This paper describes the construction and application of a social deprivation index that was created to explore the relationship between lymphatic filariasis and socioenvironmental variables in the municipality of Jaboatão dos Guararapes, Pernambuco, Brazil, thereby contributing towards identifying priority areas for interventions. This indicator was obtained from principal-component factor analysis. Variables available from the national census representing socioenvironmental conditions, household characteristics and urban services were used. Epidemiological data came from a parasitological survey on lymphatic filariasis. 23 673 individuals were examined and 323 were positive (1.4%). Two factors that together explained 80.61% of the total variance were selected. The social deprivation strata were capable of indicating a risk gradient, with 74.9% of the microfilaremia cases situated in the high-risk stratum. Principal-component factor analysis was shown to be sensitive for selecting indicators associated with the risk of lymphatic filariasis transmission and for detecting areas potentially at risk. The capacity of the social deprivation index for picking up social inequalities qualifies it as a new tool for use in planning interventions aimed at controlling lymphatic filariasis in urban spaces.

Summaryobjective To describe the spatial distribution of lymphatic filariasis and its relationship with the socioenvironmental risk indicator, thus identifying priority localities for interventions in endemic urban areas.methods The study area was the municipality of Jaboatã o dos Guararapes, State of Pernambuco, Brazil. The data sources were a parasitological survey and the 2000 demographic census. From these data, a socioenvironmental composite risk indicator was constructed using the 484 census tracts (CT) as the analysis units, based on the score-formation technique. Census tracts with higher indicator values presented higher risk of occurrences of filariasis.results Six thousand five hundred and seven households were surveyed and 23 673 individuals were examined, among whom 323 cases of microfilaremia were identified. The mean prevalence rate for the municipality was 1.4%. The indicator showed that 73% (237 ⁄ 323) of the cases of microfilaremia were in high-risk areas (third and fourth quartiles) with worse socioenvironmental conditions (RR = 4.86, CI = 3.09-7.73, P < 0.05).conclusions The socioenvironmental composite risk indicator demonstrated sensitivity, since it was able to identify the localities with greater occurrence of infection. Because it can stratify spaces by using official and available data, it constitutes an important tool for use in the worldwide program for eliminating lymphatic filariasis.

Summaryobjective To evaluate composite living conditions as indicators of urban areas with a higher risk of filariasis transmission.methods This was an ecological study in the municipality of Jaboatã o dos Guararapes, in Brazil. The analysis units were census tracts. The study was divided into three phases. First, data gathered during an epidemiological investigation were analysed. Secondly, living condition indicators were drawn up and the relationship between these indicators and microfilaremia prevalence rates was analysed. Thirdly, positive cases were georeferenced with a view to identifying spatial concentration using kernel intensity estimates. Two composite living condition indicators were calculated: a socio-environmental risk index (in the form of scores) and a social deprivation index (through principal-component factor analysis).results Of 23 673 individuals examined, 1.4% had microfilaremia. According to the two indicators, greater prevalence was found in the high-risk strata, and this association was confirmed by the kernel intensity estimates.conclusions Classification of census tracts into risk strata showed the relevance of socio-economic factors and environmental conditions in identifying priority areas in urban spaces for interventions by the surveillance services and in planning filariasis control. Spatial analysis also proved to be an important tool for building up a territorially based surveillance system. These indicators, used in association with spatial analysis, are an instrument to be used by the Global Programme to Eliminate Lymphatic Filariasis.keywords lymphatic filariasis, spatial analysis, socio-economic factors, risk index, control programs

Background: Brazil has the second highest prevalence of leprosy worldwide. Autoregressive integrated moving average models are useful tools in surveillance systems because they provide reliable forecasts from epidemiological time series. Aim: To evaluate the temporal patterns of leprosy detection from 2001 to 2015 and forecast for 2020 in a hyperendemic area in northeastern Brazil. Methods: A cross-sectional study was conducted using monthly leprosy detection from the Brazil information system for notifiable diseases. The Box–Jenkins method was applied to fit a seasonal autoregressive integrated moving average model. Forecasting models (95% prediction interval) were developed to predict leprosy detection for 2020. Results: A total of 44,578 cases were registered with a mean of 247.7 cases per month. The best-fitted model to make forecasts was the seasonal autoregressive integrated moving average ((1,1,1); (1,1,1)). It was predicted 0.32 cases/100,000 inhabitants to January of 2016 and 0.38 cases/100,000 inhabitants to December of 2020. Limitations: This study used secondary data from Brazil information system for notifiable diseases; hence, leprosy data may be underreported. Conclusion: The forecast for leprosy detection rate for December 2020 was < 1 case/100,000 inhabitants. Seasonal autoregressive integrated moving average model has been shown to be appropriate and could be used to forecast leprosy detection rates. Thus, this strategy can be used to facilitate prevention and elimination programmes.

Este artigo tem por objetivo identificar áreas no município de Jaboatão dos Guararapes, estado de Pernambuco, com padrões homogêneos de condições de vida, a fim de caracterizar o método proposto como instrumento de planejamento das ações de vigilância em saúde. Trata-se de um estudo ecológico, no qual foi construído um índice composto de carência social formado por variáveis socioeconômicas do Censo Demográfico. Os 484 setores censitários do município foram definidos como unidades geográficas de análise. Foram reconhecidos quatro grupos homogêneos com base nas condições sociais, mostrando relevantes diferenças na concentração espacial da pobreza, com grupos e áreas prioritárias para intervenção. Em 45% dos bairros, a maioria dos setores censitários situou-se nos estratos de alta e muito alta carência social. No estrato IV (carência social muito alta), encontra-se a maior proporção (28%) dos domicílios do município onde se situam as piores condições de infraestrutura sanitária. O método utilizado permitiu a identificação e a agregação dos setores censitários, segundo a condição de vida da população, evidenciando as desigualdades entre os estratos. As áreas mais carentes devem receber maior atenção das autoridades públicas; tal identificação torna o método útil para efeito de planejamento das ações de vigilância em saúde.

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