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IJE Advance Access published online on May 11, 2009
International Journal of Epidemiology, doi:10.1093/ije/dyp207
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2009; all rights reserved.

Climate and acute/subacute paracoccidioidomycosis in a hyper-endemic area in Brazil

Ligia V Barrozo1,*, Rinaldo P Mendes2, Silvio A Marques3, Gil Benard4, Maria E Siqueira Silva1 and Eduardo Bagagli5

1Department of Geography, School of Philosophy, Literature and Human Sciences, University of São Paulo. Av. Prof. Lineu Prestes, 338. CEP 05508-900, São Paulo, SP, Brazil.
2Department of Tropical Diseases, Botucatu Medical School, São Paulo State University, SP, Brazil.
3Department of Dermatology and Radiotherapy, Botucatu Medical School, São Paulo State University, SP, Brazil.
4Laboratory of Medical Investigation in Dermatology and Immunodeficiencies and Laboratory of Medical Mycology, Medical School, University of São Paulo, SP, Brazil.
5Department of Microbiology and Immunology, Institute of Biosciences, Botucatu, São Paulo State University, SP, Brazil.

*Corresponding author. Departamento de Geografia, Faculdade de Filosofia, Letras e Ciências Humanas, Universidade de São Paulo, Av. Lineu Prestes, 338, CEP 05508-900, SP, Brazil. E-mail: lija{at}usp.br


  Abstract

Background Paracoccidioidomycosis (PCM) is Latin America's most prevalent systemic mycosis, carrying an important social burden. Its agent, Paracoccidioides brasiliensis, has rarely been identified in nature. Studies characterizing acute/subacute PCM incidence and their relationship with climate variables are not available. This work analysed a series of acute/subacute cases that occurred in the Botucatu area, São Paulo State, Brazil, from 1969 to 1999, as an outcome of weather variability.

Methods Stepwise regression of annual data was applied to model incidence, calculated based on 91 cases, from lagged variables: antecedent precipitation, air temperature, soil water storage, absolute and relative air humidity, and Southern Oscillation Index (SOI).

Results Multiple regression analyses resulted in a model, which explains 49% of the incidence variance, taking into account the absolute air humidity in the year of exposure, soil water storage and SOI of the previous 2 years.

Conclusions The correlations may reflect enhanced fungal growth after increase in soil water storage in the longer term and greater spore release with increase in absolute air humidity in the short term.

Keywords Paracoccidioidomycosis, climate, environment

Accepted 2 April 2009


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