We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
HANSENÍASE NO ESTADO DO MARANHÃO: ANÁLISE DAS ESTRATÉGIAS DE CONTROLE E OS IMPACTOS NOS INDICADORES EPIDEMIOLÓGICOS.
- Authors
de Castro Passos, Carlos Eduardo; da Silva, Antônio Rafael; da Graça do Rosário Gonçalves, Eloisa; Gomes Carreiro Neiva, Felipe; Gomes Monteiro, Silvio
- Abstract
Leprosy control strategies have been improving over the decades. However, in 2011, Brazil still has the largest number of leprosy cases in the Americas (93%) and ranks second case in the world. Strengthening such statistic is Maranhao: 4th place in Brazil in detection of new cases; 3rd in children under 15 years of age; and, overall, the most prevalent state in the Northeast. This study aimed to analyze the epidemiological indicators recommended for monitoring and evaluation, describing strategies for leprosy control in the state of Maranhao. Thus, we developed an exploratory ecological study of the temporal evolution of the epidemiological leprosy and public policies to control the endemic in the period 2002-2011. Regarding control strategies was observed that the state follows the recommendations of the Ministry of Health, however, with low resolution, the administrative and political difficulties for social abyss in which the state is. The main epidemiological and operational indicators of leprosy were identified, in which one can observe a downward trend in new case detection with strong statistical significance (R2 = 0.83, P < 0.0001.On the other hand, new multibacillary cases revealed in inverse trend (R2 = 0,95, P <0,0001). Should be highlighted in the value of maintaining the proportion of cases with grade 2 disability at diagnosis, generating a stable trend in the course of the study series. The analysis also showed that the ratio of new cases was significantly higher in Maranhão (74,3 / 100.000). In the country than the average (24,9 / 100.000), with RR = 2,96, 95% CI: 1,88 to 4,66 ; p < 0,0001 ; followed the same trajectory as the ratio of new cases in children under 15 years and the annual rate of prevalence. Regarding covariates, the case detection calls attention to the fall of the difference between the sexes, even keeping a significant difference with respect to male OR = 2,36 [ 95% CI 2,28 to 2,46 ], p < 0,0001, and the stagnation of prevalence and incidence reason . It was also observed that it was maintained the number of cities in the five biennia in hyperendemic situation through the study and the total period, the results pointed to a default number of cases in the northwest not yet reported by other studies - central and western state - demonstrated by a vision of periods under study bubbles and maps that can pass a real dimension of the disease in each municipality analyzed. Thus, the study reveals that even with leprosy control strategies through constant maturation processes, it remains a neglected disease, hyperendemic, diagnosed more cases in the study area with no prospect of decrease in the coming years, leading to the belief that the process of social maturity is a major step towards achieving the goal of disease control .
- Publication
Hygeia: Revista Brasileira de Geografia Médica e da Saúde, 2016, Vol 12, Issue 22, p88
- ISSN
1980-1726
- Publication type
Article
- DOI
10.14393/hygeia1230888