Leprosy in children and adolescents under 15 years old in an urban centre in Brazil

Abstract

This original study describes the intra-urban distribution of cases of leprosy in residents under 15 years old in Salvador, Bahia, Brazil; the study also identifies the environment in which Mycobacterium leprae is being transmitted. The cases were distributed by operational classification, clinical forms, type of contact and the addresses were geo-referenced by neighborhood. Between 2007 and 2011, were reported 145 cases of leprosy in target population living in Salvador, corresponding to detection rates of 6.21, 6.14, 5.58, 5.41 and 6.88/100,000 inhabitants, respectively. The spatial distribution of the disease was focal. Of the 157 neighborhoods of Salvador, 44 (28.6%) notified cases of leprosy and in 22 (50%) of these were detected more than 10 cases per 100,000 inhabitants. The infectious forms were found in 40% of cases. Over 90% of cases had been living in Salvador for more than five years. Overall, 52.6% reported having had contact with another infected individual inside the household and 25% in their social circle. In Salvador, M. leprae transmission is established. The situation is a major concern, since transmission is intense at an early age, indicating that this endemic disease is expanding and contacts extend beyond individual households.

Hanseníase em menores de 15 anos no estado do Tocantins, Brasil, 2001-2012: padrão epidemiológico e tendência temporal

“…There was no significant proportional difference between genders; however, the predominance of paucibacillary cases is opposite to the profile of adults, who usually present multibacillary leprosy in epidemiological studies [15][16][17] . Although the disease is more common in its initial clinical classifications in children, due to the exposure and incubation periods, these children were also diagnosed with multibacillary clinical forms, evidencing the delay in diagnosis by health services, as well as in other scenarios 18,19 . The visible physical deformities presented by the children at the time of diagnosis shows the higher severity of the disease.…”

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

“…In this study, the income variable is categorized based on the Regency / City Minimum Wage which is set by the East Java governor and almost all respondents, both the case group and the control group, have less income than the regional minimum wage set by the government. Santos, Penna, Costa, Natividade, & Teixeira (2016) show that leprosy is considered endemic in some countries with low economic and social levels, especially in India and Brazil. Income levels as one of a person's socio-economic indicators can also be a risk factor for leprosy.…”

Indicators related to physical disability and diagnosis of leprosy

“…In addition, it may be suggested undiagnosed home contact (4) . It is worth remembering that the transmission of the disease is not restricted to the household (14) , thus, this highlights the important role of extra-household or social contacts in the transmission chain of leprosy.…”

“…But in endemic sites, children, considered the most resistant group, become vulnerable as a result of being continually exposed to active transmission foci (13) . Thus, evaluating the occurrence of the disease in children under 15 years is important since this indicator reflects the intensity of propagation of Mycobacterium leprae and the impact of the control actions (14) , as illness in this age group involves recent transmission (15) . Corroborating with our result, it had already been evidenced a decrease of this illness in children under 15 years in Maranhão (9) .…”

“…The fact that children under the age of 15 have been ill makes is concerning because it indicates that a significant number of cases have not been detected or treated in a timely manner to break the disease transmission chain (14) . In addition, it may be suggested undiagnosed home contact (4) .…”