Spatial patterns of new leprosy cases in a northeastern state of Brazil, 2011-2021.

OBJECTIVE: To analyze the spatial patterns of leprosy in Pernambuco from 2011 to 2021. METHODS: This is an ecological epidemiological study, carried out with data from the Notifiable Diseases Information System, based on new cases of leprosy among inhabitants of Pernambuco, between 2011-2021. An empirical Bayesian analysis of local and spatial dependence was performed with the global and local Moran indices. RESULTS: 25,008 new cases of leprosy were registered with an annual case detection rate in the general population of 16.51 cases/100,000 inhabitants - which is considered high. Among those younger than 15 years of age, there were 5.16 cases/100,000 inhabitants (high) and 0.89/100,000 inhabitants with degree II of physical disability (low); there were also many high-risk cases with an overall Moran index of 0.33 (p<0.001), active transmission (0.26; p<0.001), and subsequent diagnosis of the disease (0.12; p<0.006), as well as distribution in macro-region 1 and macro-region 4. CONCLUSION: There was a heterogeneous spatial distribution in the state, showing two overviews, the first being the presence of municipalities with high risk of disease transmission and the second with clusters of silent municipalities, reinforcing the character of leprosy neglect as a major public health problem. This study brings reflections for leprosy control actions, due to the identification of priority areas to combat this disease in Pernambuco.

Spatial patterns of new leprosy cases in a northeastern state of Brazil, 2011-2021 / Padrões espaciais dos casos novos de hanseníase em um estado nordestino do Brasil, 2011-2021

ABSTRACT Objective: To analyze the spatial patterns of leprosy in Pernambuco from 2011 to 2021. Methods: This is an ecological epidemiological study, carried out with data from the Notifiable Diseases Information System, based on new cases of leprosy among inhabitants of Pernambuco, between 2011-2021. An empirical Bayesian analysis of local and spatial dependence was performed with the global and local Moran indices. Results: 25,008 new cases of leprosy were registered with an annual case detection rate in the general population of 16.51 cases/100,000 inhabitants — which is considered high. Among those younger than 15 years of age, there were 5.16 cases/100,000 inhabitants (high) and 0.89/100,000 inhabitants with degree II of physical disability (low); there were also many high-risk cases with an overall Moran index of 0.33 (p<0.001), active transmission (0.26; p<0.001), and subsequent diagnosis of the disease (0.12; p<0.006), as well as distribution in macro-region 1 and macro-region 4. Conclusion: There was a heterogeneous spatial distribution in the state, showing two overviews, the first being the presence of municipalities with high risk of disease transmission and the second with clusters of silent municipalities, reinforcing the character of leprosy neglect as a major public health problem. This study brings reflections for leprosy control actions, due to the identification of priority areas to combat this disease in Pernambuco.

RESUMO Objetivo: Analisar os padrões espaciais da hanseníase em Pernambuco no período de 2011 a 2021. Métodos: Trata-se de um estudo epidemiológico ecológico, realizado com dados do Sistema de Informações de Agravos de Notificação com base nos casos novos de hanseníase em residentes de Pernambuco, entre 2011-2021. Foi realizada uma análise bayesiana empírica local e de dependência espacial com os índices de Moran global e local. Resultados: Foram registrados 25.008 casos novos de hanseníase com coeficiente médio anual de detecção de casos novos na população geral de 16,51 casos/100 mil habitantes — classificado como alto. Na população menor de 15 anos, ocorreu 5,16 casos/100 mil habitantes (muito alto) e 0,89/100 mil habitantes com grau II de incapacidade física (baixo) com aglomerados de alto risco para ocorrência com índice global de Moran de 0,33 (p<0,001), transmissão ativa (0,26; p<0,001) e diagnóstico tardio da doença (0,12; p<0,006), localizados na macrorregião 1 e na macrorregião 4. Conclusão: Houve uma distribuição espacial heterogênea no estado, evidenciando dois panoramas, o primeiro, a presença de municípios com alto risco de transmissão da doença e, o segundo, aglomerados de municípios silenciosos reforçando o caráter de negligência da hanseníase como grande problema de saúde pública. Este estudo traz reflexões para ações de controle da hanseníase, dada a identificação de áreas prioritárias para o enfrentamento dess/a doença em Pernambuco.