Spatial patterns of leprosy in a hyperendemic state in Northern Brazil, 2001-2012

Monteiro, Lorena Dias, Martins-Melo, Francisco Rogerlândio, Brito, Aline Lima, Alencar, Carlos Henrique, and Heukelbach, Jorg (2015) Spatial patterns of leprosy in a hyperendemic state in Northern Brazil, 2001-2012. Revista de Saúde Pública, 49. 84.

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Objective: To describe the spatial patterns of leprosy in the Brazilian state of Tocantins.

Methods: This study was based on morbidity data obtained from the Sistema de Informacoes de Agravos de Notificacao (SINAN - Brazilian Notifiable Diseases Information System), of the Ministry of Health. All new leprosy cases in individuals residing in the state of Tocantins, between 2001 and 2012, were included. In addition to the description of general disease indicators, a descriptive spatial analysis, empirical Bayesian analysis and spatial dependence analysis were performed by means of global and local Moran's indexes.

Results: A total of 14,542 new cases were recorded during the period under study. Based on the annual case detection rate, 77.0% of the municipalities were classified as hyperendemic (> 40 cases/100,000 inhabitants). Regarding the annual case detection rate in < 15 years-olds, 65.4% of the municipalities were hyperendemic (10.0 to 19.9 cases/100,000 inhabitants); 26.6% had a detection rate of grade 2 disability cases between 5.0 and 9.9 cases/100,000 inhabitants. There was a geographical overlap of clusters of municipalities with high detection rates in hyperendemic areas. Clusters with high disease risk (global Moran's index: 0.51; p < 0.001), ongoing transmission (0.47; p < 0.001) and late diagnosis (0.44; p < 0.001) were identified mainly in the central-north and southwestern regions of Tocantins.

Conclusions: We identified high-risk clusters for transmission and late diagnosis of leprosy in the Brazilian state of Tocantins. Surveillance and control measures should be prioritized in these high-risk municipalities.

Item ID: 43230
Item Type: Article (Research - C1)
ISSN: 1518-8787
Keywords: leprosy, epidemiology, spatial analysis, endemic diseases, neglected diseases, epidemiological surveillance
Additional Information:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Funders: Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Projects and Grants: CNPq 404505/2012
Date Deposited: 24 Feb 2016 07:39
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110309 Infectious Diseases @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920109 Infectious Diseases @ 100%
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