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Visceral Leishmaniasis in Araçatuba. Evaluation and Epidemiology of Visceral Leishmaniasis Ana Luiza, Daniel, Simone, Tatiana & Wildo Examining Socioeconomic Conditions Amelia, Otibho & Renata Methods of Canine Control Danielle, Joanna, Rei & Tracy Methods of Diagnosis and Treatment
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Visceral Leishmaniasis in Araçatuba • Evaluation and Epidemiology of Visceral Leishmaniasis • Ana Luiza, Daniel, Simone, Tatiana & Wildo • Examining Socioeconomic Conditions • Amelia, Otibho & Renata • Methods of Canine Control • Danielle, Joanna, Rei & Tracy • Methods of Diagnosis and Treatment • Felipe, Josy, Leo, Michelle & Ricky
Introduction: Visceral Leishmaniasis (VL) • VL in the world • ~ 500,000 cases/yr • ~ 59,000 deaths/yr • Brazil reports most cases in Latin America • ~3,500/yr • Socio-economic trends • 80% of victims live on < $2/day • Drastic increase in cases: 1980-2003 • 51,222 cases reported, 10% fatality • Brazilian Leishmaniasis Control Program (BLCP) est. 1950 • However, increase in VL cases continues
Key Biological Components of Disease Host: Human Parasite: L. (infantum) chagasi Vector: L. longipalpis Reservior: dog (foxes, oppossums, etc.)
Araçatuba: Demographics • Area: 1,167 km2, 530 km from Sao Paulo • Human Pop.: 179,000 • Canine Pop.: 32,000 (1:4 dog-to-human ratio) • 100% access to running water, sewage and waste disposal services (Datasus report, 2000) • Median income = R$ 902.68 per month • M:F median income ratio = 2:1 • 34.6% report no income • Education • 85% literacy • 6.4% < 1 year of schooling; 50.9% < 8 years of schooling; 30.5 % 11+ years of schooling. (Datasus, 2007) (Barão, 2007)
Spread of VL in Araçatuba Araçatuba 1997: L. Longipalpis 1998: 1st dog case 1999: 1st human case São Paulo
VL in Araçatuba cont. • VL incidence = 11.2 cases per 100,000 persons (2007) • Vector-borne Disease Control • SUCEN divides city into 8 areas for control (5 urban and 3 rural or semi-rural regions) • VL initially distributed evenly (lat e 1990s) • After establishment of the disease control program • Currently, VL concentrated in peripheral regions • Disproportionate levels of lower socio-economic status (Datasus, 2007) (Barão, 2007)
