Inequality of gender, age and disabilities due to leprosy and trends in a hyperendemic metropolis: Evidence from an eleven-year time series study in Central-West Brazil

Abstract

The present study aimed to investigate the epidemiological situation of leprosy (Hansen’s Disease), in a hyperendemic metropolis in the Central-West region of Brazil. We studied trends over eleven years, both in the detection of the disease and in disabilities, analyzing disparities and/or differences regarding gender and age. This is an ecological time series study conducted in Cuiabá, capital of the state of Mato Grosso. The population consisted of patients diagnosed with leprosy between the years 2008 and 2018. The time series of leprosy cases was used, stratifying it according to gender (male and female), disability grade (G0D, G1D, G2D, and not evaluated) and age. The calendar adjustment technique was applied. For modeling the trends, the Seasonal-Trend decomposition procedure based on Loess (STL) was used. We identified 9.739 diagnosed cases, in which 58.37% were male and 87.55% aged between 15 and 59 years. Regarding detection according to gender, there was a decrease among women and an increase in men. The study shows an increasing trend in disabilities in both genders, which may be related to the delay in diagnosis. There was also an increasing number of cases that were not assessed for disability at the time of diagnosis, which denotes the quality of the services.

Epidemiological features of leprosy in China, 2020

“…From 2010 to 2020, the male-to-female ratio fluctuated between 1.7 and 2.4. The tendency for leprosy to be detected in more women than men has been reported in other countries, such as Brazil 16,17 ; this may be attributable to sex-related differences in the perception and knowledge of leprosy, economic dependence, and the sex insensitivity of leprosy services that leads to delay in diagnosis in females. 18 A previous study found that men had a higher level of knowledge about leprosy than women in Guizhou, China.…”

Epidemiological characteristics of leprosy during the period 2005–2020: A retrospective study based on the Chinese surveillance system

“…Similar results have also been found in other countries (India, Bangladesh, and Brazil) ( 15 , 35 – 38 ). Although no medical evidence suggests that men are more likely to develop leprosy than women, the reason may be that men have more opportunities to be exposed to a more intensive social network ( 39 ). The inconsistency between the operating hours of health care facilities and the workday, the belief that men are less sensitive to leprosy compared to women, and the barriers associated with difficulties in accessing health care services may also contribute to the increased burden of leprosy among the male population ( 38 ).…”

“…Furthermore, we observed a higher concentration of new cases detected between July and October, while the lowest was in March. Although leprosy is not traditionally considered a seasonal disease, studies have considered the highest positivity rate for Mycobacterium leprae in the nasal mucosa during the monsoon season ( 39 , 53 ). Our results may support the idea.…”

Aglomerados de risco para ocorrência de hanseníase e as incapacidades em menores de 15 anos em Cuiabá: um estudo geoespacial

“…Leprosy in children under 15 years of age in Cuiabá classifies the municipality as a scenario of very high endemicity for the disease, being one of the Brazilian cities that most notified the disease in the period from 2008 to 2018 26 .…”