Incidence and Epidemiological Aspects of Tegumentary Leishmaniasis in Maranhão (Brazil)
Authors: Marques Walter Rodrigues , Marques Francisca Maria Rodrigues , Santos Roberto Pereira 
Published: February 2025

Objective: The aim of this study is to investigate the incidence of Tegumentary Leishmaniasis, highlighting the need for awareness and effective public policies to control the disease.
 
Theoretical Framework: Leishmaniasis is an endemic infectious-parasitic disease caused by a protozoan of the genus Leishmania, distributed throughout the planet. It is a tropical disease that manifests two clinical forms: Visceral Leishmaniasis (VL) and Tegumentary Leishmaniasis (TL) (Brazil, 2020). Seven species are known in Brazil, with six Viannia subgenera and one Leishmania that develop Tegumentary Leishmaniasis (TL), in which they stand out: L. (Leishmania) amazonenses, L. (Viannia) guyanensis and L. (Viannia) braziliensis (Brasil, 2020). Brazil stands out with the highest number of case notifications, despite the drop between 2018 and 2019, with 16,432 and 15,484 respectively (PAHO, 2020; WHO, 2021). Transmission occurs through the bite of the infected female phlebotomine bug, known as the straw mosquito, and can change its name depending on the geographical region (Almeida et al., 2020; Brasil, 2020). It is a disease that affects the skin and mucous tissue, but can also reach the lymph nodes (Almeida et al., 2020). In Maranhão, there was only a recurrence of Tegumentary Leishmaniasis (TL) caused by the species Leishmania (Leishmania) amazonensis and Leishmania (Viannia) braziliensis. Recently, a Viannia subgenus, L. (V) shawi, was found to affect humans (Brazil, 2020). The Epidemiological Bulletin of Neglected Tropical Diseases presents five classification levels ranging from low, medium, high, intense and very intense.  Maranhão is in levels two to four for Tegumentary Leishmaniasis (TL) (Brazil, 2021). According to the risk stratification of the pathology by municipality of infection - Brazil 2017 to 2019, the municipality of Paço do Lumiar in Maranhão has a low index for Tegumentary Leishmaniasis (TL) (Brazil, 2019). However, in the Visceral Leishmaniasis (VL) risk stratification by municipality of infection - Brazil 2018 to 2020, there is a high index for the same location (Brazil, 2020).
 
Method: The methodology adopted for this research comprises a literature review and quantitative analysis of epidemiological data. Secondary data on notifications of TL and VL cases between 2015 and 2024 was analysed. Data was collected from the National System of Notifications and Diseases (SINAN), Scielo, Scopus, Google Scholar and the Capes Journal Portal.
 
Results and Discussion: The results obtained indicated a high prevalence of TL in the region, with a higher incidence among men and populations with a low level of education. It was also observed that the Covid-19 pandemic had a negative impact on the notification of new cases, resulting in a significant drop in expectations of new diagnoses. The analysis revealed the vulnerability of specific groups and the urgent need for public health actions, such as prevention campaigns and continuous monitoring. The conclusion is that Tegumentary Leishmaniasis (TL) in Maranhão requires special attention (without neglecting other forms of the disease), with the implementation of control and prevention strategies that integrate public health and social and educational policies.
 
Research Implications: The practical and theoretical implications of this research are discussed, providing insights into how the results can be applied or influence practices in the field of public health and epidemiology. These implications may cover how to act to eradicate the disease with a multidisciplinary approach, with the aim of improving the health of the population.
 
Originality/Value: This study contributes to the literature by highlighting the practical contributions that can help eradicate pathology. The relevance and value of this research is highlighted when emphasising the importance of a multidisciplinary approach that can impact the field of study or professional practice in promoting the health of the population.