A tale of two neglected tropical infections: using GIS to assess the spatial and temporal overlap of schistosomiasis and leprosy in a region of Minas Gerais, Brazil

• Published in: Memórias do Instituto Oswaldo Cruz Vol. 112; no. 4; pp. 275 - 280
• Main Authors: Phillips, David Alexander, Ferreira, José Antonio, Ansah, Deidra, Teixeira, Herica Sa, Kitron, Uriel, Filippis, Thelma de, Alcântara, Marcelo H de, Fairley, Jessica K
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Instituto Oswaldo Cruz, Ministério da Saúde 01.04.2017; Fundação Oswaldo Cruz (FIOCRUZ)
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Brazil; Brazil - epidemiology; Child; Child, Preschool; coinfection; Coinfection - epidemiology; Endemic Diseases; Female; geographic; Geographic Information Systems; Humans; Incidence; Infant; Infant, Newborn; information systems; leprosy; Leprosy - epidemiology; Male; Middle Aged; Neglected Diseases - epidemiology; PARASITOLOGY; Risk Factors; schistosomiasis; Schistosomiasis mansoni - epidemiology; Spatio-Temporal Analysis; TROPICAL MEDICINE; Young Adult; leprosy; Brazil; geographic; information systems; schistosomiasis; coinfection
• ISSN: 0074-0276; 1678-8060; 1678-8060; 0074-0276
• DOI: 10.1590/0074-02760160395

Despite public health efforts to reduce the global burden of leprosy, gaps remain in the knowledge surrounding transmission of infection. Helminth co-infections have been associated with a shift towards the lepromatous end of the disease spectrum, potentially increasing transmission in co-endemic areas. Using this biologically plausible association, we conducted a geographic information systems (GIS) study to investigate the spatial associations of schistosomiasis and leprosy in an endemic area of Minas Gerais (MG), Brazil. Data on new cases of Mycobacterium leprae and Schistosoma mansoni infections from 2007-2014 were retrieved from the Brazilian national notifiable diseases information system for seven municipalities in and surrounding Vespasiano, MG. A total of 139 cases of leprosy and 200 cases of schistosomiasis were mapped to a municipality level. For one municipality, cases were mapped to a neighborhood level and a stratified analysis was conducted to identify spatial associations. A relative risk of 6.80 [95% confidence interval (CI) 1.46 - 31.64] of leprosy was found in neighborhoods with schistosomiasis. Incidence rates of leprosy increased with corresponding incidence rates of schistosomiasis, and the temporal trends of both infections were similar. The associations found in this project support the hypothesis that helminth infections may influence the transmission of leprosy in co-endemic areas.