Title : Impacts of climate change on the occurrence of Leishmaniasis and COVID-19 in Brazil
Abstract:
Brazil is particularly vulnerable to the increase in the incidence of vector-borne diseases, in the context of global climate change. It is estimated that such events may impact geographic distribution, population density, seasonality, prevalence of infection and parasite load of vectors. In Brazil, the ecoepidemiology of leishmaniasis is extremely complex, considering that different species of vectors, parasites and hosts participate in the transmission cycles, in restricted ecological niches. According to the World Health Organization (2010, 2011) the policies of surveillance/control actions for neglected diseases must be aligned with agendas committed to the assessment of climate and environmental changes. It is known that climatic conditions can play a crucial role in driving epidemics caused by respiratory viruses. Although there is still no consensus on whether the circulation of SARS-CoV-2 is effectively associated with environmental factors and climatic parameters, it is a gap to be filled. For now it is impossible to predict if new epidemic waves of Covid-19 will occur seasonally or will remain in transmission throughout the year, like other respiratory viruses. We evaluate the impact of climate change, in face of the spatial distribution of leishmaniasis vectors (Lutzomyia flaviscutellata, L. whitmani, L. intermedia, L. neivai, L. wellcomei, L. complexa, L. umbratilis, L. migonei, L. longipalpis and L. cruzi) and the expansion in Brazil. The control of visceral (AVL) and cutaneous leishmaniasis (ACL) has been a major challenge for the Ministry of Health. The goals of reducing the lethality of AVL and the incidence of ATL have not advanced and the scenario that we have today is the expansion and increase in the number of human cases. The actions currently recommended, when the outbreak is already installed, have been ineffective. Therefore, it is necessary to think about alternative planning proposals in the short and medium term, identifying areas vulnerable to the occurrence of these diseases, working with surveillance as a tool that promotes health. Projections of vector distribution, associated with socioeconomic variables and incidence of leishmaniasis, will serve as a basis for calculating vulnerability indexes by municipality. The results disaggregated and analyzed per municipality are important products to subsidize the Brazilian National Leishmaniasis Control Program in the planning of surveillance and control actions. In addition, the information may support the adaptation measures and integrate the National Plan for Adaptation to Climate Change. Predicting regions of occurrence of vectors is a complex exercise that the technicians of the leishmaniasis surveillance and control programs face, in the design of a more effective intervention planning. In view of the complexity and challenge posed by the control of these diseases in Brazil, the indication of future risk scenarios for epidemic outbreaks, can optimize costs and facilitate the planning of well-targeted actions with a focus on permanent monitoring and surveillance in areas of environmental impacts. Evaluate the possible relationship between climate and climate change with the dispersion of Covid-19 cases through a literature review based on previously published data. Now, to Covid19 we will perform a meta-analysis, being a statistical analysis that combines the results of the multple scientific studies.
