Risk factors for Leishmania chagasi infection in an urban area of Minas Gerais State Fatores de risco para infecção por Leishmania chagasi em uma área urbana do Estado de Minas Gerais

نویسندگان

  • Elizabeth Castro Moreno
  • Maria Norma Melo
  • Odair Genaro
  • José Roberto Lambertucci
  • José Carlos Serufo
  • Antero Silva Ribeiro Andrade
  • Mariângela Carneiro
چکیده

In order to understand the determinants of human infection by Leishmania chagasi in an urban area, a cross-sectional population based study was conducted using molecular and serologic methods to identify infection. Participants were interviewed using a pre-coded questionnaire. Two criteria were tested to identify risk factors: Model 1including all participants positive in hybridization by Leishmania donovani complex probe; Model 2including all participants positive for hybridization and at least one serologic test. In Model 1, the variables associated with infection were: ownership of birds, time spent outside house between 6:00-10:00 PM and garbage not collected. In Model 2, the variables associated with infection were: family with knowledge of the vector, garbage not collected, garbage not removed or buried, ownership of birds and eroded areas in the neighborhood. The risk factors identified were associated with household conditions, presence of animals and the likelihood of contact with phlebotomine sandflies. Key-words: Visceral leishmaniasis. Kala-Azar. Leishmania chagasi. Asymptomatic infection. Risk factors. RESUMO Com o objetivo de identificar os determinantes da infecção humana por Leishmania chagasi em uma área urbana, foi realizado um estudo seccional de base populacional utilizando-se métodos moleculares e sorológicos para identificar a infecção. Os participantes foram entrevistados utilizando-se questionário pré-codificado. Dois critérios foram testados para identificar os fatores de risco: Modelo 1incluindo todos os participantes positivos na hibridização com sonda para o complexo Leishmania donovani; Modelo 2incluindo todos os participantes positivos na hibridização e em pelo menos um teste sorológico. No Modelo 1, as variáveis associadas à infecção foram: criar pássaros, encontrar-se fora de casa entre 18:00-22:00h e não ter o lixo coletado. No Modelo 2, as variáveis associadas à infecção foram: família conhecer o vetor, não ter o lixo coletado, lixo não removido ou queimado, criar pássaros, proximidade de áreas erodidas. Os fatores de risco identificados foram associados às condições das moradias, presença de animais e probabilidade de contato com flebotomíneos. Palavras-chaves: Leishmaniose visceral. Calazar. Leishmania chagasi. Infecção assintomática. Fatores de risco. American v isceral le ishmanias is (AVL), caused by Leishmania (Leishmania) chagasi, is transmitted by the phlebotomine sand fly Lutzomyia longipalpis. In the last 10 years the disease has become a serious public health problem in Brazil due to the high prevalence of canine infection and the increase of human cases in peri-urban and urban areas of large cities. Although 90% of clinical cases of AVL occur in the Northeastern region of the Country, in recent years the incidence of cases has increased in Southeastern states like Minas Gerais,

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تاریخ انتشار 2005