Social determinants of leprosy in a hyperendemic State in North Brazil

Monteiro, Lorena Dias, Salani Mota, Rosa Maria, Martins-melo, Francisco Rogerlândio, Alencar, Carlos Henrique, and Heukelbach, Jorg (2017) Social determinants of leprosy in a hyperendemic State in North Brazil. Revista de Saude Publica, 51. 70.

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Objective: To identify the socioeconomic, demographic, operational, and health service-related factors associated with the occurrence of leprosy in a hyperendemic State in North Brazil.

Methods: This is an ecological study based on secondary data from the Sistema de Informacoes de Agravos de Notificacao in municipalities of the State of Tocantins from 2001 to 2012. Units of analysis were the 139 municipalities of the State. Negative binomial log linear regression models were used to estimate incidence rate ratios.

Results: In bivariate analysis, the incidence rate ratios were significantly higher for municipalities with higher income ratio of the poorest 20.0% (1.47; 95% CI 1.19-1.81) and better Municipal Human Development Index (1.53; 95% CI 1.14-2.06). In multivariate analysis, the incidence rate ratios were significantly higher in municipalities with higher proportion of immigrants (1.31; 95% CI 1.11-1.55) and higher proportion of households with waste collection (1.37; 95% CI 1.11-1.69). There was a significant reduction in the incidence rate ratio with increased coverage of the Bolsa Familia Program (0.98; 95% CI 0.96-0.99).

Conclusions: Control programs need to focus on activities in municipalities of greater social vulnerability with intersectoral investment for the improvement of the living conditions of the population.

Item ID: 51000
Item Type: Article (Research - C1)
ISSN: 1518-8787
Keywords: leprosy, epidemiology, socioeconomic factors, neglected diseases, prevention & control, health Inequalities
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, Brazil (CNPq), Department of Science and Technology of the Ministry of Health of Brazil (DECIT)
Projects and Grants: CNPq Process 404505/2012, DECIT - MCTI/CNPq/MS-SCTIE-Decit 40/2012
Date Deposited: 04 Oct 2017 07:32
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320211 Infectious diseases @ 50%
42 HEALTH SCIENCES > 4206 Public health > 420606 Social determinants of health @ 50%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920109 Infectious Diseases @ 50%
92 HEALTH > 9202 Health and Support Services > 920208 Health Inequalities @ 50%
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