Socioeconomic, environmental, and behavioural risk factors for leprosy in North-east Brazil: results of a case–control study

“…Brazil is about to reach the World Health Organization's target of control, but 535 municipalities are still classified as hyperendemic, with CDRs higher than 40/100,000 inhabitants 8 . The geographical distribution of leprosy is uneven and the disease persists in regions with higher levels of poverty and malnutrition, showing a close relationship with precarious conditions of living, low educational level, social inequality, and also with migratory movements 9,10 .…”

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confidence: 99%

Spatial distribution of leprosy in Brazil: a literature review

Silva

Fonseca

Kawa

et al. 2017

Rev. Soc. Bras. Med. Trop.

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Leprosy remains a public health problem in developing countries. Among communicable diseases, it is one of the leading causes of permanent disability. Brazil had not reached the goal of reducing cases to less than 1 per 10,000 population. This study aimed to analyze the spatial distribution of leprosy cases in Brazil, using a literature review. The search strategy included the LILACS and MEDLINE databases with no language or period restriction. Ecological studies with spatial data analysis were considered as a criterion for the inclusion. We found 38 studies for review after the selection criteria. Among the epidemiological indicators of the disease, the most common was the new case detection rate. Several articles have explored the association between spatial distribution of leprosy and socioeconomic, demographic, and environmental factors. The most common unit of analysis was the municipality. The spatial distribution methods mostly used were: empirical Bayesian method, autocorrelation (Moran's I index) and Kernel estimates. The distribution of leprosy was very heterogeneous, independent of t h e unit of analysis. There was a decrease in the rate of detection and among under-15-year-olds, but some regions maintained high endemicity during the study period. The distribution and risk of illness were directly related to living conditions of the population. Improved access to health services was associated with increased detection rate in some regions. Spatial analysis seems to be a very useful tool to study leprosy and to guide interventions and surveillance.

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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.…”

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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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Socioeconomic, environmental, and behavioural risk factors for leprosy in North-east Brazil: results of a case–control study

Cited by 154 publications

References 9 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)

Spatial distribution of leprosy in Brazil: a literature review

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

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