Spatiotemporal analysis of visceral leishmaniasis in Belo Horizonte, Brazil: a historical perspective (1994-2018).

Background: In the Americas, visceral leishmaniasis (VL) results from the zoonotic transmission of Leishmania infantum. VL has a high occurrence rate in the Metropolitan Region of Belo Horizonte (BH), Minas Gerais, Brazil, and has rapidly spread throughout the municipality since it was first recorded in 1994. This research analysed a historical perspective over 25 y of human VL occurrence in BH.

Methods: An ecological study of reported human VL occurrence from January 1994 to December 2018 in BH was performed. Epidemiological indicators and changes in the spatiotemporal transmission patterns of human VL were analysed throughout the study period.

Results: The average annual incidence of human VL was 3.20 cases per 100 000 inhabitants over the study period. The case fatality rate ranged from 7% to 21%. The proportion of VL/human immunodeficiency virus coinfection was >20% in the years 2012, 2015 and 2018. Human VL was introduced into BH through the East and Northeast regions, expanding to other areas. The coverage areas of the São Miguel Arcanjo and Cafezal health centres (both in the Centro-Sul region of the city) as well as other areas in the Northeast, Northwest, Pampulha, Venda Nova, North, and East regions of the city presented higher relative risks for human VL occurrence.

Conclusions: The study contributes to a better understanding of the disease's epidemiological profile and identifies priority areas for developing control and monitoring actions.