Cutaneous leishmaniasis (CL) is a neglected disease widely distributed in Maranhão, Brazil and presents a significant public health problem. However, its transmission dynamics and determining factors are not clearly understood. In this context, geospatial technologies help interpret the process. This study, then, characterized the space–time dynamics and the influence of social vulnerability on CL in an endemic area in Northeast Brazil. This is an ecological study about new cases of CL in Maranhão, from 2007 to 2020, obtained directly from the Notifiable Diseases Information System. The incidence rate was smoothed using a spatial empirical Bayesian method. Subsequently, global and local Moran statistics and their association with social vulnerability indicators were determined. Disease distribution was not random but grouped in space and time. All Social Vulnerability Index domains were positively correlated with the CL incidence. A likely cluster was detected in western Maranhão (P < 0.001), which encompassed 18 municipalities, from January 2007 to December 2013, with a high relative risk (5.06). The research findings suggest that planning public health actions and allocating resources should be prioritized in these areas to help effectively reduce the incidence of the disease.

中文翻译：

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巴西马拉尼昂州皮肤利什曼病监测和控制的时空风险集群、社会脆弱性和确定优先领域：一项生态研究

皮肤利什曼病（CL）是一种被忽视的疾病，广泛分布于巴西马拉尼昂州，是一个严重的公共卫生问题。然而，其传播动力学和决定因素尚不清楚。在这种情况下，地理空间技术有助于解释这一过程。然后，本研究描述了巴西东北部流行区 CL 的时空动态和社会脆弱性对 CL 的影响。这是一项关于 2007 年至 2020 年马拉尼昂州 CL 新病例的生态研究，直接从法定疾病信息系统获得。使用空间经验贝叶斯方法对发病率进行平滑处理。随后，确定了全球和地方莫兰统计数据及其与社会脆弱性指标的关联。疾病分布不是随机的，而是按空间和时间分组的。所有社会脆弱性指数域均与 CL 发生率呈正相关。2007 年 1 月至 2013 年 12 月期间，在马拉尼昂州西部发现了一个可能的集群（P < 0.001），该地区涵盖 18 个城市，相对风险较高（5.06）。研究结果表明，应优先在这些领域规划公共卫生行动和分配资源，以帮助有效降低疾病的发病率。