This study analyzed the impact of the COVID‐19 pandemic on the detection of new cases of leprosy in the state of Bahia, Brazil. The periods January–September 2019 and January–September 2020 were compared. There was a 44.40% reduction in the diagnosis of leprosy when comparing the two periods (1,705 in 2019 and 948 in 2020). There was a reduction in the number of municipalities with reported cases: 251 municipalities in 2019 and 202 in 2020, expressing a reduction of 24.25%. Considering only the months following the arrival of the virus (April–September), the reduction was 51.10%. An inverse correlation was observed between the number of new cases of leprosy and the cumulative number of cases of COVID‐19 (Spearman's correlation coefficient = −0.840; P < 0.001) and the number of new monthly cases of COVID‐19 (Spearman's correlation coefficient = −0.817; P < 0.001). A slight increase was also observed in the proportion of multibacillary cases in the state (70.38% in 2019 and 72.69% in 2020) as well as in the proportion of individuals with the degree of physical disability not assessed at diagnosis, whose proportion rose from 16.39% in 2019 to 22.53% in 2020. The negative impact of COVID‐19 in tackling leprosy should be seen as a warning sign for health and political authorities.
Objective: To analyze the degree of physical disability in the elderly population affected by leprosy in Bahia State, between 2001 and 2012. Methods: The data relating to cases of leprosy was obtained from National System of Notifiable Diseases. Variables analyzed gender, age, race/color, education level, clinical and operational classification, degree of physical incapacity in diagnosis and discharge. Epidemiological indicators related to physical incapacity were calculated. Results: The leprosy features high magnitude in the elderly population, with a coefficient of detection of new cases higher than the general population, situated at a hyperendemic level. As to the epidemiological profile of leprosy in elderly, stands out: men, age 60 to 69 years, white race, low education level, dimorphic clinical manifestation and multibacillary operational classification. 36.25% of diagnosed cases had a physical incapacity at the time of diagnosis, with emphasis on the masculine gender. Conclusion: The high proportion of individuals with physical incapacity at the time of diagnosis suggests late diagnosis and hidden prevalence of the disease, mostly in Individuals of the male gender.
Background
Dengue is an acute viral disease of major relevance and impact on public health, causing major epidemics around the world, especially in tropical regions. Here we aimed to analyse the temporal trend and spatial risk, as well as social vulnerability factors, associated with the occurrence of dengue in the state of Bahia, Brazil between 2009 and 2018.
Methods
This is an ecological study carried out with all suspected cases of dengue in Bahia between 2009 and 2018. The data were obtained from the National Notifiable Diseases Information System, available on the website of the Health Department of the State of Bahia, and from the Brazilian Institute of Geography and Statistics. We used the Joinpoint regression model, local empirical Bayesian model for smoothing, global and local Moran statistics and spatial scanning statistics. The relationship between the dengue incidence rate and social determinants was tested using Moran's bivariate correlation.
Results
During the study period, 451 847 probable dengue cases were registered in Bahia. A declining trend was observed in 39.28% (n=11) of the state's health regions and 60.71% (n=17) showed a stationary tendency. The spatiotemporal scanning statistic showed nine clusters of dengue occurrence. The largest cluster had a radius of 342.14 km, consisting of 160 municipalities, 120 094 cases (710.20 cases/100 000 inhabitants) and a relative risk of 2.80. In the multivariate regression model, 11 variables showed a significant association: Social Vulnerability Index (SVI), Municipal Human Development Index (MHDI), SVI urban infrastructure, SVI human capital, MHDI longevity, MHDI education, proportion of people living in households with per capita income less than half the minimum wage (in 2010) and who spend more than 1 h commuting, proportion of mothers who are heads of household who did not complete elementary school and with children <15 y of age, activity rate of persons ages 10–14 y and per capita income.
Conclusions
In the analysis of the spatial distribution, areas of risk of disease transmission throughout the state were identified. These results can provide subsidies for the strategic planning of actions, as well as for the implementation of programs and/or public policies in order to control the incidence of dengue in the population.
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