Temporal and spatial analysis of visceral leishmaniasis in Brazil, by age group and sex: an ecological study, 2013-2022.

OBJECTIVE

The aim of the study was to analyze the temporal trend and spatial distribution of the incidence rate of visceral leishmaniasis by age and sex across Brazilian states, macro-regions, and nationally, from 2013 to 2022.

METHODS

Ecological study with temporal and spatial analyses of cases recorded in Brazil's national disease notification system, using Prais-Winsten regression and global and local Moran indices.

RESULTS

A total of 31,453 visceral leishmaniasis cases were recorded in Brazil in the period (mean incidence of 1.68 per 100,000). A statistically significant decreasing trend was observed in Brazil (annual percent change [APC]: -3.25, 95% confidence interval [95%CI] -5.65; -0.79), particularly among women (APC -4.12, 95%CI -6.68; -1.49) and children and adolescents (APC -5.17; 95%CI -8.59; -1.62). An increase was observed among women in Santa Catarina (APC 9.03; 95%CI 6.49; 11.64), in adults in Rio Grande do Sul (APC 7.39; 95%CI 3.47; 11.45) and Santa Catarina (APC 6.48; 95%CI 1.89; 11.27) and in older adults in Paraíba (APC 2.13; 95%CI 0.46; 3.84). Spatial analysis revealed high-risk municipality clusters in the Northeast, North, Midwest, and Southeast, with the highest incidence rate in children and adolescents.

CONCLUSIONS

demographic factors such as age range (especially children and adolescents) and sex were associated with a high risk of visceral leishmaniasis, indicating a need for targeted control measures in Brazil.