Abstract
To analyze trends, and the main socioeconomic and clinical factors related to treatment abandonment and the cure of leprosy in Sergipe. For the present study, data from all new cases of cure and abandonment of leprosy treatment notified by the health centers of the municipalities to the SINAN (Information System on Notifiable Diseases) in the state of Sergipe, Brazil, from 2007 to 2017, were used. This is an ecological study of cases of cure and abandonment of leprosy treatment, rates were calculated based on the "Guidelines for surveillance, care and elimination of leprosy as a public health problem".using time-series analysis and multivariate logistic regression. Concerning multivariate regression, the young age group presents a higher risk for quitting the treatment (p = 0.429; OR = 2.75). Blacks/browns/indigenous were more likely to abandon treatment (p = 0.482; OR = 1.69), as well as multibacillary individuals (p = 0.541; OR = 2.26). Regarding the cure, the young age group has less chances of cure (OR = 0.34). The same happens for the operational classification; the multibacillary patients have a lower chance of cure (OR = 0.35). Finally, individuals with grade 2 of physical disability are less likely to be cured (OR = 0.54). Health services are noticeably weak, especially when it comes to clinical factors associated with treatment abandonment and a low proportion of cure. Multibacillary (Borderline and Lepromatous) are responsible for the active transmission of leprosy.
Highlights
Leprosy is still a relevant public health problem due to its heterogeneous character in the Brazilian territory
The results of this study demonstrate a vulnerability related to leprosy operational indicators, treatment abandonment, and cure, in the state of Sergipe, in Brazil
Some studies indicate that the organizational structure of the health system has a greater influence on the epidemiological situation of leprosy than the socioeconomic disparities, given that, greater coverage of the Estratégia Saúde da Família (The Family Health Strategy) effectively contributes to the promotion of greater adherence to treatment (Lapa et al.,2006; Brito et al, 2015)
Summary
Leprosy is still a relevant public health problem due to its heterogeneous character in the Brazilian territory. Over the years, a decreasing trend both in the prevalence and in the incidence of leprosy, the maintenance of the disease in the territory is linked to the socioeconomic and health conditions of the population. As well as the effectiveness or not of the health system, corroborate for the persistence of the disease in the country (Ribeiro, Silva & Oliveira, 2018). Despite the existence of effective diagnostics for leprosy, in addition to the availability and efficacy of polychemotherapy, operational failures at different points in the health care network play a fundamental role in the persistence of the Mycobacterium leprae transmission chain (Noriega et al, 2016)
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