Trend analysis of leprosy indicators in a hyperendemic Brazilian state, 2001–2015

Abstract

OBJECTIVE: To analyze the temporal trend of leprosy indicators in a hyperendemic state of Brazil, from 2001–2015. METHODS:This is a time-series study of leprosy indicators in the state of Maranhão, Northeastern region of Brazil. The study used data from the Brazilian National System of Reportable Diseases, for the period between 2001 and 2015. The following indicators were evaluated: (i) detection coefficient in the general population; (ii) detection coefficient in people under 15 years old; (iii) rate of cases with grade 2 physical disability in the diagnosis; (iv) rate of examined contacts, and (v) proportion of healing . The Prais-Winsten regression model was used for trend analysis. Analyses were performed for the state and by each health region. RESULTS: 77,697 leprosy cases were analyzed in the general population and 7,599 in individuals under 15 years old. The detection coefficient in the general population ranged from 80.7/100 thousand inhabitants in 2001 to 51.2/100 thousand inhabitants in 2015. The coefficient in the general population presented a downward trend (annual percentage variation [APV] = -2.98; 95%CI -4.15– -1.79). For the population under 15 years old, the rate was 24.9/100 thousand inhabitants in 2001, and 19.9/100 thousand inhabitants in 2015, with downward trend (APV = -3.07; 95%CI -4.95– -1.15). It was observed upward trend in rate of contacts examined (APV = 2.35; 95%CI 0.58–4.15) and rate of cases with grade 2 disability (APV = 2.19; 95%CI 0.23–4.19). Stationary trend was observed in the proportion of healing (APV = -0.10; 95%CI -0.50–0.30). Regional differences were found in the performance of the indicators. CONCLUSIONS: A downward trend for the detection coefficients in the general population and in individuals under 15 years old was found in Maranhão. Despite this result, the rates are still very high, demanding efforts from all spheres of public administration and health professionals to reduce the burden of the disease in the state.

Trends and forecasts of leprosy for a hyperendemic city from Brazil’s northeast: Evidence from an eleven-year time-series analysis

“…The downward trend in total detection, of men and women, possibly reflects the intensification of leprosy control actions in Maranhão in recent years. A study carried out in the municipalities of Maranhão (including Imperatriz) found that the decreasing trend in general detection are caused by actions to expand MDT, early detection of new cases, BCG vaccination of patient contacts, training of health professionals for diagnosis and active case-finding campaigns [43].…”

“…Anchieta et al (2019) [43] identified that Imperatriz showed a decreasing trend in the detection rate of children under 15 years old in the period from 2001 to 2015, a phenomenon explained by active case-finding national campaigns in the school-aged population in the years 2013 and 2016. Despite this decrease, the authors reaffirm that detection in children under 15 years old remains high in the municipality.…”

Magnitude e tendência temporal dos indicadores da hanseníase em Goiás: um estudo ecológico do período 2001-2017

“…18 A rising trend was found in the proportion of cases with grade 2 physical disability, possibly indicating late detection -despite increased Family Health Strategy coverage -, besides difficulties in preventing disabilities. 19 Previous studies have shown a stationary trend 20,21 or a rising trend 8,11,20 in this indicator in Brazil.…”

“…Tocantins, Maranhão, Paraíba and Bahia, as well as for Brazil as a whole. [9][10][11][12][13] Certain factors may have contributed to the reduction in leprosy magnitude and incidence in Goiás. Standing out among these factors are (i) increased early diagnosis through prevention actions, (ii) specific polychemotherapy, (iii) increased Family Health Strategy coverage in recent years, contributing to identification and prioritization of families at risk and reduction in health inequities, [14][15][16] (iv) active tracing of social and/or family contacts and active tracing among school-age children (e.g., campaigns in schools) and (v) vaccination/revaccination against the Calmette-Guérin bacillus (BCG), which, although not specific for leprosy, offers protection and contributes to preventing new cases of the disease.…”

Tendência da situação epidemiológica e operacional da hansení­ase no estado de Minas Gerais (2008 - 2018)

“…A partir dos resultados obtidos, observou-se que houve um decréscimo na taxa de detecção de novos casos de hanseníase no estado durante o intervalo analisado, o que demonstra que Minas Gerais, nesse período, acompanhou a tendência nacional (19) . No entanto, Minas Gerais permanece com uma área de média endemicidade para a doença (10).…”