{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T12:39:29Z","timestamp":1784896769878,"version":"3.55.0"},"reference-count":45,"publisher":"Pan American Health Organization","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,28]]},"abstract":"<p><bold>Objetivo.<\/bold> Determinar y caracterizar \u00e1reas de riesgo potencial de la ocurrencia de leishmaniasis cut\u00e1nea (LC) en Am\u00e9rica Latina (AL).<\/p>\n<p><bold>M\u00e9todo.<\/bold> Estudio observacional ecol\u00f3gico con unidades de observaci\u00f3n definidas por municipios con transmisi\u00f3n de LC entre 2014-2018. Se utilizaron variables medioambientales y socioecon\u00f3micas disponibles para al menos 85% de los municipios, combinados en una sola base de datos, a trav\u00e9s del <bold><italic>software<\/italic><\/bold> R. Se combin\u00f3 la metodolog\u00eda de an\u00e1lisis de componentes principales con un an\u00e1lisis de conglomerados jer\u00e1rquicos para la formaci\u00f3n de conglomerados de municipios en funci\u00f3n de su similitud. Se estim\u00f3 el V-test para definir la asociaci\u00f3n positiva o negativa de las variables con los conglomerados y separaci\u00f3n por divisiones naturales para determinar cu\u00e1les contribuyeron m\u00e1s a cada conglomerado. Se incorporaron los casos para atribuir el riesgo de LC para cada conglomerado.<\/p>\n<p><bold>Resultados.<\/bold> Se incluyeron en el estudio 4 951 municipios con transmisi\u00f3n de LC (36,5% del total en AL) y se definieron siete conglomerados por su asociaci\u00f3n con 18 variables medioambientales y socioecon\u00f3micas. El riesgo hist\u00f3rico de LC se asocia de manera positiva y en forma decreciente con los conglomerados Amaz\u00f3nico, Andino y Sabana; y de manera negativa con los conglomerados Boscoso\/perenne, Boscoso\/cultivo y Boscoso\/poblado. El conglomerado Agr\u00edcola no revel\u00f3 ninguna asociaci\u00f3n con los casos de LC.<\/p>\n<p><bold>Conclusiones.<\/bold> El estudio permiti\u00f3 identificar y caracterizar el riesgo de LC por conglomerados de municipios y conocer el patr\u00f3n propio epidemiol\u00f3gico de distribuci\u00f3n de la transmisi\u00f3n, lo que proporciona a los gestores una mejor informaci\u00f3n para las intervenciones intersectoriales para el control de la LC.<\/p>","DOI":"10.26633\/rpsp.2021.49","type":"journal-article","created":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T13:55:13Z","timestamp":1619618113000},"page":"1","source":"Crossref","is-referenced-by-count":6,"title":["Interacci\u00f3n entre los determinantes medioambientales y socioecon\u00f3micos para el riesgo para leishmaniasis cut\u00e1nea en Am\u00e9rica Latina"],"prefix":"10.26633","volume":"45","author":[{"given":"Ana Nilce S.","family":"Maia-Elkhoury","sequence":"first","affiliation":[{"name":"aelkhoury@paho.org"},{"name":"Organizaci\u00f3n Panamericana de la Salud, R\u00edo de Janeiro, Brasil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Magalh\u00e3es Lima","sequence":"first","affiliation":[{"name":"Centro Panamericano de Fiebre Aftosa, Organizaci\u00f3n Panamericana de la Salud, R\u00edo de Janeiro, Brasil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar Daniel","family":"Salom\u00f3n","sequence":"first","affiliation":[{"name":"Instituto Nacional de Medicina Tropical, Puerto Iguaz\u00fa, Argentina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lia Puppim","family":"Buzanovsky","sequence":"first","affiliation":[{"name":"Centro Panamericano de Fiebre Aftosa, Organizaci\u00f3n Panamericana de la Salud, R\u00edo de Janeiro, Brasil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha Idal\u00ed","family":"Saboy\u00e1-D\u00edaz","sequence":"first","affiliation":[{"name":"Organizaci\u00f3n Panamericana de la Salud, Washington, D.C., Estados Unidos de Am\u00e9rica."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha Y.O.B.","family":"Valadas","sequence":"first","affiliation":[{"name":"Organizaci\u00f3n Panamericana de la Salud, R\u00edo de Janeiro, Brasil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel J.","family":"Sanchez-Vazquez","sequence":"first","affiliation":[{"name":"Centro Panamericano de Fiebre Aftosa, Organizaci\u00f3n Panamericana de la Salud, R\u00edo de Janeiro, Brasil."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11167","reference":[{"key":"ref1","unstructured":"Organizaci\u00f3n Mundial de la Salud. Global leishmaniasis update, 2006-2015: a turning point in leishmaniasis surveillance. Weekly epidemiological record N.\u00b0 38. 2017;92:557-572. Disponible en: https:\/\/www.who.int\/leishmaniasis\/resources\/who_wer9238\/en\/"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Roque ALR, Jansen AM. Wild and synanthropic reservoirs of Leishmania species in the Americas. Int J Parasitol Parasites Wildl. 2014;3(3):251-262. Doi: 10.1016\/j.ijppaw.2014.08.004","DOI":"10.1016\/j.ijppaw.2014.08.004"},{"key":"ref3","unstructured":"World Health Organization. Global leishmaniasis surveillance, 2017-2018, and first report on 5 additional indicators. Weekly epidemiological record N.\u00b0 25. 2020; 95:265-280. Disponible en: https:\/\/www.who.int\/publications\/i\/item\/who-wer9525"},{"key":"ref4","unstructured":"Organizaci\u00f3n Panamericana de la Salud. Leishmaniasis: informe epidemiol\u00f3gico en las Am\u00e9ricas. [Internet]. Washington, D.C.: OPS; 2019 [consultado el 05 de octubre del 2020]. Disponible en: https:\/\/iris.paho.org\/handle\/10665.2\/51739"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Alvar J, Yactayo S, Bern C. Leishmaniasis and poverty. Trends Parasitol. 2006;22(12):552-557. Doi: 10.1016\/j.pt.2006.09.004.","DOI":"10.1016\/j.pt.2006.09.004"},{"key":"ref6","unstructured":"Organizaci\u00f3n Mundial de la Salud. Health in 2015: from MDGS, millennium development goals, to SDGS, sustainable development goals. [Internet]. Ginebra: OMS; 2015 [consultado el 05 de octubre 2020]. Disponible en: https:\/\/apps.who.int\/iris\/handle\/10665\/200009"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Shaw J. The leishmaniases, survival and expansion in a changing world: a mini-review. Mem Inst Oswaldo Cruz. 2007;102(5):541-547.","DOI":"10.1590\/S0074-02762007000500001"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Rangel EF, Carvalho BM, Costa SM, Lainson R, Shaw JJ. Sand fly vectors of American cutaneous leishmaniasis in Brazil. 1\u00b0 Ed. Rio de Janeiro: Springer, Cham; 2018:341-380.","DOI":"10.1007\/978-3-319-75544-1_7"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"El-Sayed A, Kamel M. Climatic changes and their role in emergence and re-emergence of diseases. Environ Sci Pollut Res Int. 2020;27(18):22336-22352. Doi: 10.1007\/s11356-020-08896-w.","DOI":"10.1007\/s11356-020-08896-w"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Carvalho BM, Rangel EF, Ready PD, Vale M.M. Ecological niche modelling predicts southward expansion of Lutzomyia (Nyssomyia) flaviscutellata (Diptera: Psychodidae: Phlebotominae), vector of Leishmania (Leishmania) amazonensis in South America, under climatecChange. PLoS ONE. 2015;10(11):e0143282. Doi: https:\/\/doi.org\/10.1371\/journal.pone.0143282.","DOI":"10.1371\/journal.pone.0143282"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Costa SM, Cordeiro LP, Rangel EF. Environmental suitability for Lutzomyia (Nyssomyia) whitmani (Diptera: Psychodidae: Phlebotominae) and the occurrence of American cutaneous leishmaniasis in Brazil. Parasites & Vectors. 2018;11(155):e0143282.","DOI":"10.1186\/s13071-018-2742-7"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Buzanovsky LP, Sanchez-Vazquez MJ, Maia-Elkhoury ANS, Werneck GL. Major environmental and socioeconomic determinants of cutaneous leishmaniasis in Brazil: a systematic literature review. Rev Soc Bras Med Trop. 2020;53:e20190291. Doi: https:\/\/doi.org\/10.1590\/0037-8682-0291-2019","DOI":"10.1590\/0037-8682-0291-2019"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Maia-Elkhoury ANS, Valadas SYOB, Puppim-Buzanovsky L, Rocha F, Sanchez-Vazquez MJ. SisLeish: a multi-country standardized information system to monitor the status of Leishmaniasis in the Americas. PLoS Negl Trop Dis. 2017;11(9):e0005868. Doi: https:\/\/doi.org\/10.1371\/journal.pntd.0005868","DOI":"10.1371\/journal.pntd.0005868"},{"key":"ref14","unstructured":"Worldclim [Internet]. Historical climate data. [actualizado en enero del 2020; consultado el 19 junio del 2020]. Disponible en: https:\/\/www.worldclim.org\/data\/worldclim21.html"},{"key":"ref15","unstructured":"Organizaci\u00f3n de las Naciones Unidas para la Alimentaci\u00f3n y la Agricultura [Internet]. Occurence of forest [actualizado en mayo del 2007; consultado el 19 de junio del 2020]. Disponible en: http:\/\/www.fao.org:80\/geonetwork\/srv\/en\/resources.get?id=14066&fname=Map5_1.zip&access=private"},{"key":"ref16","unstructured":"Agencia Espacial Europea [ Internet]. GlobCover 2009 [actualizado en diciembre del 2010; consultado el 19 de junio del 2020]. Disponible en: http:\/\/due.esrin.esa.int\/page_globcover.php"},{"key":"ref17","unstructured":"U.S Geological Survey [Internet]. Mineral resources online spatial sata [consultado el 19 de junio del 2020]. Disponible en: https:\/\/mrdata.usgs.gov\/#mineral-resources"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Saboy\u00e1-D\u00edaz MI, Betanzos-Reyes AF, West SK, Mu\u00f1oz B, Castellanos LG, Espinal M. Trachoma elimination in Latin America: prioritization of municipalities for surveillance activities. Rev Panam Salud Publica. 2019;43:e93. Doi: https:\/\/doi.org\/10.26633\/RPSP.2019.93","DOI":"10.26633\/RPSP.2019.93"},{"key":"ref19","unstructured":"Baston D. Exactextractr: fast extraction from raster datasets using polygons. R package version 0.3.0. [consultado el 05 de agosto del 2020]. Disponible en: https:\/\/CRAN.R-project.org\/package=exactextractr. 2020."},{"key":"ref20","unstructured":"R Core Team [Internet]. R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria [consultado el 04 de agosto del 2020]. Disponible en: https:\/\/www.R-project.org\/"},{"key":"ref21","unstructured":"Husson F, Josse J, Pag\u00e8s J. Principal component methods - hierarchical clustering - partitional clustering: why would we need to choose for visualizing data? Tech Rep Appl Math Dep. 2010:1-17."},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Husson F. Exploratory multivariate analysis by example using R. J Stat Softw. 2011;40.","DOI":"10.18637\/jss.v040.b02"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"L\u00eb S, Josse J, Husson F. FactoMineR: an R package for multivariate analysis. J Stat Softw. 2008;25(1):1-18. Doi: 10.18637\/jss.v025.i01","DOI":"10.18637\/jss.v025.i01"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Armstrong MP, Xiao N, Bennett DA. Using genetic algorithms to create multicriteria class intervals for choropleth maps. Ann Assoc Am Geogr. 2003;93(3):595-623. Doi: https:\/\/doi.org\/10.1111\/1467-8306.9303005","DOI":"10.1111\/1467-8306.9303005"},{"key":"ref25","unstructured":"Jenks G. Optimal data classification for choropleth maps. Kansas: University Dept. of Geography-Meteorology: 1977."},{"key":"ref26","unstructured":"Organizaci\u00f3n Mundial de la Salud. Ending the neglect to attain the sustainable development goals: a road map for neglected tropical diseases 2021-2030. Ginebra: OMS; 2020. Disponible en: https:\/\/www.who.int\/neglected_diseases\/resources\/who-ucn-ntd-2020.01\/en\/"},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"P\u00e9rez-Fl\u00f3rez M, Ocampo CB, Valderrama-Ardila C, Alexander N. Spatial modeling of cutaneous leishmaniasis in the Andean region of Colombia. Mem Inst Oswaldo Cruz. 2016;111(7):433-442. Doi: https:\/\/doi.org\/10.1590\/0074-02760160074","DOI":"10.1590\/0074-02760160074"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Colston J, Saboy\u00e1 M. Soil-transmitted helminthiasis in Latin America and the Caribbean: modelling the determinants, prevalence, population at risk and costs of control at sub-national level. Geospat Health. 2013;7(2):321-40. Doi: 10.4081\/gh.2013.90","DOI":"10.4081\/gh.2013.90"},{"key":"ref29","unstructured":"Salomon OD. Instructions on how to make an outbreak of American cutaneous leishmaniasis. J Trop Med Health. 2019; 3:146. doi: 10.29011\/2688-6383.000146"},{"key":"ref30","doi-asserted-by":"crossref","unstructured":"Chavy A, Nava AFD, Luz SLB, Ram\u00edrez JD, Herrera G, Dos Santos TV, et al. Ecological niche modelling for predicting the risk of cutaneous leishmaniasis in the neotropical moist forest biome. PLoS Negl Trop Dis. 2019;13(8):e0007629. Doi: 10.1371\/journal.pntd.0007629","DOI":"10.1371\/journal.pntd.0007629"},{"key":"ref31","doi-asserted-by":"crossref","unstructured":"Rodrigues MGA, Sousa JDB, Dias \u00c1LB, Monteiro WM, Sampaio VS. The role of deforestation on American cutaneous leishmaniasis incidence: spatial-temporal distribution, environmental and socioeconomic factors associated in the Brazilian Amazon. Trop Med Int Health. 2019;24(3):348-355. Doi: 10.1111\/tmi.13196","DOI":"10.1111\/tmi.13196"},{"key":"ref32","doi-asserted-by":"crossref","unstructured":"Bonilla-Aldana DK, Su\u00e1rez JA, Franco-Paredes C, Vilcarromero S, Mattar S, G\u00f3mez-Mar\u00edn JE, et al. Brazil burning! What is the potential impact of the Amazon wildfires on vector-borne and zoonotic emerging diseases? A statement from an international experts meeting. Travel Med Infect Dis. 2019;31:101474. Doi: 10.1016\/j.tmaid.2019.101474","DOI":"10.1016\/j.tmaid.2019.101474"},{"key":"ref33","doi-asserted-by":"crossref","unstructured":"Reb\u00ealo JMM, Moraes JLP, Cruz GBV, Andrade-Silva J, Bandeira MDCA, Oliveira YNP, Santos CLCD. Influence of deforestation on the community structure of sand flies (Diptera: Psychodidae) in Eastern Amazonia. J Med Entomol. 2019;56(4):1004-1012. Doi: 10.1093\/jme\/tjz014.","DOI":"10.1093\/jme\/tjz014"},{"key":"ref34","doi-asserted-by":"crossref","unstructured":"Hashiguchi Y, Gomez LEA, C\u00e1ceres AG, Velez LN, Villegas NV, Hashiguchi K, et al. Andean cutaneous leishmaniasis (Andean-CL, uta) in Peru and Ecuador: the vector Lutzomyia sand flies and reservoir mammals. Acta Trop. 2018; 178:264-275. Doi: 10.1016\/j.actatropica.2017.12.008","DOI":"10.1016\/j.actatropica.2017.12.008"},{"key":"ref35","doi-asserted-by":"crossref","unstructured":"Hern\u00e1ndez AM, Gutierrez JD, Xiao Y, Branscum AJ, Cuadros DF. Spatial epidemiology of cutaneous leishmaniasis in Colombia: socioeconomic and demographic factors associated with a growing epidemic. Trans R Soc Trop Med Hyg. 2019;113(9):560-568. doi: 10.1093\/trstmh\/trz043","DOI":"10.1093\/trstmh\/trz043"},{"key":"ref36","doi-asserted-by":"crossref","unstructured":"Torres-Slimming P. Globalizaci\u00f3n, el proyecto Camisea y la salud de los matsiguengas. Rev Peru Med Exp Salud Publica. 2010;27(3):458-65.","DOI":"10.1590\/S1726-46342010000300021"},{"key":"ref37","doi-asserted-by":"crossref","unstructured":"Guti\u00e9rrez JD, Mart\u00ednez-Vega R, Ramoni-Perazzi J, Diaz-Quijano FA, Guti\u00e9rrez R, Ruiz FJ, et al. Environmental and socio-economic determinants associated with the occurrence of cutaneous leishmaniasis in the northeast of Colombia. Trans R Soc Trop Med Hyg. 2017;111(12):564-571. Doi: 10.1093\/trstmh\/try011","DOI":"10.1093\/trstmh\/try011"},{"key":"ref38","doi-asserted-by":"crossref","unstructured":"Guerra JAO, Guerra MGVB, Vasconcelos ZS, Freitas NS, Fonseca FR, da Silva J\u00fanior RC, et al. Socioenvironmental aspects of the Purus Region - Brazilian Amazon: Why relate them to the occurrence of American tegumentary leishmaniasis? PLoS One. 2019;14(2): e0211785. Doi: https:\/\/doi.org\/10.1371\/journal.pone.0211785","DOI":"10.1371\/journal.pone.0211785"},{"key":"ref39","doi-asserted-by":"crossref","unstructured":"de Bustamante MC, Pereira MJ, Schubach Ade O, da Fonseca AH. Epidemiological profile of cutaneous leishmaniasis in an endemic region in the State of Rio de Janeiro, Brazil. Rev Bras Parasitol Vet. 2009;18(3):34-40. Doi: https:\/\/doi.org\/10.4322\/rbpv.01803006","DOI":"10.4322\/rbpv.01803006"},{"key":"ref40","doi-asserted-by":"crossref","unstructured":"Quintana MG, Salom\u00f3n OD, De Grosso MS. Distribution of phlebotomine sand flies (Diptera: Psychodidae) in a primary forest-crop interface, Salta, Argentina. J Med Entomol. 2010;47(6):1003-10. Doi: https:\/\/doi.org\/10.1603\/ME09072","DOI":"10.1603\/ME09072"},{"key":"ref41","unstructured":"Z\u00fa\u00f1iga PM. Dimensi\u00f3n sociocultural de la leishmaniasis cut\u00e1nea. Estados Unidos de Am\u00e9rica: Editorial Acad\u00e9mica Espa\u00f1ola; 2015."},{"key":"ref42","doi-asserted-by":"crossref","unstructured":"Chaves LF, Cohen JM, Pascual M, Wilson ML. Social exclusion modifies climate and deforestation impacts on a vector-borne disease. PLoS Negl Trop Dis. 2008;2(1):e176. Doi: https:\/\/doi.org\/10.1371\/journal.pntd.0000176","DOI":"10.1371\/journal.pntd.0000176"},{"key":"ref43","doi-asserted-by":"crossref","unstructured":"Eid D, Guzman-Rivero M, Rojas E, Goicolea I, Hurtig AK, Illanes D, et al. Risk factors for cutaneous leishmaniasis in the rainforest of Bolivia: a cross-sectional study. Trop Med Health. 2018; 46:9. Doi: 10.1186\/s41182-018-0089-6","DOI":"10.1186\/s41182-018-0089-6"},{"key":"ref44","unstructured":"G\u00f3mez LE, Corredor A. Caracterizaci\u00f3n sociocultural y epidemiol\u00f3gica de un foco de leishmaniasis cut\u00e1nea en Cimitarra, Santander. Rev Salud Publica 2000;2(3):261-271."},{"key":"ref45","unstructured":"Cruz CB, da Silva MA, Afonso WBB. Perfil da popula\u00e7\u00e3o acometida por Leishmaniose tegumentar americana em Barra do Gar\u00e7as \u2013 MT. Revista Eletr\u00f4nica Interdisciplinar. 2017;18(2):84-90."}],"container-title":["Revista Panamericana de Salud P\u00fablica"],"original-title":[],"language":"es","link":[{"URL":"https:\/\/iris.paho.org\/bitstream\/handle\/10665.2\/53773\/v45e492021.pdf?sequence=1&isAllowed=y","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T13:58:09Z","timestamp":1619618289000},"score":1,"resource":{"primary":{"URL":"https:\/\/iris.paho.org\/handle\/10665.2\/53773"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,28]]},"references-count":45,"alternative-id":["RPSP.2021.49"],"URL":"https:\/\/doi.org\/10.26633\/rpsp.2021.49","relation":{},"ISSN":["1020-4989","1680-5348"],"issn-type":[{"value":"1020-4989","type":"print"},{"value":"1680-5348","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,28]]}}}