Factors associated with leprosy in a municipality of the Pre-Amazon region, state of Maranhão, Brazil

Abstract

Introduction: The Integrated Program of Leprosy Control was initiated in the municipality of Buriticupu, Maranhão, Brazil, an area considered hyperendemic for leprosy in 2003. It aims at assessing the clinical and epidemiological characteristics of the disease to reduce the detection rate of new cases until 2015. Here, we present the evolution of the indicators of leprosy within the period from 2003 to 2015. Methods: We conducted a descriptive analytical study based on the active search for and voluntary referral of cases of leprosy. The detection rate of new cases was analyzed over time. We included individuals diagnosed with leprosy between January 2003 and December 2015. The association between categorical variables was assessed using the chisquare test of independence, considering a level of significance of 5%. When the association was significant, the detection rate (with a confidence interval of 95%) was calculated. Results: Overall, 879 new leprosy cases were detected; the majority of the affected individuals were men (65.9%). Multibacillary leprosy was the most common type of the disease, according to the operational classification (55.5%); it showed the strongest association with an age ≥60 years. We also detected an association between the male sex and both, lepromatous and multibacillary leprosy. The detection rate reduced from 211.09/100,000 population in 2003 to 50.26/100,000 population in 2015. Conclusions: We found an improvement in leprosy control, with a reduction in the detection rate and the absolute number of cases. Strengthening of disease control measures should be prioritized to eliminate leprosy as a public health concern in this municipality.

Spatial analysis of epidemiological and quality indicators of health services for leprosy in hyperendemic areas in Northeastern Brazil

“…A predominance of cases with more than five skin lesions (multibacillary) was observed among men, a result in line with those obtained in Cebu, Lapu-Lapu, Talisay and Mandaue cities (Philippines) 1 , Chengalpattu district (India) 21 , Rio Grande do Norte State (Brazil) 22 , and Buriticupu city (Brazil) 23 . In the latter report, the probability of multibacillary leprosy was almost twice as high among men as among women.…”

“…This group includes older people who, in studies conducted in Brazil 8 , Mexico 25 and Korea 26 , were the most affected by the disease. In a study conducted in Maranhao (Brazil), the number of paucibacillary cases was 2.43 times higher among individuals aged < 15 years than among those aged ≥ 60 years 23 . Similar to the findings of this study, > 10% of new leprosy cases among patients aged < 15 years old are paucibacillary.…”

The Effect of Contact History and Immunization Status on the New Case of Leprosy

“…Research conducted by Efrizal, Lazuardi, & Seobono (2016) shows that the number of male (67.86%) affected by lepers is greater than female ones. According to Silva et al (2018) in his research carried out in the City of Buriticupu, Maranhao, Brazil, an area considered a hyperendemic leprosy, stated that the majority of individuals affected by leprosy were male at 65.90%.…”

“…This can increase the possibility of contact with at-risk populations (Thakkar & Patel, 2014). The clinical development of leprosy requires a long incubation period and a complex system of host-pathogen interactions which is in individuals who are in productive age and have broad social interactions, especially male individuals who have high mobilization (Silva et al, 2018).…”

Leprosy and cutaneous leishmaniasis affecting the same individuals: A retrospective cohort analysis in a hyperendemic area in Brazil

“…leprae infections [ 42 , 43 ]. Silva et al [ 44 ] also described a higher number of leprosy cases among males than in females in the Brazilian state of Maranhão. For CL, the association between male sex and the occurrence of the disease is well established [ 42 , 45 , 46 ].…”