THE EPIDEMIOLOGICAL SCENARIO OF HUMAN VISCERAL LEISHMANIASIS AND ENVIRONMENTAL RACISM IN BARCARENA, PARÁ, EASTERN AMAZON, BRAZIL: ONE HEALTH CHALLENGES

Abstract

Human visceral leishmaniasis is a major public health problem in Brazil. This research aimed to analyze the spatial distribution of human visceral leishmaniasis and its relationship with epidemiological and environmental variables in the municipality of Barcarena, in the state of Pará, from 2008 to 2022. To this end, this ecological study used data obtained from official Brazilian government databases. Descriptive and inferential statistical techniques were applied using percentages and the non-parametric chi-square test of equal expected proportions. Spatial analysis was carried out using the Kernel Density Estimation and Global Moran's Kernel Density Estimation and Bivariate Global Moran's Index, with the results being expressed in thematic and choropleth maps. The epidemiological profile observed followed the national trend, with a higher incidence among men, brown people, children below school age, living in urban areas, new cases and those progressing to a cure. The disease did not occur homogeneously in the municipality. Different spatial relationships were identified between the studied variables and the occurrence of the pathology in question. A direct autocorrelation was observed between areas with cases and those with high anthropization with the occurrence of a socio-environmental production of the pathology related to the unsustainable development model implemented in the region. The cumulative and synergistic impacts resulting from anthropic activities have influenced the epidemiological scenario of the disease, whose human populations have historically suffered a process of environmental racism far from what is advocated by one health. We emphasize the need for control and monitoring of the disease in the study area.