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Operational failures of leprosy control in household social networks with overlapping cases in endemic areas in Brazil* * Article derived from the Master’s Degree dissertation entitled ‘Epidemiological, sociodemographic, clinical and operational patterns of overlapping leprosy cases in household social networks in municipalities of the North and Northeast regions of Brazil’, defended by Reagan Nzundu Boigny at the Federal University of Ceará (UFC) Public Health Postgraduate Program in 2018. The study received financial support from the National Scientific and Technological Development Council (CNPq)/Ministry of Science, Technology, Innovation and Communication (MCTIC) (Process No. 404505/2012-0, MCTI/CNPq/MS-SCTIE-Decit No. 40/2012 – Research on Neglected Diseases); and from Netherlands Hanseniasis Relief / Brazil (NHR Brazil), via a project to characterize leprosy case spatial and temporal distribution patterns focusing on vulnerability associated with leprosy recurrence in families and early detection of new cases (Opinion No. 2.365.953; Certification of Submission for Ethical Appraisal – CAAE No. 72571517.4.0000.5054). Alberto Novaes Ramos Junior is a CNPq/MCTIC Productivity grantee. Reagan Nzundu Boigny was a CNPq/MCTIC Master’s Degree grantee.

Abstract

Objective. To analyze institutional/programmatic vulnerability of health services in the development of health care actions for people affected by leprosy and contact surveillance. Methods. This was a cross-sectional study conducted in 2017 based on primary data from a sample of leprosy cases notified between 2001-2014 with overlapping cases in household social networks (HSN) in municipalities in the states of Bahia, Piauí and Rondônia, Brazil. Results. A total of 233 leprosy cases were analyzed, 154 (66.1%) belonged to HSN with 3 or more leprosy cases. In 53.2% of cases, 2 or more generations were affected, this being an outcome associated with absence of dermato-neurological examination (prevalence ratio 1.32; confidence interval [95%CI 1.10;1.59]; p-value=0.004). Conclusion. Operational failures in the surveillance of leprosy contacts in areas of high endemicity reinforce the character of institutional/programmatic vulnerability in HSN contexts with more than one case of leprosy in the three states analyzed.

Leprosy; Epidemiology; Contact Tracing; Surveillance; Cross-Sectional Studies

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