A tale of two neglected tropical infections: using GIS to assess the spatial and temporal overlap of schistosomiasis and leprosy in a region of Minas Gerais, Brazil

BACKGROUND Despite public health efforts to reduce the global burden of leprosy, gaps remain in the knowledge surrounding transmission of infection. Helminth co-infections have been associated with a shift towards the lepromatous end of the disease spectrum, potentially increasing transmission in co-endemic areas. OBJECTIVES Using this biologically plausible association, we conducted a geographic information systems (GIS) study to investigate the spatial associations of schistosomiasis and leprosy in an endemic area of Minas Gerais (MG), Brazil. METHODS Data on new cases of Mycobacterium leprae and Schistosoma mansoni infections from 2007-2014 were retrieved from the Brazilian national notifiable diseases information system for seven municipalities in and surrounding Vespasiano, MG. A total of 139 cases of leprosy and 200 cases of schistosomiasis were mapped to a municipality level. For one municipality, cases were mapped to a neighborhood level and a stratified analysis was conducted to identify spatial associations. FINDINGS A relative risk of 6.80 [95% confidence interval (CI) 1.46 - 31.64] of leprosy was found in neighborhoods with schistosomiasis. Incidence rates of leprosy increased with corresponding incidence rates of schistosomiasis, and the temporal trends of both infections were similar. CONCLUSIONS The associations found in this project support the hypothesis that helminth infections may influence the transmission of leprosy in co-endemic areas.

A geografia social do zika no Brasil / The social geography of zika in Brazil

A crise do vírus do zika, como todas as doenças, é um indicador da desigualdade que persiste no Brasil mesmo após décadas de democracia. O zika ilustra disparidade não apenas em termos de classe e com a variedade de questões que se conectam com classe, como gênero e raça. Questões éticas relacionadas ao vírus do zika também têm impactos diferenciais em termos de escolhas reprodutivas, no uso de produtos químicos para a pulverização e no desenvolvimento de mosquitos geneticamente modificados. Ao utilizarem um conjunto multidisciplinar de métodos baseados em história, antropologia e ecoepidemiologia, os autores mostram como a crise atual do zika é parte do histórico de saúde no Brasil com as relações muitas vezes tensas entre atores estatais e população em geral

The Zika virus crisis, like of all diseases, is an indicator of the inequality that persists in Brazil, even after decades of democracy. Zika illustrates disparity not only in terms of class, and a variety of other issues linked to class, but also of gender and race. Ethical issues related to the Zika virus also have different impacts in terms of reproductive choices, the use of chemicals for spraying, and the development of genetically-modified mosquitoes. By using a multi-disciplinary set of methods based on history, anthropology, and eco-epidemiology, the authors show how the current Zika crisis is part of the long history of health in Brazil, with often-tense relations between agents of the State and the population at-large