02433nas a2200277   4500000000100000008004100001653002000042653001200062653003500074653001600109653001100125100001600136700001600152700001200168700001600180700001300196700001500209700001700224700001400241245017000255856007100425300001200496490000800508520162500516022001402141       2017                            d10aschistosomiasis10aleprosy10aGeographic Information Systems10aCoinfection10aBrazil1 aPhillips DA1 aFerreira JA1 aAnsah D1 aTeixeira HS1 aKitron U1 aFilippis T1 aAlcântara M1 aFairley J00aA tale of two neglected tropical infections: using GIS to assess the spatial and temporal overlap of schistosomiasis and leprosy in a region of Minas Gerais, Brazil.  uhttp://www.scielo.br/pdf/mioc/v112n4/0074-0276-mioc-112-4-0275.pdf  a275-2800 v1123 a<p><strong>BACKGROUND: </strong>Despite public health efforts to reduce the global burden of leprosy, gaps remain in the knowledge surrounding transmission of infection. Helminth co-infections have been associated with a shift towards the lepromatous end of the disease spectrum, potentially increasing transmission in co-endemic areas.</p>

<p><strong>OBJECTIVES: </strong>Using this biologically plausible association, we conducted a geographic information systems (GIS) study to investigate the spatial associations of schistosomiasis and leprosy in an endemic area of Minas Gerais (MG), Brazil.</p>

<p><strong>METHODS: </strong>Data on new cases of Mycobacterium leprae and Schistosoma mansoni infections from 2007-2014 were retrieved from the Brazilian national notifiable diseases information system for seven municipalities in and surrounding Vespasiano, MG. A total of 139 cases of leprosy and 200 cases of schistosomiasis were mapped to a municipality level. For one municipality, cases were mapped to a neighborhood level and a stratified analysis was conducted to identify spatial associations.</p>

<p><strong>FINDINGS: </strong>A relative risk of 6.80 [95% confidence interval (CI) 1.46 - 31.64] of leprosy was found in neighborhoods with schistosomiasis. Incidence rates of leprosy increased with corresponding incidence rates of schistosomiasis, and the temporal trends of both infections were similar.</p>

<p><strong>CONCLUSIONS: </strong>The associations found in this project support the hypothesis that helminth infections may influence the transmission of leprosy in co-endemic areas.</p>
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