ArticleRevista do Instituto de Medicina Tropical de Sao Paulo2025
Spatiotemporal patterns of acute paracoccidioidomycosis hospitalizations in Brazil, 2014-2023.
Article in Revista do Instituto de Medicina Tropical de Sao Paulo, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Paracoccidioidomycosis in Brazil: 25-Year Nationwide Trends in Mortality, Hospitalisations and In-Hospital Deaths of a Neglected Systemic Mycosis.Tropical medicine & international health : TM & IH · 2026Article
- Combined anti-PD-1 and amphotericin B therapy reduces fungal burden and enhances control of murine paracoccidioidomycosis.Frontiers in cellular and infection microbiology · 2026Article
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Authors and funding
7 authors.
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Abstract
Paracoccidioidomycosis (PCM) is a neglected fungal disease with a rising incidence in Brazil, including increasing hospitalizations in previously non-endemic regions outside the Amazon. This study analyzed the spatiotemporal patterns of acute PCM hospitalizations and their relationship with deforestation. We carried out a retrospective ecological analysis of all PCM-related hospitalizations that were registered in the Brazilian Hospital Information System from 2014 to 2023. Acute and subacute cases were defined using ICD-10 codes (B40.0, B40.7, B40.8, B40.9, B41.0, B41.7, B41.8, and B41.9), whereas chronic forms were excluded. Rates were calculated with census population data and stabilized by Spatial Empirical Bayes smoothing. Space-time cube analysis was applied to detect clusters, which were then compared with deforestation alerts from the DETER-B satellite monitoring system. This study found 4,232 acute PCM hospitalizations, predominantly in men (80%), with a median age of 49 years. Cases were reported in 1,292 municipalities (23%), of which 78% were outside the Amazon. This study also found four significant hotspot clusters, including a newly emergent area in the Cerrado region along the Tocantins-Goias border near Brasilia. Hotspot municipalities showed the largest deforested areas (1,178 km2) when compared to coldspots (24 km2), suggesting a strong spatial association. The spatiotemporal dynamics of acute PCM indicate expansion into deforested areas of the Cerrado, highlighting the role of environmental disruption in shaping disease risk. Mitigating PCM spread in Brazil urgently requires strengthened surveillance and integrated health-environmental policies.
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