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Submitted by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2016-01-11T17:05:00Z No. of bitstreams: 2 renata_luiz_ursine.pdf: 3230501 bytes, checksum: 2f2b878292cb8aa11d8b2f215f77aeda (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2016-01-11T17:05:22Z (GMT) No. of bitstreams: 2 renata_luiz_ursine.pdf: 3230501 bytes, checksum: 2f2b878292cb8aa11d8b2f215f77aeda (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) Made available in DSpace on 2016-01-11T17:05:22Z (GMT). No. of bitstreams: 2 renata_luiz_ursine.pdf: 3230501 bytes, checksum: 2f2b878292cb8aa11d8b2f215f77aeda (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) Previous issue date: 2014 Com o prop?sito de conhecer os aspectos epidemiol?gicos da Leishmaniose Visceral (LV) entre os munic?pios sob a jurisdi??o da Superintend?ncia Regional de Sa?de de Diamantina (SRSD), realizou-se um estudo da distribui??o da LV humana e canina nestes por meio de dados disponibilizados no Sistema de Informa??o de Agravos de Notifica??o e de dados registrados em livros da SRSD. No munic?pio com maior ocorr?ncia da LV humana, realizou-se o georreferenciamento dos casos humanos e caninos associados a fatores ambientais e sociais; analisou-se a percep??o das pessoas acometidas pela doen?a por meio de entrevistas; aspectos da estrutura e funcionamento do servi?o de controle da doen?a foram analisados por meio de question?rios. No per?odo de 2007 a 2012 houve a notifica??o de 79 casos de LV humana e 451 c?es positivos para a infec??o canina nos munic?pios que comp?em a SRSD. Nestes, a LV humana foi mais prevalente em crian?as, pessoas do g?nero masculino e residentes em ?reas rurais. Em Ara?ua?, munic?pio com maior transmiss?o da LV humana, houve a notifica??o de 41 casos de LV entre os anos de 2007 a 2013. Neste, a infec??o acometeu principalmente crian?as, pessoas do g?nero masculino e residentes da ?rea urbana. A distribui??o espacial dos casos de LV humana e da infec??o canina na ?rea urbana do munic?pio de Ara?ua? exibiu um padr?o aglomerado, com agrupamentos de casos humanos estatisticamente significativos a dist?ncias superiores a 350 metros e agrupamentos estatisticamente significativos de c?es infectados a dist?ncias superiores a 75 metros. A an?lise explorat?ria por meio do estimador de Kernel apontou para maior ocorr?ncia de casos humanos e caninos na ?rea central da cidade. N?o foi observada rela??o entre o ?ndice de Vegeta??o da Diferen?a Normalizada e as ?reas de maior ocorr?ncia da doen?a. A an?lise socioambiental dos ambientes domiciliares das pessoas acometidas pela LV no munic?pio de Ara?ua? revelou um predom?nio de defici?ncias em estruturas de saneamento ambiental; presen?a de arbustos, ?rvores frut?feras e diferentes animais ao redor dos domic?lios; proximidade com ambientes naturais e casas aglomeradas. Por meio das entrevistas com as pessoas que foram acometidas pela LV, foi poss?vel perceber um desconhecimento em rela??o ? doen?a, principalmente no que diz respeito ?s formas de transmiss?o. P?de-se perceber tamb?m que os m?dicos tiveram dificuldade em diagnosticar a LV e que o tratamento que estes prescreveram para os pacientes foi, no geral, demorado. De forma geral, o munic?pio de Ara?ua? desenvolve a maioria das a??es propostas pelo Minist?rio da Sa?de para o Programa de Controle da Leishmaniose Visceral (PCLV), contudo, h? necessidade de melhor estrutura??o do servi?o de controle da LV neste. A realiza??o de planejamentos para os levantamentos das demandas de materiais para a execu??o dos diagn?sticos da LV para que n?o os falte durante a realiza??o dos inqu?ritos e o estabelecimento de condi??es para a execu??o de levantamentos entomol?gicos ? uma necessidade premente. O investimento em trabalhos de educa??o em sa?de para a popula??o, educa??o continuada para os m?dicos, Agentes de Combate a Endemias e demais profissionais envolvidos no PCLV tamb?m ? fundamental. Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Sa?de, Sociedade e Ambiente, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2014. ABSTRACT In order to know the epidemiology of visceral leishmaniasis (VL) between the municipalities under the jurisdiction of the Regional Health Superintendency of Diamantina (SRSD), carried out a study of the distribution of human and canine LV these using data available in Diseases Information system Notification and data recorded in the SRSD books. In the city with the highest occurrence of human VL was held georeferencing of human and canine cases associated with environmental and social factors; analyzed the perception of people with the disease through interviews; aspects of the structure and function of disease control service were analyzed by means of questionnaires. In the period 2007-2012 there was a notification of 79 cases of human VL and 451 dogs positive for canine infection in the municipalities that make up the SRSD. In these, the human VL was more prevalent in children, male gender and living people in rural areas. In Ara?ua?, municipality with greater transmission of human VL, there was notification of 41 cases of VL between the years 2007 to 2013. In this, the infection affected mainly children, males and gender residents of the urban area. The spatial distribution of cases of human VL and canine infection in urban Ara?ua? municipality exhibited a pattern crowded with groups of statistically significant human cases at distances greater than 350 meters and statistically significant clusters of infected dogs at distances greater than 75 meters . The exploratory analysis using the Kernel estimator pointed to a higher incidence of human and canine cases in the central area of the city. No relationship was found between the Difference Vegetation Index Normalized and areas of highest incidence of the disease. The environmental analysis of the home environments of people affected by LV in the municipality of Ara?ua? revealed a predominance of deficiencies in environmental sanitation structures; presence of shrubs, fruit trees and different animals around the household; proximity to natural environments and clustered houses. Through interviews with people who have been affected by LV, it was revealed an ignorance about the disease, particularly with regard to forms of transmission. It could be perceived also that doctors had difficulty diagnosing VL and the treatment prescribed for these patients was generally, time consuming. In general, the municipality of Ara?ua? develop most of the actions proposed by the Ministry of Health for the Control Program Visceral Leishmaniasis (PCLV), however, there is need for a better structuring of the LV control this service. The realization of plans for surveys of the demands of materials for the execution of LV diagnostics lest they miss during the surveys and the establishment of conditions for the implementation of entomological surveys is urgently needed. Investment in health education work for the population, continuing education for physicians, Fighting Endemic Diseases agents and other professionals involved in PCLV is also key.