Impact of health interventions on epidemiological and operational leprosy indicators in a hyperendemic municipality of Brazil.

The study aimed to analyze the impact of health interventions carried out in the city of Palmas, Brazil, on the epidemiological and operational indicators of leprosy between 2007 and 2017. The intervention consisted of training healthcare personnel on the diagnosis and follow-up of patients and organizing the referral of patients to health units. Estimates of the impact were calculated by taking the differences between indicators reported in two equal periods of 1.5 years pre- and post-intervention, with a transition period of six months. During the study period, the database contained 1,875 notifications, with 66% of cases diagnosed in the post-intervention period. There was a predominance of males (52%); aged 50 years or more (34.9%); with mixed ethnicity (63.5%). The low level of education was noticeable, with more than half of the cases (51.7%) reporting illiteracy or ≤ 7 years of education. The intervention resulted in an increase in both, epidemiological and operational indicators, suggesting a positive impact of the intervention on leprosy detection and treatment. Our results also emphasize the need for further studies addressing the impact of pragmatic health interventions aiming at controlling and eliminating the disease.

Impact of health interventions on epidemiological and operational leprosy indicators in a hyperendemic municipality of Brazil

O estudo teve como objetivo analisar o impacto das intervenções de saúde realizadas na cidade de Palmas, Brasil, sobre os indicadores epidemiológicos e operacionais da hanseníase entre 2007 e 2017. A intervenção consistiu na capacitação de profissionais de saúde no diagnóstico e acompanhamento de pacientes e organizar o encaminhamento dos pacientes às unidades de saúde. As estimativas do impacto foram calculadas tomando as diferenças entre os indicadores reportados em dois períodos iguais de 1,5 anos pré e pós-intervenção, com um período de transição de seis meses. No período do estudo, o banco de dados continha 1.875 notificações, com 66% dos casos diagnosticados no período pós-intervenção. Houve predomínio do sexo masculino (52%); com 50 anos ou mais (34,9%); com etnia mista (63,5%). A baixa escolaridade foi perceptível, com mais da metade dos casos (51. 7%) relatando analfabetismo ou ≤ 7 anos de estudo. A intervenção resultou em um aumento nos indicadores epidemiológicos e operacionais, sugerindo um impacto positivo da intervenção na detecção e tratamento da hanseníase. Nossos resultados também enfatizam a necessidade de mais estudos que abordem o impacto de intervenções pragmáticas em saúde com o objetivo de controlar e eliminar a doença(AU).

The study aimed to analyze the impact of health interventions carried out in the city of Palmas, Brazil, on the epidemiological and operational indicators of leprosy between 2007 and 2017. The intervention consisted of training healthcare personnel on the diagnosis and follow-up of patients and organizing the referral of patients to health units. Estimates of the impact were calculated by taking the differences between indicators reported in two equal periods of 1.5 years pre- and post-intervention, with a transition period of six months. During the study period, the database contained 1,875 notifications, with 66% of cases diagnosed in the post-intervention period. There was a predominance of males (52%); aged 50 years or more (34.9%); with mixed ethnicity (63.5%). The low level of education was noticeable, with more than half of the cases (51.7%) reporting illiteracy or ≤ 7 years of education. The intervention resulted in an increase in both, epidemiological and operational indicators, suggesting a positive impact of the intervention on leprosy detection and treatment. Our results also emphasize the need for further studies addressing the impact of pragmatic health interventions aiming at controlling and eliminating the disease(AU).