Human migration, railways and the geographic distribution of leprosy in Rio Grande do Norte State--Brazil.

INTRODUCTION: Leprosy is a public health problem in Brazil where 31,044 new cases were detected in 2013. Rio Grande do Norte is a small Brazilian state with a rate of leprosy lower than other areas in the same region, for unknown reasons. OBJECTIVES: We present here a review based on the analysis of a database of registered leprosy cases in Rio Grande do Norte state, comparing leprosy's geographic distribution among municipalities with local socio-economic and public health indicators and with historical documents about human migration in this Brazilian region. RESULTS: The current distribution of leprosy in Rio Grande do Norte did not show correlation with socio-economic or public health indicators at the municipal level, but it appears related to economically emerging municipalities 100 years ago, with spread facilitated by railroads and train stations. Drought-related migratory movements which occurred from this state to leprosy endemic areas within the same period may be involved in the introduction of leprosy and with its present distribution within Rio Grande do Norte. CONCLUSIONS: Leprosy may disseminate slowly, over many decades in certain circumstances, such as in small cities with few cases. This is a very unusual situation currently and a unique opportunity for epidemiologic studies of leprosy as an emerging disease.

A hanseníase no diagnóstico diferencial das adenomegalias: relato de caso / Leprosy in differential diagnosis of adenomegalies

A hanseníase é doença infecto-contagiosa, crónica, causada pelo Mycobacterium leprae, com tropismo, predominante, por pele e nervos periféricos. Os autores apresentan o caso de um paciente masculino, de 60 anos, que evoluia há 6 meses com perda de peso de 17 kg, febre diária e adenomegalia generalizada. Iniciou investigaçao para doença hematológica, más o estudo histopatológico de gânglio axilar, revelou tratar-se de hanseníase virchowiana. O exame físico nao evidenciou alteraçoes. A partir deste caso, revisaram a literatura sobre as causas de adenomegalia e seu diagnóstico diferencial com hanseníase