Abstract
This study aimed to identify the distribution pattern of leprosy in a hyperendemic municipality in Brazil and determine its relationship with the clinico-epidemiological situation over 11 years. The geographic information system, MapInfo, spatial scan statistics and the Moran I index were used to analyze new cases. The digital cartographic base was used to map clusters of new paucibacillary and multibacillary cases and cases in minors under 15 years old. Socioeconomic indicators are shown using the choropleth mapping technique. A reduction in the detection coefficient, increases in high-risk spatial clusters, marked changes in the distribution of high-risk and low-risk clusters, and high-risk clusters of minors under 15 years old were observed from 2006 to 2010, showing recent illness, the presence of active foci, and overlapping of high-risk clusters of multibacillary infection in minors under 15 years old. Leprosy remains a public health problem in Rondonópolis, Mato Grosso State; the high-risk areas require an intensification of control measures and active search strategies to detect new cases.
Highlights
Leprosy is a chronic infectious disease caused by Mycobacterium leprae, an intracellular parasite with tropism for skin macrophages and Schwann cells of the peripheral nervous system 1
According to the World Health Organization (WHO), leprosy is a public health problem, with 17 endemic countries accounting for 95% (215,938) of new cases in 2010, 55.5% (126,800) of them detected in India, which is the country with the highest number of new cases, followed by Brazil (15.3% – 34,894), and Indonesia (7.5% – 17,260) 2
The transcribed data included the identification number of the cases and full address, date of diagnosis, treatment regimen, completion date, and clinical form according to the Ridley & Jopling (R&J) classification 19, with inclusion of the indeterminate clinical form; therapeutic regimen, complications, and disability grading (WHO)
Summary
According to the World Health Organization (WHO), leprosy is a public health problem, with 17 endemic countries accounting for 95% (215,938) of new cases in 2010, 55.5% (126,800) of them detected in India, which is the country with the highest number of new cases, followed by Brazil (15.3% – 34,894), and Indonesia (7.5% – 17,260) 2. In 2016, this ranking remained the same: India, with 63% (135,485) of new cases, followed by Brazil (11.7% – 25,218) and Indonesia (7.8% – 16,826) 3. Transmission occurs via the upper airways by daily contact with untreated patients with active lepromatous and borderline leprosy. Contact between healthy and infected family members increases the risk of developing the disease by 3.5 fold compared with the general population 4. Extradomiciliary contacts (neighbors, school, work) with daily interactions with multibacillary patients increase the risk of contracting the illness 5. The incubation period is long and variable, and clinical manifestations occur on average 2 to 10 years later 6
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