Título:	Trends of main indicators of leprosy in Brazilian municipalities with high risk of leprosy transmission, 2001–2012
Autor(es):	Freitas, Lúcia Rolim Santana de Duarte, Elisabeth Carmen Garcia, Leila Posenato
Assunto:	Hanseníase Vigilância epidemiológica
Data de publicação:	5-Set-2016
Editora:	BioMed Central
Referência:	FREITAS, Lúcia Rolim Santana de et al. Trends of main indicators of leprosy in Brazilian municipalities with high risk of leprosy transmission, 2001–2012. BMC Infectious Diseases, v. 16, Article 472, 5 set. 2016. Disponível em: <https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-016-1798-2>. Acesso em: 14 jun. 2017. doi: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-016-1798-2.
Abstract:	Background: Leprosy incidence has reduced in recent years in Brazil, although the disease still persists as a public health problem in some regions. To investigate the trends of selected leprosy indicators in Brazilian municipalities with high risk of transmission is essential to provide effective control of the disease, yet this area has not been investigated. Methods: This is an ecological time-series study with multiple groups using Notifiable Diseases Information System (SINAN) data. All 692 municipalities of the states of Mato Grosso, Tocantins, Rondônia, Pará and Maranhão were included. The incidence rates of leprosy were calculated, as well as incidence rates in children under 15 years per 100,000 inhabitants and rates of new cases presenting grade-2 disabilities per 100,000 inhabitants. Joinpoint Regression was used to analyse the time trends of the different indicators studied. The spatial distribution of temporal variations of the indicators in the period was presented. Results: Between 2001 and 2012, 176,929 leprosy cases were notified in the area studied, this being equivalent to 34. 6 % of total cases in Brazil. In the aggregate of municipalities, there was a reduction in incidence rate of leprosy from 89.10 to 56.98 new cases per 100,000 inhabitants between 2001 and 2012, with a significant reduction between 2003 and 2012 (APC: − 6.2 %, 95 % CI: −7.2 % to −5.2 %). The incidence rate in <15 years also reduced significantly between 2003 and 2012 (APC: −5.6 %; 95 % CI: −7.2 % to −4.1 %). The rate of new cases with grade 2 disability remained stable between 2001 and 2012 (APC: −1.3 %; 95 % CI: −2.6 % to 0.1 %). Conclusion: Despite the reduction in the leprosy incidence rate, strategies for controlling this disease need to be enhanced to enable early case detection, especially in hyperendemic municipalities, in order to prevent disability.
Unidade Acadêmica:	Faculdade de Medicina (FMD)
Licença:	© 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Fonte: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-016-1798-2. Acesso em: 14 jun. 2017.
DOI:	https://dx.doi.org/10.1186/s12879-016-1798-2
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