| Autor: |
Pescarini JM; Centro de Integração de Dados e Conhecimentos para Saúde, Fundação Oswaldo Cruz, Salvador, Brasil.; Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, U.K., Teixeira CSS; Centro de Integração de Dados e Conhecimentos para Saúde, Fundação Oswaldo Cruz, Salvador, Brasil.; Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil., Silva NBD; Centro de Integração de Dados e Conhecimentos para Saúde, Fundação Oswaldo Cruz, Salvador, Brasil.; Departamento de Estatística, Universidade Federal da Bahia, Salvador, Brasil., Sanchez MN; Centro de Integração de Dados e Conhecimentos para Saúde, Fundação Oswaldo Cruz, Salvador, Brasil.; Núcleo de Medicina Tropical, Universidade de Brasília, Brasília, Brasil., Natividade MSD; Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil., Rodrigues LC; Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, U.K., Penna MLF; Departamento de Epidemiologia e Bioestatística, Universidade Federal Fluminense, Niterói, Brasil., Barreto ML; Centro de Integração de Dados e Conhecimentos para Saúde, Fundação Oswaldo Cruz, Salvador, Brasil., Brickley EB; Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, U.K., Penna GO; Núcleo de Medicina Tropical, Universidade de Brasília, Brasília, Brasil.; Gerência Regional de Brasília, Fundação Oswaldo Cruz, Brasília, Brasil., Nery JS; Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil. |
| Abstrakt: |
Our study aims to describe trends in new case detection rate (NCDR) of leprosy in Brazil from 2006 to 2017 overall and in subgroups, and to analyze the evolution of clinical and treatment characteristics of patients, with emphasis on cases diagnosed with grade 2 physical disabilities. We conducted a descriptive study to analyze new cases of leprosy registered in the Brazilian Information System for Notificable Diseases (SINAN), from 2006-2017. We calculated the leprosy NCDR per 100,000 inhabitants (overall and for individuals aged < 15 and ≥ 15 years) by sex, age, race/ethnicity, urban/rural areas, and Brazilian regions, and estimated the trends using the Mann-Kendall non-parametric test. We analyzed the distributions of cases according to relevant clinical characteristics over time. In Brazil, there was a sharp decrease in the overall NCDR from 23.4/100,000 in 2006 to 10.3/100,000 in 2017; among children < 15 years, from 6.94 to 3.20/100,000. The decline was consistent in all Brazilian regions and race/ethnicity categories. By 2017, 70.2% of the cases were multibacillary, 30.5% had grade 1 (G1D) or 2 (G2D) physical disabilities at diagnosis and 42.8% were not evaluated at treatment completion/discharge; cases with G2D at diagnosis were mostly detected in urban areas (80%) and 5% of cases died during the treatment (leprosy or other causes). Although the frequency of leprosy NCDR decreased in Brazil from 2006 to 2017 across all evaluated population groups, the large number of cases with multibacillary leprosy, physical disabilities or without adequate evaluation, and among children suggest the need to reinforce timely diagnosis and treatment to control leprosy in Brazil. |
