A historical overview of leprosy epidemiology and control activities in Amazonas, Brazil

Cunha, Carolina Cândida da; Pedrosa, Valderiza; Dias, Luiz C.; Braga, Andréa B. C.; Chrusciak‐Talhari, Anette; Santos, M. A. V.; Penna, Gerson Oliveira; Talhari, Sinésio; Talhari, Carolina

doi:10.1590/0037-8682-0103-2013

Cited by 13 publications

(15 citation statements)

References 12 publications

(7 reference statements)

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“…Therefore, the inference is usually made under the Bayesian framework, in which the extra information can be accommodated through appropriate prior distributions. Based on the prior knowledge we have available [ 25 ], we employed the hierarchical Poisson model under the Bayesian framework proposed by [ 23 ] in order to fit our model to the Brazilian leprosy data.…”

Section: Methodsmentioning

confidence: 99%

Estimating underreporting of leprosy in Brazil using a Bayesian approach

Oliveira

Pescarini

et al. 2021

PLoS Negl Trop Dis

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Background Leprosy remains concentrated among the poorest communities in low-and middle-income countries and it is one of the primary infectious causes of disability. Although there have been increasing advances in leprosy surveillance worldwide, leprosy underreporting is still common and can hinder decision-making regarding the distribution of financial and health resources and thereby limit the effectiveness of interventions. In this study, we estimated the proportion of unreported cases of leprosy in Brazilian microregions. Methodology/Principal findings Using data collected between 2007 to 2015 from each of the 557 Brazilian microregions, we applied a Bayesian hierarchical model that used the presence of grade 2 leprosy-related physical disabilities as a direct indicator of delayed diagnosis and a proxy for the effectiveness of local leprosy surveillance program. We also analyzed some relevant factors that influence spatial variability in the observed mean incidence rate in the Brazilian microregions, highlighting the importance of socioeconomic factors and how they affect the levels of underreporting. We corrected leprosy incidence rates for each Brazilian microregion and estimated that, on average, 33,252 (9.6%) new leprosy cases went unreported in the country between 2007 to 2015, with this proportion varying from 8.4% to 14.1% across the Brazilian States. Conclusions/Significance The magnitude and distribution of leprosy underreporting were adequately explained by a model using Grade 2 disability as a marker for the ability of the system to detect new missing cases. The percentage of missed cases was significant, and efforts are warranted to improve leprosy case detection. Our estimates in Brazilian microregions can be used to guide effective interventions, efficient resource allocation, and target actions to mitigate transmission.

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Section: Methodsmentioning

confidence: 99%

Estimating underreporting of leprosy in Brazil using a Bayesian approach

Oliveira

Pescarini

et al. 2021

PLoS Negl Trop Dis

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“…If such a study was available, we could center the covariate w with respect to its observed mean and then elicit an appropriate informative prior for parameter α 0 , which, in this case, could be interpreted as the overall mean reporting rate. In the work by Cunha et al 2015, the authors present results of an active search survey, performed in 2012, in some municipalities of the state of Amazon, Northern of Brazil. Based on their findings, the microregion Rio Preto da Eva (RPE), composed by the municipalities Rio Preto da Eva and Presidente Figueiredo , showed reporting rates of approximately 91% when comparing the total cases registered by the local health centers.…”

Section: Methodsmentioning

confidence: 99%

“…To do so, we center the covariate w with respect to its observed value for Itacoatiara so that the parameter α 0 , on the logarithmic scale, represents the average level of notification of leprosy cases in such microregion. Moreover, we assume that the information for the level of notification for the period from 2007 to 2015 can be represented by findings of Cunha et al 2015 for year 2012. We then specified a N (2.5, 0.3) as the prior distribution for the parameter, which provides an a priori average level of reporting of approximately 91% for this microregion, on the logistic scale.…”

Section: Methodsmentioning

confidence: 99%

Estimating Under Reporting of Leprosy in Brazil using a Bayesian Approach

Oliveira

Andrade

et al. 2020

Preprint

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Leprosy remains an important health problem in Brazil - the country register the second largest number of new leprosy cases each year, accounting for 14% of the world's new cases in 2019. Although there was increasing advances in leprosy surveillance worldwide, the true number of leprosy cases is expected to be much larger than the reported. Leprosy underreporting impair planning effective interventions and thoughful decisions about the distribution of financial and health resources. In this study, we estimated leprosy underreporting for each Brazilian microregion in order to guide effective interventions and resouce allocation to improve leprosy detection in the country. We extracted the number of new cases of leprosy from 2007 to 2015 and population and socioeconomic information from the 2010 Census for each Brazilian municipality and grouped data in microregions. We applied a Bayesian hierarchical model to obtain the best explicative model for leprosy underreporing using Grade 2 of leprosy-related disabilities as a proxy to explain the incidence rates. Then, we estimated the number of missing leprosy cases (underreported cases) and the corrected leprosy incidence rates for each Brazilian microrregion.

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“…Cunha et al (13) discuss Hansen disease in the State of Amazonas and demonstrate a reduction in its incidence associated with decentralization of healthcare delivery by the national control program. The authors point out the dilemma faced by a region where new cases are now very rare, but there is a need to expand the coverage of dermatological examination to improve detection as well to maintain the accumulated experience of highly qualified institutions such as the Alfredo da Matta Foundation in Manaus (13) .…”

Section: Conflict Of Interestmentioning

confidence: 99%

“…The authors point out the dilemma faced by a region where new cases are now very rare, but there is a need to expand the coverage of dermatological examination to improve detection as well to maintain the accumulated experience of highly qualified institutions such as the Alfredo da Matta Foundation in Manaus (13) .…”

Section: Conflict Of Interestmentioning

confidence: 99%