Objective: To describe the entry of Dengue virus (DENV) serotypes in Brazil and its federative units. Methods: A systematic review of studies published between 1980 and 2018 in databases and in the gray literature was performed using descriptors related to the years of entry of the DENV serotypes. Additionally, experts and official sources of information (Brazilian Ministry of Health) were consulted. Results: From 100 publications selected for the systematic review, 26 addressed the entry of DENV serotypes in the North region of the country, 33 in the Northeast, 24 in the Southeast, 14 in the Central-West, and five in the South. DENV-1 and DENV-4 were introduced in the North region in 1981. DENV-2 was introduced in the Southeast in 1990. DENV-3 was introduced in the North in 1999. Conclusion: The rapid expansion of dengue throughout the Brazilian territory was verified from the second half of the 1980s, with the gradual entry of the four serotypes, which resulted in the emergence of epidemics of arbovirus, which are currently verified in the country. Considering the epidemiology of the disease, more information should be disseminated and published in the wide-ranging scientific literature for a better understanding of the spread and circulation of DENV serotypes.
Cutaneous leishmaniasis (CL) is an important public health problem in Brazil and in several tropical regions of the world. In the Americas, Brazil is the country with the highest number of registered cases. In Brazil, the state of Minas Gerais has the highest number of cases in the southeastern region. In the present study, we used spatial analysis in the State of Minas Gerais to identify municipalities of priority during a nine-year period (2007–2015), which might be used to guide surveillance and control measures. An ecological study with spatial analysis of autochthonous cases of CL was performed in the state of Minas Gerais between 2007 and 2015. We calculated incidence rates, used Empirical Bayesian smoothing for each municipality, and divided the analyses into three-year intervals. In order to analyze the existence of spatial autocorrelation, and to define priority areas, Moran’s Global Index and Local Indicators of Spatial Association (LISA) were used. The mean incidence rate for the entire state was 6.1/100,000 inhabitants. For Minas Gerais, analysis of CL cases over time revealed a successive increase of indicated mesoregions with high priority municipalities. Eight of the designated mesoregions contained municipalities classified as high priority areas in any of the three evaluated trienniums, and four mesoregions had high priority municipalities throughout the entire investigation. Within the southeastern region of Brazil, Minas Gerais State stands out, with highest CL incidence rates. Using spatial analysis, we identified an increasing numbers of cases in the municipalities classified as high priority areas in different mesoregions of the state. This information might be of value to direct surveillance and control measures against CL and to understand the dynamics of the expansion of CL in Minas Gerais. Similar approaches might be used to map CL in other regions throughout Brazil, or in any other country, where national notification and control programs exist.
Visceral leishmaniasis (VL) is endemic in 70 countries and has been reported in 12 countries of Latin America, with over 90% of the cases reported in Brazil, where epidemics have occurred since 1980. The objective of this review is to describe the factors associated with the occurrence of VL epidemics in humans in urban areas. A systematic review was conducted according to the PRISMA-P guidelines. The databases PubMed (by Medline), Cochrane Library, Embase, Amed, LILACS and grey literature [Google Scholar and handsearch of the database of the Information System for Notifiable Diseases (SINAN) of Brazil's Unified Health System] were used. The protocol was registered under PROSPERO (CRD42019128998). Climatic, environmental factors and indicators of urban social structure were described as influencing the outbreaks in the North and Northeast regions. Gender and age characteristics were related to a greater chance of developing VL in the Central-West, Northeast and Southeast regions. Vector indicators showed a positive correlation with the incidence of VL in studies in the Northeast region. In the Southeast and Northeast regions, studies revealed the presence of dogs with positive correlation with VL. Knowledge gaps remain regarding the contribution to the increase in the risk factors described in ecological approaches, as no analysis was performed at the individual level, and it is still necessary to discuss the influence of other associated elements in epidemic episodes in the spread of VL.
Objective. To identify and describe broadly the factors related to the occurrence of dengue epidemics in Brazil. Methods. Systematic review of studies published in Medline, Lilacs, PubMed, Cochrane, BVS, Web of Science, Scopus, and thesis and dissertations databases using descriptors cataloged in DeCs and MeSH on dengue and factors associated with the occurrence of epidemics, published from 2008 to 2018. Results. Thirty-five studies carried out in the country were selected. The epidemics recorded in Brazil were associated and/or correlated with multiple factors such as environment, socioeconomic conditions, climate, and aspects related to the vector, among others. Conclusions. Dengue epidemics are complex and multifactorial. The continuity of the vector control actions was found to be relevant to the reduction of Aedes aegypti and for disease control. To contain the spread of the disease, effective measures are needed in all sectors, including health, education, economy, population, business, and government. Actions for the early detection of cases of the disease can prevent new outbreaks of epidemics.