Temporal trend of leprosy in a region of high endemicity in the Brazilian Northeast

Pereira, Thayza Miranda; Silva, Lucilane Maria Sales da; Dias, Maria Socorro de Araújo; Monteiro, Lorena Dias; Silva, Maria Rocineide Ferreira da; Alencar, Olga Maria de

doi:10.1590/0034-7167-2018-0682

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 72 (5) • Sep-Oct 2019 • https://doi.org/10.1590/0034-7167-2018-0682 copy

Temporal trend of leprosy in a region of high endemicity in the Brazilian Northeast

Tendencia temporal de la lepra en región de alta endemicidad del Nordeste brasileño

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to analyze the temporal trend and epidemiological patterns of leprosy indicators in Sobral, a municipality countryside of the state of Ceará, from 2001 to 2016.

Method:

a time series study based on data from the Department of Informatics of the Unified Health System. The time trend analysis was performed using the join point regression model.

Results:

There were 2,220 new cases of leprosy in Sobral from 2001 to 2016. Of these, 158 (7.2%) in children younger than 15 years of age, the proportion of new male cases was 52.8% (1,162), cases with grade 2 were 7.0% (156), and proportion of cases diagnosed by contact examination 5.7% (126).

Final considerations:

leprosy remains hyperendemic in adults and children, demonstrating the character of neglected disease. Analysis of the temporal trend allowed to verify that the instability in the detection coefficients, reflect operational problems in the organization of the services

Descriptors:
Leprosy; Nursing; Epidemiology; Public Health; Neglected Diseases

Variables	2001	2002	2003	2004	2005	2006	2007	2008	2009	2010	2011	2012	2013	2014	2015	2016
General Detection Coefficient	111.0	115.4	277.1	139.9	59.6	62.0	65.6	71.1	57.6	50.5	45.6	52.8	45.0	44.6	41.1	31.9
Coefficient detection <15 years	23.4	24.8	41.8	24.0	13.2	8.1	28.8	14.5	18.2	18.3	18.1	9.9	13.4	9.8	13.9	8.0
% healed	91.5	89.2	87.7	84.1	95.1	89.9	91.4	93.0	87.6	94.7	90.8	92.2	89.9	93.3	94.0	86.2
% male	51.7	47.3	45.6	53.6	50.5	55.0	57.8	57.8	60.0	52.6	55.2	52.0	57.3	51.7	59.0	58.5
% female	48.3	52.7	54.4	46.4	49.5	45.0	42.2	42.2	40.0	47.4	44.8	48.0	42.7	48.3	41.0	41.5
% PB	36.4	41.9	11.9	21.5	51.5	48.6	43.1	50.8	33.3	41.1	36.8	51.0	38.2	38.2	28.9	36.9
% MB	63.6	58.1	88.1	78.5	48.5	51.4	56.9	49.2	66.7	58.9	63.2	49.0	61.8	61.8	71.1	63.1
% assessed at diagnosis	90.3	89.8	91.4	93.1	77.7	77.1	82.8	75.0	73.3	97.9	95.4	94.1	80.9	96.6	98.8	100.0
% grade o	55.7	62.9	55.5	67.4	66.0	63.3	47.4	54.7	38.1	60.0	59.8	61.8	55.1	53.9	68.7	67.7
% grade 1	25.0	21.5	28.4	20.2	8.7	10.1	23.3	18.8	27.6	26.3	29.9	26.5	21.3	34.8	16.9	21.5
% grade 2	9.7	5.4	7.5	5.6	2.9	3.7	12.1	1.6	7.6	11.6	5.7	5.9	4.5	7.9	13.3	10.8
% cases diag. by referral	43.2	43.0	26.0	27.9	39.8	54.1	36.2	18.8	34.3	31.6	36.8	40.2	31.5	42.7	34.9	36.9
% cases diag. by spontaneous demand	40.3	41.4	48.9	51.1	48.5	41.3	52.6	62.5	61.9	61.1	54.0	48.0	57.3	49.4	50.6	52.3
% population tests diagnosis	0.6	4.8	9.0	7.3	4.9	2.8	6.9	11.7	1.0	2.1	4.6	5.9	3.4	1.1	12.0	7.7
% cases diag. by collective examination	1.7	5.4	11.2	12.9	3.9	0.9	1.7	6.3	1.0	2.1	2.3	2.0	4.5	3.4	2.4	1.5

Indicators	Annual Percentage Change (APC)			Average Annual Percentage Change (AAPC)
Sobral	Period	APC	95% CI	Total period	AAPC	95% CI
General population detection/100,000 inhab.	2001-2003	59.6*	28.1 a 98.8	2001 a 2016	-5.7*	-10.4 a -0.8
	2003-2006	-36.8*	-50.6 a -19.1
	2006-2016	-4.3*	-6.6 a -2.0
Detection <15 years/100,000 inhabitants	2001 -2016	-6.9*	-10.9 a -2.7	2001 -2016	-6.9*	-10.9 a -2.7
% Male	2001 -2016	1.3*	0.4 a 2.2	2001 -2016	1.3*	0.4 a 2.2
% Female	2001 -2016	1.5*	-2.4 a -0.5	2001 -2016	1.5*	-2.4 a -0.5
% Paucibacilares	2001 -2016	2.2	-2.7 a 7.2	2001 -2016	2.2	-2.7 a 7.2
% Multibacilares	2001-2003	22.5	-6.3 a 60.1	2001 -2016	0.9	-5.3 a 7.6
	2003-2006	-15.5	-38.5 a 16.1
	2006-2016	2.4	-0.5 a 5.5
% healed	2006-2016	0.3	-0.1 a 0.7	2006-2016	0.3	-0.1 a 0.7
% cases assessed as to the degree of incapacity	2001 -2016	0.3	- 0.8 a 1.4	2001 -2016	0.3	- 0.8 a 1.4
% Grade 0	2001 -2016	- 0.2	-1.7 a 1.3	2001 -2016	- 0.2	-1.7 a 1.3
% Grade 1	2001 -2016	0.2	-2.7 a 3.2	2001 -2016	0.2	-2.7 a 3.2
% of cases with grade 2	2001 -2016	2.0	-2.5 a 6.8	2001 -2016	2.0	-2.5 a 6.8
Grade 2/100,000 inhab.	2001-2016	-9.6*	-15.4 a -3.4	2001 -2016	- 9.6*	-15.4 a -3.4
% cases diagnosed by referral	2001 -2016	0.2	-2.8 a 3.3	2001 -2016	0.2	-2.8 a 3.3
% cases diagnosed by spontaneous demand	2001 -2009	4.5*	1.4 a 7.7	2001 -2016	0.9	-1.5 a 3.5
% cases diagnosed by spontaneous demand	2009 -2016	-2.9	-7.5 a 1.8	2001 -2016	0.9	-1.5 a 3.5
% cases diagnosed by collective examination	2001 -2016	0.1	-6.3 a 6.9	2001 -2016	0.1	-6.3 a 6.9
% cases diagnosed by contact examination	2001 -2003	137.8	-63.4 a 1444.4	2001 -2016	-1.5	-22.0 a 24.5
% cases diagnosed by contact examination	2003-2016	-14.0*	-21.8 a -5.4	2001 -2016	-1.5	-22.0 a 24.5

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[1] Corresponding Author: Thayza Miranda Pereira E-mail: thayzinhamiranda@gmail.com