Fatores associados à positividade da intradermorreação de Montenegro em Teresina, Piauí

Abstract

The American visceral leishmaniasis (AVL) or kalazar is an example of reemerging infectious disease, its urbanization being one of the most typical feature of its new epidemiologic pattern of occurrence. In Brazil, epidemics of infection by L. chagasi have occurred in several regions and control strategies have not been effective to contain the spread of the disease. To better understand this process, we have studied the association between cellular immunity, measured by the Montenegro Skin Test (MST), and demographic, social, economic and environmental factors in an urban area with high force of transmission. Statistical analysis was performed using Poisson regression models adjusted by the chi-square. Associations between variables were expressed by prevalence ratios (PR) and their respective 95% confidence intervals (CI). Higher prevalence of positivity to MST was detected among male participants (PR = 1.32 CI: 1.11 1.56), for each ten years increase of age (PR = 1.18 CI: 1.10 1.26), among subjects who owned dogs for three or more years (PR = 1.26 CI: 1.01 1.56) and for those who lived in households with precarious sewage system (PR = 1.33 CI: 0.99 1.77). Individuals with higher literacy (PR = 0.81 CI: 0.66 0.99), living in households where a case of AVL had occurred before (PR = 0.40 CI: 0.16 0.99), or in houses with walls made of bricks without finishing (PR = 0.79 CI: 0.64 0.98), or with three or more persons (PR = 0.66 CI: 0.47 0.93), showed lower prevalence of positivity to MST, indicating that these factors might have protected for earlier infection. These results might contribute to a better understanding of the behavior of the infection in urban context, and maybe useful for directing intervention to high-risk groups.