OBJECTIVES: the aim of this study was to verify certain processes that are related to the occupation of urban areas and which contribute to the occurrence and expansion of kala-azar in a medium-sized town undergoing economic growth with a high influx of migrants. METHODS: the study is an epidemiological cross-section, in which house-to-house investigation was conducted concerning cases registered in 8 districts and their respective census areas, all in the municipality of Petrolina, Pernambuco state, Brazil, from 1992 to 1997. The study was backed up by laboratory research, taking into consideration both the transmitter and animal reservoir. An explanatory social determination model for the health-illness process of this endemic-epidemic situation was used. RESULTS: a concentration of kala-azar cases was observed in the urban periphery of the town of Petrolina, in areas of squatter settlement and growth, where basic sanitation was precarious, in which animals and the vector were present around the household and the population had a low level of schooling. Males and the 0-4 age group were the most affected. CONCLUSIONS: the findings suggest the establishment of a new epidemiological pattern for kala-azar in Petrolina, where this endemic occurs in areas that have been highly modified by the population. Such a situation characterises the ruralisation process of the urban peripheries endemic in large cities.
Visceral leishmaniasis; Endemic diseases; Epidemiology
