Spatial-temporal analysis of leprosy in a priority Brazilian northeast municipality for disease control.

OBJECTIVES: to analyze the spatial-temporal distribution of leprosy in a priority municipality for leprosy control. METHODS: ecological study, conducted in a city in the Northeast of Brazil, whose analysis units were census sectors. The study used compulsory notification data for cases registered between 2008 and 2017. TerraView software and the Batch Geocode tool was used for geocoding. The detection of spatial-temporal agglomerations of high relative risks was done by scanning statistics. RESULTS: the spatial-temporal distribution of cases was heterogeneous, creating four agglomerations of high relative risks in the urban area of the municipality between the years 2008 and 2012; and annual prevalence rates classified from high to hyperendemic. CONCLUSIONS: areas of higher risk and concentration of the disease in space-time were linked to the characteristics of high population density and social vulnerability of these spaces, raising the prioritization of health professionals' actions, systems, and services for control, and monitoring the disease.

Nineteenth century Indian leper censuses and the doctors.

This study describes the circumstances under which enumerations of "lepers" were conducted in India in the late 19th century, and the ideological biases of the respective investigators and the meanings that they read into the statistics. This report focuses on the Bombay Presidency leprosy returns of 1867, examined in 1871 by Henry Vandyke Carter, and the decennial nation-wide population census of 1871-1872, 1881, and 1891, in which the leprosy-affected, among other infirm persons, were also enumerated. The evidence examined includes the investigators' reports and other published and unpublished contemporaneous documents. These censuses were undertaken at a time when the etiology of leprosy was a major controversy, but the evidence here indicates that the efforts to clarify the etiology and estimate the virulence of the disease in India by means of statistics were animated by the desire to justify and embellish pre-conceptions. Despite the claim that they were necessary for leprosy control, the censuses, for various reasons, were not utilized towards that end in India.

[Surveillance of endemic diseases in urban areas: the interface between census tract maps and morbidity data]. / Vigilância de doenças endêmicas em áreas urbanas: a interface entre mapas de setores censitários e indicadores de morbidade.

In this article we discuss the methodological issues associated with the creation of a surveillance system for endemic diseases in urban areas based on analysis of populations at risk and on spatially referenced epidemiological indicators. We comment on the system's basic requirements, selection criteria for socioeconomic variables, and methodological steps to combine these variables so as to construct a census-based deprivation index. We also present the ways we solved some operational problems related to generation of digitized census tracts maps and linkage of morbidity data from different sources. This approach, spatial organization into account in surveillance of endemic diseases, exemplified here by tuberculosis and leprosy, allows for the interaction of several official data sets from census and health services in order to geographically discriminate inner-city risk strata. Criteria for constructing these risk strata were considered a useful tool for health planning and management activities for the control of endemic diseases in cities.

The population of persons with disabilities in Pakistan.

PIP: This article provides a discussion of deficiencies in the data collection on disabilities in Pakistan, identifies data sources, and makes recommendations for improving the quality of the data. Major trends in disabilities are identified. In Pakistan, there is social stigma attached to persons with disabilities. Disabilities are concealed within families so as not to limit the marriage prospects of relatives who might otherwise be suspected of carrying defective genes. Religion perpetuates superstitions about the disabled. Families bear an extra expense in caring for a disabled member, due to loss of additional labor, increased demands on resources for taking care of the disabled member, and increased need to compensate with higher fertility. There is a lack of social institutional support for care of the disabled. The population censuses of 1961 and 1981 were the first to collect information on the disabled. The inadequacy of census data led to the initiation of a national survey in 1984/85 for collecting data on blindness, deafness, mutism, leprosy, retardation, lameness, and handicaps. A special in-depth survey on disabilities was also conducted in Islamabad and Rawalpindi districts in 1986. This survey focused on mental retardation, visual and hearing disabilities, deformity and wasting of the limbs, and physical disabilities, such as paralysis. This survey was the most valid but it was not comparable to prior surveys. Trends indicate a smaller number of disabled at older ages. Specific disabilities by age showed some peculiar age patterns that suggest unreliability. Data from the 1984/85 survey show higher sex ratios for all disabilities for certain provinces compared to the national ratios. If the trend accurately reflects increased disabilities, the education of high risk groups must be improved, accessibility to medical care must be increased, and the population needs to be educated about the disabled. Government social programs need more accurate assessments of the causes of disability and the extent and duration of disablement.^ieng

Togo.

PIP: This compendium on Togo contains a summary of current and projected demographic indicators, of government population policies and attitudes, and of the current status of the country's population data collecting system. The information is further summarized in a 1-page fact sheet. In 1981 the total population was 2.7 million. In 1980-85, the annual population growth rate was 2.9%, and the annual natural increase rate was 2.9%, life expectancy at birth was 48.7 years, the infant mortality rate was 113, and the crude birth rate was 45.4. Per capita income was US$406 in 1979, and in 1981, 67% of the labor force was engaged in agriculture. Currently the government has no policies in regard to population growth and is satisfied with the current fertility level. Earlier the government's position was pronatalist; but, in 1976, the government approved the establishment of the Togolese Family Welfare Association (ATBEF), an affiliate of the International Planned Parenthood Federation. In addition, the government is promoting the integration of family planning services in the nation's primary health program. The government is concerned with the problem of teenage pregnancy. Abortion, except to save the life of the mother, is illegal, and there are no legal provisions concerning sterilization. In recent years, the government adopted several measures aimed at improving the status of women. These measures included the passage of a new family code. The major concerns of the government are to improve the health status of the population and to promote rural and regional development. The primary health care program was expanded in 1977, and the country has a fairly successful immunization program. It also operates a leprosy control program and is improving the country's water supply. Currently the level of international migration, both emigration and immigration, is low, and the government has no migration policy. Togo has a low urban rate (17.4%), and between 1970-80, the rate of annual urban growth rate was 5.3%. The government is concerned about the high rate of growth in Lome, the capital city. Togo conducts a census every 10 years, and the last one was conducted in 1981. Birth and death registration is incomplete. There is no institutionalized mechanism for promoting the integration of population and development planning.^ieng

[An overall index as a measure of quality in a census or survey]. / Un indice global como medida de la calidad en un censo o encuesta

PIP: A method for evaluating the quality of census or survey data is outlined. The method is based on a model developed in 1961 by Hansen, Hurvitz, and Bershad. The use of the present model for comparisons of data quality among countries is described and evaluated. Applications to data from Cuba, Spain, Hungary, and the United States are included. (summary in ENG, RUS)^ieng