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

Abstract

This study's objective was to estimate the temporal trends of leprosy according to sex and age groups, as well as to estimate and predict the progression of the disease in a hyperendemic city located in the northeast of Brazil. This ecological time-series study was conducted in Imperatriz, Maranhão, Brazil. Leprosy cases diagnosed between 2006 and 2016 were included. Detection rates stratified by sex and age groups were estimated. The study of temporal trends was accomplished using the Seasonal-Trend Decomposition method and temporal modeling of detection rates using linear seasonal autoregressive integrated moving average model according to Box and Jenkins method. Trend forecasts were performed for the 2017-2020 period. A total of 3,212 cases of leprosy were identified, the average incidence among men aged between 30 and 59 years old was 201.55/100,000 inhabitants and among women in the same age group was 135.28/100,000 inhabitants. Detection rates in total and by sex presented a downward trend, though rates stratified according to sex and age presented a growing trend among men aged less than 15 years old and among women aged 60 years old or over. The final models selected in the timeseries analysis show the forecasts of total detection rates and rates for men and women presented a downward trend for the 2017-2020 period. Even though the forecasts show a downward trend in Imperatriz, the city is unlikely to meet a significant decrease of the disease burden by 2020.

Serum Levels of Ficolin-3 and Mannose-Binding Lectin in Patients with Leprosy and Their Family Contacts in a Hyperendemic Region in Northeastern Brazil

“…In the present study, it was observed that the patients who were diagnosed with leprosy were more likely to be male and children. The above finding agrees with other studies reporting a higher occurrence of leprosy in men in most regions of the world as well as in Brazil [ 23 , 24 ]. The higher frequency of leprosy in males may be related to biological aspects, such as the role of testosterone in creating a favorable environment for the growth of M. leprae , resulting in a greater disease burden and greater clinical severity in male patients [ 25 , 26 ].…”

Profil Penderita Morbus Hansen di Poliklinik Kulit dan Kelamin RSUD Bali Mandara Januari 2018-Desember 2020

“…8 Morbus Hansen (MH) lebih sering pada lakilaki mungkin berhubungan dengan aspek biologis, seperti peran hormon testosteron dalam menciptakan lingkungan yang baik bagi pertumbuhan Mycobacterium leprae. 9 Faktor lain adalah faktor individu, seperti keterlambatan atau tidak mencari pelayanan medis. 9 Laki-laki lebih sering beraktivitas di luar rumah, menyebabkan lebih berisiko tertular dibandingkan perempuan akibat paparan dengan sumber infeksi.…”

“…9 Faktor lain adalah faktor individu, seperti keterlambatan atau tidak mencari pelayanan medis. 9 Laki-laki lebih sering beraktivitas di luar rumah, menyebabkan lebih berisiko tertular dibandingkan perempuan akibat paparan dengan sumber infeksi. 10 Di Asia, penderita MH lebih banyak pada laki-laki, tetapi di Afrika penderita MH lebih banyak pada perempuan.…”

“…Penelitian di RSUP Prof. Dr. R.D. Kandou Manado juga mendapatkan hasil serupa, yaitu penderita MH tipe MB sebesar 93,9% dan PB sebesar 6,1% 9. Data dari negara lain, antara lain di Brasil, penderita MH tipe MB sebesar 61% 12.…”

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

“…There are several tools that could be used to test these hypotheses; among them, one of the more sensitive tools is the time series. Its use is justified in the field of public health, as it can show the trend of the disease in vulnerable groups and verify how much success has been achieved in terms of the goal of elimination and reduction of injustices and/or inequity [ 12 ].…”