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A negative binomial regression analysis was performed to evaluate the association of the factors studied with the mean incidence rate of <jats:styled-content style=\"fixed-case\">ACL<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The average proportion of deforestation was negatively associated with the average incidence rate of cutaneous leishmaniasis in municipalities (<jats:italic>\u03b2<\/jats:italic> = \u22122.178; <jats:italic>P<\/jats:italic> = 0.019; 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u22123.996, \u22120.361), and the health system performance index (effectiveness) (<jats:italic>\u03b2<\/jats:italic> = \u22120.852; <jats:italic>P<\/jats:italic> = 0.008; 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u22121.481, \u22120.225). Conversely, the municipal human development index (<jats:styled-content style=\"fixed-case\">MHDI<\/jats:styled-content>) was a factor positively related to the average incidence among the municipalities (<jats:italic>\u03b2<\/jats:italic> = 7.728; <jats:italic>P<\/jats:italic> = 0.003; 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.716, 12.738).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study shows the important impact of socioeconomic and environmental factors on <jats:styled-content style=\"fixed-case\">ACL<\/jats:styled-content> incidence in the Amazonas State.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13196","type":"journal-article","created":{"date-parts":[[2018,12,22]],"date-time":"2018-12-22T05:24:12Z","timestamp":1545456252000},"page":"348-355","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["The role of deforestation on American cutaneous leishmaniasis incidence: spatial\u2010temporal distribution, environmental and socioeconomic factors associated in the Brazilian Amazon"],"prefix":"10.1111","volume":"24","author":[{"given":"Maria Gabriela de Almeida","family":"Rodrigues","sequence":"first","affiliation":[{"name":"Sala de An\u00e1lise de Situa\u00e7\u00e3o em Sa\u00fade Funda\u00e7\u00e3o de Vigil\u00e2ncia em Sa\u00fade do Amazonas Manaus Brazil"},{"name":"Programa de P\u00f3s\u2010gradua\u00e7\u00e3o em Medicina Tropical Universidade do Estado do Amazonas Manaus Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Diego de Brito","family":"Sousa","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s\u2010gradua\u00e7\u00e3o em Medicina Tropical Universidade do Estado do Amazonas Manaus Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1dila Liliane Barros","family":"Dias","sequence":"additional","affiliation":[{"name":"Centro Universit\u00e1rio do Norte Manaus Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wuelton Marcelo","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s\u2010gradua\u00e7\u00e3o em Medicina Tropical Universidade do Estado do Amazonas Manaus Brazil"},{"name":"Funda\u00e7\u00e3o de Medicina Tropical Dr. Heitor Vieira Dourado Manaus Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanderson de Souza","family":"Sampaio","sequence":"additional","affiliation":[{"name":"Sala de An\u00e1lise de Situa\u00e7\u00e3o em Sa\u00fade Funda\u00e7\u00e3o de Vigil\u00e2ncia em Sa\u00fade do Amazonas Manaus Brazil"},{"name":"Programa de P\u00f3s\u2010gradua\u00e7\u00e3o em Medicina Tropical Universidade do Estado do Amazonas Manaus Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,28]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0035671"},{"key":"e_1_2_7_3_1","unstructured":"World Health Organization.Weekly epidemiological record Relev\u00e9 \u00e9pid\u00e9miologique hebdomadaire [Internet]. 2017. 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