Epidemiological, Clinical, and Socioenvironmental Characteristics of Cutaneous Leishmaniasis Cases in the Xakriabá Indigenous Population, Brazil

Abstract

Background Cutaneous leishmaniasis (CL) remains a neglected tropical disease that disproportionately affects indigenous populations, where transmission is shaped by complex socioenvironmental conditions. Our objective is to describe and analyze the sociodemographic, environmental, clinical, and therapeutic characteristics of CL cases in the Xakriabá indigenous population, and to explore associations between these characteristics and clinical outcomes. Methods An observational analytical study based on a case series was conducted using secondary data from the Brazilian Notifiable Diseases Information System (SINAN), covering the period from 2013 to 2024. Analyses were restricted to internal associations among reported cases, without inference of population-level risk. Sociodemographic, environmental, clinical, and therapeutic variables were analyzed using descriptive statistics and logistic regression models. Results A total of 259 CL cases were identified. Most cases occurred in males (63%) and individuals aged 20–39 years (38%), with nearly all cases residing in rural areas (99%). Associations were observed between clinical outcomes and variables such as occupational exposure (OR = 2.45; 95% CI 1.38–4.33) and proximity to vegetation (OR = 2.71; 95% CI 1.49–4.92). These findings represent associations within the case population and should not be interpreted as causal effects or population risk estimates. A high proportion of missing laboratory data was identified. Spatial distribution was described without inferential analysis. Conclusion CL in the Xakriabá population is characterized by heterogeneous distribution and associations with socioenvironmental factors within reported cases. Given the study design, results should be interpreted cautiously, without causal inference. Strengthening diagnostic capacity, improving data quality, and implementing territorially adapted public health strategies are essential to improve disease management in indigenous contexts.

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