Leishmaniose tegumentar americana e a relação doença-espaço geográfico: aportes para a gestão dos Parques Estaduais do Aguapeí e do Rio do Peixe-SP
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Data
2017-10-11
Autores
Henriques, Natália Poiani [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A Leishmaniose Tegumentar Americana (LTA) é uma doença infecto-parasitária, não contagiosa, transmitida aos mamíferos através da picada de fêmeas de flebotomíneos, infectadas por protozoários do gênero Leishmania. Caracterizada por afecções dermatológicas, a doença apresenta atualmente três padrões epidemiológicos e ampla distribuição geográfica. A preocupação em se entender a doença e seus fatores determinantes não é recente, e dentre eles, é preciso considerar como se processa a produção do espaço e a relação da sociedade com a natureza, o que reforça a importância dos estudos geográficos. Os Parques Estaduais do Aguapeí (PEA) e do Rio do Peixe (PERP) e os municípios que os integram, compõem a área do presente estudo, cujo objetivo geral consistiu em analisar a relação entre o espaço geográfico e a LTA, de modo a contribuir com a gestão destes espaços especialmente protegidos. Para tanto, na revisão bibliográfica, retomamos os processos de ocupação da região e os estudos da doença no estado de São Paulo em diferentes contextos históricos. Consideramos as notificações dos casos humanos da doença de 1998 a 2016, a ocorrência de casos nas proximidades dos parques e as relações socioespaciais existentes no interior dos mesmos. Utilizamos armadilhas luminosas tipo CDC para a captura de espécies de flebotomíneos e analisamos os planos de manejo com vistas à identificação da abordagem epidemiológica. Assim, constatamos que a situação epidemiológica da doença na área de interesse caracteriza-se por casos esporádicos com evidências da ocorrência de um surto em alguns municípios do PEA no ano de 2015, quando observamos um incremento significativo na participação da área de estudo nos casos totais do Estado. Foram capturadas 12 espécies de flebotomíneos, das quais Bichromomyia flaviscutellata, Migonemyia migonei, Nyssomyia neivai, Nyssomyia whitmani e Pintomyia fischeri estão associadas à transmissão da LTA. Constatamos ainda que os planos de manejo atuais não contemplam o levantamento entomológico e não abordam aspectos epidemiológicos desta ou de outras doenças. Considerando os perfis epidemiológicos da LTA e as relações sociais que ocorrem no interior dos parques, ao trazermos para a reflexão a noção de risco e vulnerabilidade em saúde, propomos ações e destacamos medidas preventivas individuais e coletivas, contribuindo para a gestão destes espaços no tocante ao risco da transmissão desta doença.
American Cutaneous Leishmaniasis (ACL) is a non-contagious infectious-parasitic disease transmitted to mammals through the bite of female sandflies infected by protozoa of the genus Leishmania. Characterized by dermatological conditions, the disease currently presents three epidemiological patterns and a wide geographic distribution. The concern to understand the disease and its determinants is not recent, and among them, it is necessary to consider how the production of space and the relation of society to nature are processed, which reinforces the importance of geographic studies. Aguapeí and Rio do Peixe State Parks and the municipalities that comprise them integrate the area of the present study, whose general aim was to analyze the relationship between geographic space and the ACL, in order to contribute with the management of these specially protected spaces. Therefore, in the bibliographic review, we return to the processes of occupation of the region and the studies of the disease in the state of São Paulo in different historical contexts. We consider the reports of the human cases of the disease from 1998 to 2016, the occurrence of cases in the vicinity of the parks and the socio-spatial relationships existing within them. We used CDC type light traps to capture sandflies species and analyzed management plans to identify the epidemiological approach. Thus, we verified that the epidemiological situation of the disease in the area of interest is characterized by sporadic cases with evidence of the occurrence of an outbreak in some municipalities of the Aguapeí State Park in the year 2015, when we observed a significant increase in the participation of the study area in the total cases of state. Twelve species of sandflies were captured, of which Bichromomyia flaviscutellata, Migonemyia migonei, Nyssomyia neivai, Nyssomyia whitmani and Pintomyia fischeri are associated with the transmission of ACL. We also found that the current management plans do not contemplate the entomological survey and do not address the epidemiological aspects of this or other diseases. Considering the epidemiological profiles of the ACL and the social relations that occur within the parks, in bringing to the reflection the notion of risk and vulnerability in health, we propose actions and highlight individual and collective preventive measures, contributing to the management of these spaces in relation to the transmission of this disease.
American Cutaneous Leishmaniasis (ACL) is a non-contagious infectious-parasitic disease transmitted to mammals through the bite of female sandflies infected by protozoa of the genus Leishmania. Characterized by dermatological conditions, the disease currently presents three epidemiological patterns and a wide geographic distribution. The concern to understand the disease and its determinants is not recent, and among them, it is necessary to consider how the production of space and the relation of society to nature are processed, which reinforces the importance of geographic studies. Aguapeí and Rio do Peixe State Parks and the municipalities that comprise them integrate the area of the present study, whose general aim was to analyze the relationship between geographic space and the ACL, in order to contribute with the management of these specially protected spaces. Therefore, in the bibliographic review, we return to the processes of occupation of the region and the studies of the disease in the state of São Paulo in different historical contexts. We consider the reports of the human cases of the disease from 1998 to 2016, the occurrence of cases in the vicinity of the parks and the socio-spatial relationships existing within them. We used CDC type light traps to capture sandflies species and analyzed management plans to identify the epidemiological approach. Thus, we verified that the epidemiological situation of the disease in the area of interest is characterized by sporadic cases with evidence of the occurrence of an outbreak in some municipalities of the Aguapeí State Park in the year 2015, when we observed a significant increase in the participation of the study area in the total cases of state. Twelve species of sandflies were captured, of which Bichromomyia flaviscutellata, Migonemyia migonei, Nyssomyia neivai, Nyssomyia whitmani and Pintomyia fischeri are associated with the transmission of ACL. We also found that the current management plans do not contemplate the entomological survey and do not address the epidemiological aspects of this or other diseases. Considering the epidemiological profiles of the ACL and the social relations that occur within the parks, in bringing to the reflection the notion of risk and vulnerability in health, we propose actions and highlight individual and collective preventive measures, contributing to the management of these spaces in relation to the transmission of this disease.
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Palavras-chave
Parques Estaduais, American Cutaneous Leishmaniasis (ACL), State Parks, Leishmaniose tegumentar americana (LTA), Flebotomíneos, Gestão, Espaço geográfico, Sandflies, Management, Geographic space