Trends of main indicators of leprosy in Brazilian municipalities with high risk of leprosy transmission, 2001–2012

Abstract

BackgroundLeprosy incidence has reduced in recent years in Brazil, although the disease still persists as a public health problem in some regions. To investigate the trends of selected leprosy indicators in Brazilian municipalities with high risk of transmission is essential to provide effective control of the disease, yet this area has not been investigated.MethodsThis is an ecological time-series study with multiple groups using Notifiable Diseases Information System (SINAN) data. All 692 municipalities of the states of Mato Grosso, Tocantins, Rondônia, Pará and Maranhão were included. The incidence rates of leprosy were calculated, as well as incidence rates in children under 15 years per 100,000 inhabitants and rates of new cases presenting grade-2 disabilities per 100,000 inhabitants. Joinpoint Regression was used to analyse the time trends of the different indicators studied. The spatial distribution of temporal variations of the indicators in the period was presented.ResultsBetween 2001 and 2012, 176,929 leprosy cases were notified in the area studied, this being equivalent to 34.6 % of total cases in Brazil. In the aggregate of municipalities, there was a reduction in incidence rate of leprosy from 89.10 to 56.98 new cases per 100,000 inhabitants between 2001 and 2012, with a significant reduction between 2003 and 2012 (APC: − 6.2 %, 95 % CI: −7.2 % to −5.2 %). The incidence rate in <15 years also reduced significantly between 2003 and 2012 (APC: −5.6 %; 95 % CI: −7.2 % to −4.1 %). The rate of new cases with grade 2 disability remained stable between 2001 and 2012 (APC: −1.3 %; 95 % CI: −2.6 % to 0.1 %).ConclusionDespite the reduction in the leprosy incidence rate, strategies for controlling this disease need to be enhanced to enable early case detection, especially in hyperendemic municipalities, in order to prevent disability.

Spatial clustering, social vulnerability and risk of leprosy in an endemic area in Northeast Brazil: an ecological study

“…The 2001–2003 increase was likely due to Brazil joining the leprosy elimination initiative in 2000, with the adoption of active case finding, multidrug therapy, contact tracing associated and population awareness campaigns. The 2006 decrease followed the lower prevalence reported from other regions in Brazil and is likely a reflection of the removal of long‐standing cases by the elimination initiative …”

Epidemiology and Spatiotemporal Patterns of Leprosy Detection in the State of Bahia, Brazilian Northeast Region, 2001–2014

“…An ecological study involving the states of Mato Grosso, Tocantins, Pará, Maranhão and Rondônia, between 2001 and 2012, recognized that the rate of new cases with G2D was stable, varying from 3.62 cases per 100,000 inhabitants in 2001 to 3.41 cases per 100,000 inhabitants in 2012. [36]. The physical disabilities caused by leprosy pervert the conditions of poverty and leprosy-related stigma [22].…”

Vulnerabilidade programática no controle da hanseníase: padrões na perspectiva de gênero no Estado da Bahia, Brasil

“…Como consequência, existe a presença de cenários de transmissão ativa de Mycobacterium leprae entre adolescentes e crianças (menores de 15 anos de idade), com diferencial entre gêneros, gerando potencialmente incapacidade e estigma 6,7,8 . O Estado da Bahia, Região Nordeste do país, está situado dentro desse contexto epidemiológico de endemicidade 9 .…”

“…em comparação aos homens (AAPC = 3,0; IC95%: 0,5;5,6) 5;9; 0,0), comparados às mulheres 4;7;1). A proporção de casos em abandono de tratamento no período foi de 5,5%, com tendência de redução mais significativa entre mulheres 9;7; -1,1) do que em homens 7;4;0).…”

“…A proporção de casos em abandono de tratamento no período foi de 5,5%, com tendência de redução mais significativa entre mulheres 9;7; -1,1) do que em homens 7;4;0). Recidiva foi verificada em 3,8% de todas as entradas do período; as mulheres apresentaram tendência de redução significativa 2;3;0) e os homens, de crescimento significativo (AAPC = 4,9; IC95%: 2,9;6,8 …”