Visceral Leishmaniasis: Clinical-epidemiological characteristics of cases and deaths in the state of Sergipe

Abstract

Background and Objectives: Visceral Leishmaniasis (VL) is an endemic antropozoonosis in tropical areas that has been showing expansion and global increase in lethality. This work aims to characterize clinical and epidemiological aspects of VL, identifying factors associated with death. Methods: This is an observational epidemiological study, using data from the state database of LV cases residing in the state of Sergipe, notified between 2007 and 2016 at the SINAN (Information System for Notifiable Diseases). Results: 577 confirmed cases of VL were reported, with concentration in the urban area (76.1%), with a general lethality of 12.3%. There was a predominance of males (69.5%), with higher lethality. The highest concentration of cases occurred in the first decade of life (38.5%). The lethality increased every decade from the age of 40, reaching 39.3% in people 60 years of age or older. In both quinquennia (2007 - 2011 and 2012 - 2016), it was observed that the mean incidence rate (MIC) in children under 10 years is similar between both sexes and from that point on, it is always higher in males. The manifestations related to higher lethality were: hemorrhages (30.3%), jaundice (28.1%), infection (26.4%), edema (25.1%) and HIV coinfection (26,9%). Conclusion: Despite being an endemic transmission area of LV, there have been changes in the epidemiological pattern with an increase in the incidence in the population over 40 years, which may reflect the increase in lethality. The identification of this new scenario and the recognition of signs of gravity are very important for its early diagnosis and timely treatment.