Leprosy in Brazil and its association with characteristics of municipalities: ecological study, 2009–2011
- 21 July 2014
- journal article
- Published by Wiley in Tropical Medicine & International Health
- Vol. 19 (10), 1216-1225
- https://doi.org/10.1111/tmi.12362
Abstract
To analyse the ecological association between the demographic and socio-economic characteristics of the Brazilian municipalities and average leprosy incidence rate in the period 2009-2011. An ecological study taking the Brazilian municipalities as its units of analysis. The local empirical Bayes estimation method was used to obtain smoothed incidence rates (SIR) for leprosy. The mean, median, first quartile (Q1) and third quartile (Q3) of the SIR were calculated per 100 000 inhabitants. Hierarchical log-linear negative binomial regression models were used to estimate the incidence rate ratios (IRR). In the period 2009-2011, the average SIR of leprosy in Brazil was 20.2 per 100 000 inhabitants, and the median incidence rate among municipalities was 9.1 per 100 000 inhabitants. Significantly higher adjusted IRR were identified for large municipalities (IRR = 1.67) compared to small municipalities, as well as in municipalities with higher illiteracy rates (IRR = 2.15), more urbanised municipalities (IRR = 1.53), those with greater social inequality as per the Gini index (IRR = 1.26), high percentage of households with inadequate sanitation (IRR = 1.63), higher average number of people per room (IRR = 1.41), high proportions of Family Health Programme coverage (IRR = 1.29), high percentage of household contacts investigated (IRR = 2.30) and those with percentage of cases with grade 2 disability considered to be the medium (IRR = 1.26). In this study, SIR was significantly associated with municipalities with low socio-economic status. Disease control activities need to be focused on these municipalities, and investments need to be made in improving the population's living conditions.Funding Information
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
This publication has 21 references indexed in Scilit:
- Patterns of Migration and Risks Associated with Leprosy among Migrants in Maranhão, BrazilPLoS Neglected Tropical Diseases, 2013
- Active Surveillance of Hansen's Disease (Leprosy): Importance for Case Finding among Extra-domiciliary ContactsPLoS Neglected Tropical Diseases, 2013
- Leprosy: An Overview of PathophysiologyInterdisciplinary Perspectives on Infectious Diseases, 2012
- Leprosy now: epidemiology, progress, challenges, and research gapsThe Lancet Infectious Diseases, 2011
- Recent Food Shortage Is Associated with Leprosy Disease in Bangladesh: A Case-Control StudyPLoS Neglected Tropical Diseases, 2011
- Potential effect of the World Health Organization’s 2011–2015 global leprosy strategy on the prevalence of grade 2 disability: a trend analysisBulletin of the World Health Organization, 2011
- Leprosy among Patient Contacts: A Multilevel Study of Risk FactorsPLoS Neglected Tropical Diseases, 2011
- Geographic Information Systems and Applied Spatial Statistics Are Efficient Tools to Study Hansen's Disease (Leprosy) and to Determine Areas of Greater Risk of DiseaseThe American Journal of Tropical Medicine and Hygiene, 2010
- Management of chronic diseases: an overview of the Brazilian governmental leprosy programInternational Journal of Dermatology, 2009
- Socioeconomic, environmental, and behavioural risk factors for leprosy in North-east Brazil: results of a case–control studyInternational Journal of Epidemiology, 2006