{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T11:31:35Z","timestamp":1788003095206,"version":"build-2784847793"},"update-to":[{"DOI":"10.1371\/journal.pntd.0009006","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T00:00:00Z","timestamp":1611878400000}}],"reference-count":68,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2021,1,19]],"date-time":"2021-01-19T00:00:00Z","timestamp":1611014400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["434623\/2018-0"],"award-info":[{"award-number":["434623\/2018-0"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005671","name":"Funda\u00e7\u00e3o de Apoio \u00e0 Pesquisa e \u00e0 Inova\u00e7\u00e3o Tecnol\u00f3gica do Estado de Sergipe","doi-asserted-by":"publisher","award":["019.203.00933\/2018-0"],"award-info":[{"award-number":["019.203.00933\/2018-0"]}],"id":[{"id":"10.13039\/501100005671","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Graduate Support Program of Federal University of Sergipe","award":["23113.062217\/2019-50"],"award-info":[{"award-number":["23113.062217\/2019-50"]}]},{"name":"Graduate Support Program of Federal University of Sergipe","award":["23113.062290\/2019-21"],"award-info":[{"award-number":["23113.062290\/2019-21"]}]},{"name":"Graduate Support Program of Federal University of Sergipe","award":["23113.062214\/2019-16"],"award-info":[{"award-number":["23113.062214\/2019-16"]}]},{"DOI":"10.13039\/100000002","name":"U.S. National Institutes of Health","doi-asserted-by":"crossref","award":["SC1GM127207"],"award-info":[{"award-number":["SC1GM127207"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>Despite visceral leishmaniasis (VL) being epidemic in most Brazilian regions, the Northeast region is responsible for the highest morbidity and mortality outcomes within the country.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Objective<\/jats:title><jats:p>To analyse the spatiotemporal dynamics of VL cases to identify the temporal trends and high-risk areas for VL transmission, as well as the association of the disease with social vulnerability in Brazilian Northeast.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Methods<\/jats:title><jats:p>We carried out an ecological time series study employing spatial analysis techniques using all VL confirmed cases of 1,794 municipalities of Brazilian Northeast between the years 2000 to 2017. The Social Vulnerability Index (SVI) was used to represent the social vulnerability. Incidence rates were standardized and smoothed by the Local Empirical Bayesian Method. Time trends were examined through segmented linear regression. Spatiotemporal analysis consisted of uni- and bivariate Global and Local Moran indexes and space-time scan statistics.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Results<\/jats:title><jats:p>Incidence rate remained stable and ranged from 4.84 to 3.52 cases\/100,000 inhabitants. There was higher case prevalence between males (62.71%), children and adolescents (63.27%), non-white (69.75%) and urban residents (62.58%). Increasing trends of new cases were observed among adult male subjects (\u2265 40 years old) and urban residents. Importantly, VL incidence showed a direct spatial dependence. Spatial and space-time clusters were identified in<jats:italic>sert\u00e3o<\/jats:italic>and<jats:italic>meio-norte<\/jats:italic>sub-regions, overlapping with high social vulnerability areas.<\/jats:p><\/jats:sec><jats:sec id=\"sec005\"><jats:title>Conclusions<\/jats:title><jats:p>VL is a persistent health issue in Brazilian Northeast and associated with social vulnerability. Space-time clustering of VL cases in socially vulnerable municipalities demands intersectoral public policies of surveillance and control, with focus on reducing inequalities and improving living conditions for regional inhabitants.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pntd.0009006","type":"journal-article","created":{"date-parts":[[2021,1,19]],"date-time":"2021-01-19T18:50:38Z","timestamp":1611082238000},"page":"e0009006","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":33,"title":["Space-time risk cluster of visceral leishmaniasis in Brazilian endemic region with high social vulnerability: An ecological time series study"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9767-3938","authenticated-orcid":true,"given":"Caique J. 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