctoral fellowship from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES/Brazil). Mariângela Carneiro is grateful to Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq-Brazil) for the research fellowships and Fundação de Amparo a Pesquisa de Minas Gerais (FAPEMIG) for Programa Pesquisador Mineiro (PPM/2016). Guilherme Loureiro Werneck is grateful to Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq-Brazil) and the Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ/Brazil) for the grant of the Programa Cientistas do Nosso Estado (CNE-2015). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests: The authors have declared that no competing interests exist.

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