2019
DOI: 10.1016/s2214-109x(19)30260-8
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Abstract: Summary Background Although leprosy is recognised as a disease of poverty, there is little evidence on the specific socioeconomic factors associated with disease risk. To inform targeted strategies for disease elimination, we investigated socioeconomic markers of leprosy risk in Brazil. Methods Socioeconomic data from the 100 Million Brazilian Cohort were linked to the Brazilian national disease registry (Sistema de Informação de Agravos de Notificação) for… Show more

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Cited by 91 publications
(115 citation statements)
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“…In conducting a nationwide analysis of 42 725 household contacts of leprosy cases from the 100 Million Brazilian Cohort, this investigation provided robust estimates of the incidence of leprosy among household contacts. Among these contacts, leprosy incidence was estimated to be approximately 37times higher than that in the 100 Million Brazilian Cohort overall (17.1 per 100 000 person-years) 8 and 50-times higher than the rate recorded for the general population of Brazil in 2017 (12.9 per 100 000 person-years). 18 Furthermore, although household contacts younger than 15 years had a lower detection rate of leprosy than adults, the rate was 100 times higher than in the full population of children from the 100 Million Brazilian Cohort (5.2 per 100 000 person-years).…”
Section: Discussionmentioning
confidence: 72%
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“…In conducting a nationwide analysis of 42 725 household contacts of leprosy cases from the 100 Million Brazilian Cohort, this investigation provided robust estimates of the incidence of leprosy among household contacts. Among these contacts, leprosy incidence was estimated to be approximately 37times higher than that in the 100 Million Brazilian Cohort overall (17.1 per 100 000 person-years) 8 and 50-times higher than the rate recorded for the general population of Brazil in 2017 (12.9 per 100 000 person-years). 18 Furthermore, although household contacts younger than 15 years had a lower detection rate of leprosy than adults, the rate was 100 times higher than in the full population of children from the 100 Million Brazilian Cohort (5.2 per 100 000 person-years).…”
Section: Discussionmentioning
confidence: 72%
“…In this study, leprosy risk among household contacts was similar across geographic location or socioeconomic conditions of households, which differed from previous studies. 8,25,26 However, given that the households affected by leprosy in the 100 Million Brazilian Cohort were more likely to have low-income circumstances, 8 the sample in the present study was relatively homogeneously composed of individuals of limited resources, which may have limited our ability to differentiate any health outcomes associated with socioeconomic status. 27 The high proportion of cases associated with exposure to leprosy cases within the household compared with exposure outside of household suggests that household contacts with low-income status may benefit from targeted and effective strategies to prevent transmission, such as strengthening screening of contacts.…”
Section: Discussionmentioning
confidence: 88%
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“…Brazil is a high-burden country for Hansen's Disease [11], with incidence varying according to geographic and socioeconomic determinants [12]. Although the disabling and disfiguring sequelae of Hansen's Disease are entirely avoidable if diagnosed and treated early [13], the social stigma of 'leprosy' has not been entirely dispelled, and still has a profoundly negative impact on people diagnosed with this disease [14,15].…”
Section: Introductionmentioning
confidence: 99%
“…Although there have been large-scale studies in Brazil studying the social determinants of leprosy incidence and treatment default [8,9], risk factors for leprosy-associated disability at the time of diagnosis remain scarcely investigated. In Brazil, there are problems related to underdiagnosis and underreporting of new cases of leprosy, which hashave a major impact on the ability to plan control control activities for the disease.…”
Section: Introductionmentioning
confidence: 99%