Dados do Trabalho

Título

Modeling vector-borne disease landscapes in the Amazon region

Introdução

Endemic and emerging vector-borne diseases are important public health problems for the Amazon region, and their burden should be considered in the search for an environmentally and economically sustainable future. In general, epidemiological studies on disease determinants tend to focus on one disease at a time, disregarding synergies and syndemics.

Objetivo(s)

The goal of this study was to disentangle the environmental and socio-demographic factors associated with the co-occurrence of vector-borne diseases of mandatory notification in the Brazilian Amazon: Chagas, vivax malaria, falciparum malaria, visceral leishmaniasis (VL), American tegumentary leishmaniasis (ATL) and dengue.

Material e Métodos

We fitted a generalized linear latent variable model to disease occurrence data to investigate risk factors associated with disease co-occurrences while accounting for influences exerted by environmental and socio-demographic parameters. This is a multivariate model approach usually applied to ecological communities. The latent variables account for disease covariances that are not explained by the predictors, indicating synergistic interactions among diseases or missing environmental predictors. We applied this method to disease cases from 2015-2019, considering as covariates, a set of indicators of environmental change, forest fragmentation, land use and cover, mobility, and climate anomalies compiled and harmonized in the Trajetorias dataset. Socio-economic covariates included the three components of the Human Development Index (income, longevity and schooling) as well as the contribution of three economic sectors (agriculture, industry and services) to the Gross domestic product (GDP) of the municipalities.

Resultados e Conclusão

The model explained 65.08% of the covariance, indicating strong syndemic interactions among the studied diseases, largely driven by the environmental e socio-demographic factors. ATL, dengue, vivax and falciparum malaria co-occurred in municipalities dominated by pasture, but still with larger forest remnants, where service is the main GDP’s contributor and schooling is lower. Chagas and malaria were associated with municipalities with mining, secondary vegetation and recent deforestation. These results show that the spatial distribution of vector-borne disease in the Amazon is closely linked to the socio-environmental landscape and propose the use of latent models to identify syndemics.

Palavras-chave

vector borne diseases, Amazon region, environmental determinants, syndemics