Spatial distribution pattern of new leprosy cases under 15 years of age and their contacts in Sobral, Ceará, Brazil.

This study's objective was to analyze the spatial distribution pattern of new leprosy cases under 15 years and their contacts. A cross-sectional descriptive study covering sociodemographic characteristics and spatial analysis was carried out. The participants were from the city of Sobral, Ceará and the study was conducted between August 2014 and September 2015. Contacts were identified by the persons responsible for the children. Seropositivity was determined with the NDO-LID antigen, and positive cases were plotted on Voronoi polygons. Nine new cases of leprosy under 15 years of age have been found. The average number of people living with the cases was higher than the number of people living with non-household contacts. All household contacts were aware of other leprosy cases and had a higher rate of seropositive tests than non-household contacts. The index cases lived in the poorest regions of the municipality and hyper-endemic areas. Spatial analysis revealed a cluster of subclinical infection within a radius of 102 meters, suggesting that non-household transmission is related to proximity with seropositive individuals. In conclusion, the search for new leprosy cases cannot be restricted to household contacts.

Spatial distribution pattern of new leprosy cases under 15 years of age and their contacts in Sobral, Ceará, Brazil / Distribuição espacial de novos casos de hanseníase em menores de 15 anos e de seus contatos em Sobral, Ceará, Brasil

Abstract This study's objective was to analyze the spatial distribution pattern of new leprosy cases under 15 years and their contacts. A cross-sectional descriptive study covering sociodemographic characteristics and spatial analysis was carried out. The participants were from the city of Sobral, Ceará and the study was conducted between August 2014 and September 2015. Contacts were identified by the persons responsible for the children. Seropositivity was determined with the NDO-LID antigen, and positive cases were plotted on Voronoi polygons. Nine new cases of leprosy under 15 years of age have been found. The average number of people living with the cases was higher than the number of people living with non-household contacts. All household contacts were aware of other leprosy cases and had a higher rate of seropositive tests than non-household contacts. The index cases lived in the poorest regions of the municipality and hyper-endemic areas. Spatial analysis revealed a cluster of subclinical infection within a radius of 102 meters, suggesting that non-household transmission is related to proximity with seropositive individuals. In conclusion, the search for new leprosy cases cannot be restricted to household contacts.

Resumo O objetivo deste estudo foi analisar o padrão de distribuição espacial de novos casos de hanseníase em menores de 15 anos e seus contatos. Estudo transversal, descritivo, abrangendo características sociodemográficas e análise espacial. Os participantes eram de Sobral, Ceará e o estudo foi realizado entre agosto de 2014 e setembro de 2015. Os contatos foram identificados pelos responsáveis pelas crianças. A soropositividade foi determinada com o antígeno NDO-LID e os casos positivos foram plotados em polígonos de Voronoi. Nove novos casos de hanseníase em menores de 15 anos foram encontrados. O número médio de pessoas que conviviam com os casos foi superior ao número de pessoas que conviviam com contatos não domiciliares. Todos os contatos domiciliares sabiam de outros casos de hanseníase e apresentaram maior taxa de testes soropositivos do que os contatos não domiciliares. Os casos índice residiam nas regiões mais pobres do município e em áreas hiperendêmicas. A análise espacial revelou um agrupamento de infecção subclínica em um raio de 102 metros, sugerindo que a transmissão não domiciliar está relacionada à proximidade com indivíduos soropositivos. Concluindo, a busca por novos casos de hanseníase não pode se restringir aos contatos domiciliares.

Aspectos epidemiológicos e espaciais de escolares avaliados na Campanha Nacional de Hanseníase em Sobral - Ceará, Brasil / Epidemiological and spatial aspects of schoolchildren in National Leprosy Campaign in Sobral ­ Ceará, Brazil

Objetivo: Descrever os aspectos epidemiológicos dos escolares da rede pública de educação, na faixa etária de cinco a quatroze anos, que participaram da Campanha Nacional de Hanseníase, em 2016. Método: Estudo transversal com dados de escolares de cinco a quatorze anos de Sobral, Ceará. Empregou-se o teste de associação Qui-quadrado de Pearson e o diagrama de Voronoi associado a matriz de distância linear e de proximidade. Resultados: Foram incluídos 1.216 escolares, dos quais 18,1% tinham casos de hanseníase na família, 31,7% apresentaram manchas no corpo e destes, 19,4% referiram ter algum caso de hanseníase na família. Dos 386 escolares que relataram mancha no corpo, 41,3% são do sexo masculino e 34,8% residiam na zona urbana. Conclusão: Evidenciou-se prevalência de manchas nos escolares do sexo masculino, residentes na zona urbana, com distância mínima espacial (de até 10 km) dos escolares com manchas para os casos que tiveram hanseníase na família. (AU)

Objectives: Describe the epidemiological aspects of schoolchildren in the public education system, aged five to fourteen years, who participated in the National Leprosy Campaign in 2016. Methods: Cross-sectional study with data from schoolchildren aged five to fourteen years, from Sobral, Ceará. Pearson's Chi-square association test and the Voronoi diagram associated with the linear distance and proximity matrix were used. Results: 1.216 students were included, of which 18.1% had cases of leprosy in the family, 31.7% had cases without leprosy, 19.4% reported some case of leprosy in the family. Of the 386 schoolchildren who relate to the body, 41.3% are male and 34.8% live in the urban area. Conclusion: There was a prevalence of spots in male students living in the urban area, with a minimum spatial distance (up to 10 km) of students with spots for cases with leprosy in the family. (AU)

Objetivos: Describa los aspectos epidemiológicos de los escolares en el sistema de educación pública, de cinco a catorce años, que participaron la Campaña Nacional contra la Lepra en 2016. Métodos: Estudio transversal con datos de escolares de cinco a catorce años, de Sobral, Ceará. Se utilizaron la prueba de asociación Chi-cuadrado de Pearson y el diagrama de Voronoi asociado con distancia lineal y la matriz de proximidad. Resultados: Se incluyeron 1.216 estudiantes, de los cuales 18.1% tenían casos de lepra en la familia, 31.7% tenían casos sin lepra, 19.4% informaron algún caso de lepra en la familia. De los 386 escolares que se relacionan con el cuerpo, 41.3% son hombres y 34.8% viven en el área urbana. Conclusión: Hubo una prevalencia de manchas en estudiantes varones que viven en el área urbana, con una distancia espacial mínima (hasta 10 km) de estudiantes con manchas para casos de lepra en la familia. (AU)