Spatial analysis of the epidemiological risk of leprosy in the municipalities of Minas Gerais.

BACKGROUND: Leprosy remains a significant public health problem of high importance. This investigation aims to analyze the spatial distribution of the leprosy epidemiological risk in the municipalities of Minas Gerais. METHODS: This ecological study was conducted with new leprosy cases diagnosed from 2004 to 2019 in the municipalities of the state of Minas Gerais. Based on the epidemiological indicators, a composite indicator called the leprosy epidemiological risk index was estimated, classifying municipalities as high, medium, low and very low risk. For the spatial analysis, the global and local spatial autocorrelation statistics were used to identify the spatial distribution of the leprosy epidemiological risk in the periods 2004-2011 and 2012-2019 and classified as High/High, Low/Low, High/Low and Low /High. RESULTS: Although leprosy is declining in the state of Minas Gerais, the Global Moran Index confirmed the spatial dependence between municipalities for the two analyzed periods, characterizing the formation of clusters. When performing the local spatial autocorrelation, it was found that the macroregions with the highest number of municipalities with high indices, surrounded by other municipalities with high indices (high-high), were Northwest, East, South East, North, and Northeast. The low risk macroregions were Southeast, Center, South-Center and South. CONCLUSION: Leprosy has a heterogeneous spatial pattern and remains concentrated in historically endemic areas of the state. It underscores the importance of intensifying actions to combat leprosy in these municipalities and macroregions. Promote improved access to health services and combat stigma and prejudice to eliminate leprosy as a public health problem.

Profile of the leprosy endemic in the district of Murrupula, Nampula, Mozambique: A population-based study.

BACKGROUND: Leprosy is a neglected chronic infection caused by Mycobacterium leprae, that is curable. The magnitude of the disease and severity of the debilitation it causes renders leprosy a public health problem. This study aimed to analyze the endemic profile of leprosy in the Murrupula district and evaluate the socioeconomic, clinical, and serological profiles of leprosy contacts. METHODS: A cross-sectional study of patients with leprosy diagnosed between 2013 and 2017 and their household and community contacts was conducted in Murrupula District, Nampula Province, Mozambique. Interviews, simplified dermatoneurological examinations, Mycobacterium leprae flow (ML Flow) tests, and Mitsuda tests were performed. RESULTS: Most of the leprosy cases were multibacillary. The patients had some degree of physical disability. ML Flow positivity was more common in household contacts of the patients diagnosed with leprosy and in community individuals who spontaneously presented for testing. In total, 17 patients were diagnosed with leprosy. CONCLUSIONS: This study revealed an active chain of transmission, hidden prevalence, and operational deficiencies in leprosy surveillance and care. The results suggest that the implementation of a public health policy for leprosy prevention and control in Nampula Province is necessary. In future, the possibility of expanding the policy to the entire country should be considered.

Profile of the leprosy endemic in the district of Murrupula, Nampula, Mozambique: A population-based study

ABSTRACT Background: Leprosy is a neglected chronic infection caused by Mycobacterium leprae, that is curable. The magnitude of the disease and severity of the debilitation it causes renders leprosy a public health problem. This study aimed to analyze the endemic profile of leprosy in the Murrupula district and evaluate the socioeconomic, clinical, and serological profiles of leprosy contacts. Methods: A cross-sectional study of patients with leprosy diagnosed between 2013 and 2017 and their household and community contacts was conducted in Murrupula District, Nampula Province, Mozambique. Interviews, simplified dermatoneurological examinations, Mycobacterium leprae flow (ML Flow) tests, and Mitsuda tests were performed. Results: Most of the leprosy cases were multibacillary. The patients had some degree of physical disability. ML Flow positivity was more common in household contacts of the patients diagnosed with leprosy and in community individuals who spontaneously presented for testing. In total, 17 patients were diagnosed with leprosy. Conclusions: This study revealed an active chain of transmission, hidden prevalence, and operational deficiencies in leprosy surveillance and care. The results suggest that the implementation of a public health policy for leprosy prevention and control in Nampula Province is necessary. In future, the possibility of expanding the policy to the entire country should be considered.

A baixa escolaridade está associada ao aumento de incapacidades físicas no diagnóstico de hanseníase no Vale do Jequitinhonha / Low level of schooling is associated with an increase in physical disabilities at diagnosis of leprosy in Jequitinhonha Valley

Introdução: a hanseníase é uma doença infecciosa cujo diagnóstico, quando realizado tardiamente, resulta em dano neural e incapacidades físicas que restringem a participação social do indivíduo e contribuem para o estigma e discriminação. Além disso, fatores de risco ambientais, socioeconômicos e individuais podem contribuir para a vulnerabilidade ao adoecimento e evolução para incapacidades físicas. Objetivo: analisar a influência da escolaridade na ocorrência de incapacidades físicas no diagnóstico da hanseníase no Vale do Jequitinhonha, Minas Gerais. Material e Métodos: trata-se de um estudo transversal realizado na população de casos de hanseníase diagnosticados no Vale do Jequitinhonha, no período de 2001 a 2017, a partir de dados obtidos no Sistema de Informação de Agravos de Notificação (SINAN). A variável dependente foi o grau de incapacidade física no diagnóstico da hanseníase e a variável explicativa o nível de escolaridade dos casos. A análise estatística compreendeu a realização dos testes qui-quadrado, coeficiente de correlação de Spearman e odds ratio. Resultados: foram notificados 1.940 casos de hanseníase no Vale do Jequitinhonha com uma taxa média de detecção de 47 casos/100.000 habitantes. Houve uma correlação inversamente proporcional entre as variáveis escolaridade e grau de incapacidade com significância estatística (-0,17; p<0,0001). Indivíduos sem escolaridade tiveram 82% mais chance de apresentarem incapacidades no diagnóstico de hanseníase quando comparados àqueles com nível fundamental (OR = 1,82; p = <0,0001), a chance de incapacidades foi ainda maior na comparação com a escolaridade de nível médio (OR = 4,03; p<0,0001). Conclusão: o aumento no nível de escolaridade dos casos reduziu a chance de ser diagnosticado com alguma incapacidade instalada.

Introduction: leprosy is an infectious disease whose diagnosis, when performed late, results in neural damage and physical disabilities that restrict the individual's social participation and contribute to stigma and discrimination. In addition, environmental, socioeconomic and individual risk factors can contribute to vulnerability to illness and evolution to physical disabilities. Objective: to analyze the influence of schooling on the occurrence of physical disabilities in the diagnosis of leprosy in the Jequitinhonha Valley, Minas Gerais. Material and Methods: the present cross-sectional study was undertaken among leprosy patients diagnosed in the Jequitinhonha Valley from 2001 to 2017. The data was obtained from the SINAN (National Notifiable Diseases Information System). The dependent variable was the degree of physical disability in the diagnosis of leprosy and the explanatory variable was the educational level of the cases. statistical analysis included the chi-square test, Spearman's correlation coefficient and odds ratio. Results: 1.940 cases of leprosy were reported in the Jequitinhonha Valley with an average detection rate of 47 cases/100.000 inhabitants. There was an inversely proportional correlation between the variables schooling and degree of disability with statistical significance (-0.17, p <0.0001). Individuals with no schooling were 82% more likely to have physical disabilities in the diagnosis of leprosy when compared to those with a low level (OR = 1.82; p = <.0001), the chance of disability was even higher when compared to a intermediate level of schooling (OR = 4.03, p <0.0001). Conclusion: the increase in the level of schooling reduced the chance of being diagnosed with physical disabilities in leprosy patients.