Inequality and leprosy in Northeast Brazil: an ecological study

Kerr, Lígia Regina Franco Sansigolo; Montenegro, Ana ClÃ¡udia Dorta; Barreto, MaurÃ­cio Lima; Werneck, Guilherme Loureiro; Feldmeier, Hermann

doi:10.1093/ije/dyh002

Cited by 121 publications

(135 citation statements)

References 12 publications

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“…However, the analysis confirmed observations by studies conducted in the North and Northeast Regions of Brazil that found leprosy to be directly associated with socioeconomic indicators and, possibly, to poor sanitary conditions. Mean ages and genders were similar to other Brazilian studies, confirming a representative sample, despite differences in ethnic composition and the heterogeneity of the social and leprosy indices of Brazilian Regions (Sommerfelt et al 1985, Kerr-Pontes et al 2004, DATASUS 2010.…”

Section: Discussionsupporting

confidence: 82%

“…The finding that our cases came from towns that were smaller than those of the controls, but did not differ in the sizes of the cities in which they currently reside, may be the result of a migratory phenomenon to larger cities where poor people go in search of jobs (Kerr-Pontes et al 2004). In the last few decades, there has been an increasing population in urban areas with people coming from rural areas.…”

Section: Discussionmentioning

confidence: 74%

“…Similarly, leprosy is associated with social inequality, poverty, malnutrition and poor sanitary conditions, which are all superposed characteristics, which must be analyzed together in risk estimation studies (Martelli et al 2002, Kerr-Pontes et al 2004, Silva Sobrinho & Mathias 2008). …”

Section: Discussionmentioning

confidence: 99%

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Armadillo meat intake was not associated with leprosy in a case control study, Curitiba (Brazil)

Schmitt

Dechandt

Dopke

et al. 2010

Mem. Inst. Oswaldo Cruz

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 74%

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Armadillo meat intake was not associated with leprosy in a case control study, Curitiba (Brazil)

Schmitt

Dechandt

Dopke

et al. 2010

Mem. Inst. Oswaldo Cruz

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“…Alguns estudos realizados na região Nordeste do Brasil, mais especificamente no Ceará, vêm contribuindo para uma maior compreensão desse aspecto da epidemiologia da doença. Municípios com maior desigualdade social apresentaram os maiores coeficientes de detecção e de prevalência de hanseníase, reforçando que indicadores sócio-econômicos e ambientais também se mostram importantes preditores da hanseníase (7)(8)(9)(10) . Portanto, estudos relacionados aos aspectos epidemiológicos e operacionais da hanseníase, uma doença expressa em territórios e populações negligenciados, principalmente nas periferias dos grandes centros urbanos são totalmente justificados.…”

Section: Introdução Introdução Introdução Introdução Introduçãounclassified

Hanseníase no município de Fortaleza, CE, Brasil: aspectos epidemiológicos e operacionais em menores de 15 anos (1995-2006)

et al. 2008

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ABSTRACT ABSTRACT ABSTRACT This is a sectional study that aims to analyze the occurrence of Hansen's disease cases in 15 year-old minors in the Municipality of Fortaleza and notified in SINAN. The epidemiological indicators in this population show hiperendemicity. In operational terms is observed the maintenance of the service concentration in some reference units, in spite of some progress. Late diagnosis, a high degree of incapacity in the diagnosis and low degree of evaluation of contacts registered reveal the fragility of the actions of control. This study emphasizes the possibility of error diagnostic front to the characteristics of the infection in this population. The occurrence of cases of leprosy in this population represents an epidemiologic indicator of great importance and its analysis extends the discussion on operational problems in the network of health services. Descriptors: Descriptors: Descriptors: Descriptors: Descriptors: Leprosy; Child; Epidemiology, descriptive; Prevention & control. RESUMEN RESUMEN RESUMEN RESUMEN RESUMEN Estudio transversal con el objetivo de analizar las ocurrencias de los casos de lepra en menores de 15 años de edad sitiados en la ciudad de Fortaleza y enterados en el SINAN. Los indicadores epidémicos en ésta población se presentaron hiperendémicos. En la operacinalización, se observa el mantenimiento de la concentración de atención en algunas unidades recomendables, a pesar de algunos avances. Diagnósticos muy tardes, gran grado de incapacidad en el diagnóstico y bajo grado de evaluación de contactos registrados, muestran la fragilidad de las acciones de control. Se resalta así la posibilidad de error de diagnóstico delante de las características de la infección en ésta población. La ocurrencia de casos de lepra en ésta población representa un indicador epidémico de gran importancia y su análisis amplia la discusión sobre los problemas operacionales en la red de servicios públicos. Descriptores Descriptores Descriptores Descriptores Descriptores: Lepra; Niño; Epidemiología descriptiva; Prevención & control. (3) .No ano de 2007 foi notificado um total de 39.271 casos novos de hanseníase no país, a maior parte na região Nordeste (16.335, 41,6% dos casos do país). O Estado do Ceará foi responsável por 2.510 casos (6,4% dos casos do país e 15,4% dos casos da região Nordeste). O país mantém um coeficiente médio de detecção em menores de 15 anos de idade de 0,53 casos novos por 10.000 habitantes (número absoluto 2.980 casos novos), considerado como muito alto. Nos últimos cinco anos, ressalta-se que a média de casos novos detectados no Brasil nessa população foi de 4.000 casos (4) .Esses dados são significativos, tanto que o Programa Nacional de Controle da Hanseníase (PNCH) nos últimos três anos vem sinalizando este indicador como prioritário para o monitoramento da doença. A região nordeste foi responsável por 47,0% de todos os casos em menores de 15 anos de idade no país em 2007. O Estado do Ceará isoladamente foi responsável por 5,5% de todos os casos...

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“…A number of previous studies conducted in Ceará have demonstrated a diverse distribution of leprosy in the state 4,22 ; the cities with a high disease incidence are in the most developed and urbanized regions, but have a high level of social inequality. Moreover, factors, such as limited education, social inequality, poor personal hygiene, and nutritional deficiency, have been reported to be associated with the development of leprosy.…”

Section: Tablementioning

confidence: 99%

Presence of Mycobacterium leprae genotype 4 in environmental waters in Northeast Brazil

Holanda

Marques

Macedo

et al. 2017

Rev. Soc. Bras. Med. Trop.

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Introduction: This study quantified Mycobacterium leprae bacilli in environmental water samples from five municipalities in the State of Ceará by quantitative polymerase chain reaction (qPCR) and compared the identified genotypes with those obtained from leprosy patient biopsies. Methods: We collected five replicas from each of the 30 selected reservoirs and skin lesion biopsies from 25 new leprosy cases treated at a reference center in Fortaleza, Ceará from 2010 to 2013. The 16S rRNA gene region of M. leprae was amplified by qPCR and a standard curve was created with the pIDTBlue 16SrRNAMlep plasmid. The Juazeiro do Norte water samples and the biopsies were genotyped (single nucleotide polymorphism [SNP] 1 to 4) and the SNP 4 genotypes were subtyped. Results: Of the 149 water samples analyzed, 54.4% were positive for the M. leprae DNA. The M. leprae bacilli copy number ranged from 1.42 × 10 -1 to 1.44 × 10 + 2 . Most biopsies showed SNP type 4 (64%), while all samples from Juazeiro do Norte were SNP type 4, with subtype 4-N appearing at the highest frequency. Conclusions: We suggest that environmental waters containing M. leprae bacilli play an important role in disease transmission, justifying PGL-1 seropositivity in individuals living in areas where there is no reported case, and in leprosy cases individuals who report no previous contact with other case. Therefore, further investigation is needed to clarify disease transmission in this region and to explore the role of the environment. We also suggest that in this area surveillance for leprosy cases should be intensified.

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Inequality and leprosy in Northeast Brazil: an ecological study

Cited by 121 publications

References 12 publications

Armadillo meat intake was not associated with leprosy in a case control study, Curitiba (Brazil)

Armadillo meat intake was not associated with leprosy in a case control study, Curitiba (Brazil)

Hanseníase no município de Fortaleza, CE, Brasil: aspectos epidemiológicos e operacionais em menores de 15 anos (1995-2006)

Presence of Mycobacterium leprae genotype 4 in environmental waters in Northeast Brazil

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