Spatial analysis of new cases of leprosy in the State of Espírito Santo, Brazil, between 2004 and 2009

Abstract

INTRODUCTION: Leprosy in Brazil is a public health issue, and there are many regions in the State of Espírito Santo with high endemic incidence levels of leprosy, characterizing this state as a priority for leprosy programs. The aim of this study was to determine the spatial distribution of coefficients of new cases of leprosy in the State of Espírito Santo, Brazil. METHODS: We conducted a descriptive and ecologic study based on the spatial distribution of leprosy in the State of Espírito Santo between 2004 and 2009. Data were gathered from the available records of the Espírito Santo State Health Secretary. The global and local Bayesian empirical methods were used to produce an estimate of leprosy risk, smoothing the fluctuation effects of the detection coefficients. RESULTS: The study resulted in a coefficient adjustment of new cases in 10 towns that changed their classification, among which, 2 went from low to medium, 4 from medium to high, 3 from high to very high, and 1 from very high to hyper-endemic. An average variation of 1.02, fluctuating between 0 and 12.39 cases/100,000 inhabitants, was found in a comparative calculation between the Local Ebest value and the average coefficient of new leprosy cases in the State of Espírito Santo. CONCLUSIONS: The spatial analysis of leprosy favors the establishment of control strategies with a better cost-benefit relationship since it reveals specific and priority regions, thereby enabling the development of actions that can interfere in the transmission chain.

Spatial distribution of leprosy in Brazil: a literature review

“…Table 1, Table 2 and Table 3 show the articles' summaries according to the scale used: two evaluated regions/ mesoregions 14,15 ; 13 used the scale of municipalities 10,[16][17][18][19][20][21][22][23][24][25][26][27] ; 4 evaluated districts [28][29][30][31] ; 6 studied neighborhoods [32][33][34][35][36][37] ; 7 analyzed the census tracts [38][39][40][41][42][43][44] ; and 3 investigated households [45][46][47] . Within each scale, the articles were organized by location: Brazil, Northern, Northeast, Midwest, and Southeast regions.…”

“…Within each scale, the articles were organized by location: Brazil, Northern, Northeast, Midwest, and Southeast regions. In all, 4 approached Brazil 10,16-18 , 7 studied the Northern region or the states of the Amazon region 14,19,20,[38][39][40]45 , 11 focused on the Northeast region [21][22][23]28,[32][33][34][35][36]40,41 , 4 the Midwest region 15,29,37,46 , and 12 the Southeast region [24][25][26][27]30,31,36,37,[42][43][44]47 .…”

Spatial Analysis Spotlighting Early Childhood Leprosy Transmission in a Hyperendemic Municipality of the Brazilian Amazon Region

“…A spatially empirical Bayes smoothed case detection rate has been used in leprosy studies to smooth the random variations in small areas with few people (where small variations in the number of cases results in dramatic changes in disease rates) and to enhance the visualization of spatial patterns [17], [50]–[52]. Smoothing is also a way to estimate uncertain values for areas with no registered cases, areas where disease is not necessarily absent but may not have been detected due to operational limitations.…”

Vigilância da infecção pelo Mycobacterium leprae por meio de sistema de informação geográfica e de ferramentas moleculares e imunológicas em município de alta endemia de hanseníase no estado de Minas Gerais

“…Our findings demonstrated that the new cases detected during the course of 10 years were heterogeneously distributed throughout the city area, in accordance with the epidemiologic indicators, and corroborating with other studies that employed spatial geographic analysis in settings highly endemic for leprosy (28,29). Different detection rates were observed within different neighbourhood sectors, varying between low and hyperendemic, following the official parameters for the annual detection rate.…”