Padrões epidemiológicos e distribuição espacial da hanseníase no município de Fortaleza, 2001 a 2012

• Autor(a) principal: Brito, Aline Lima
• Data de Publicação: 2015
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal do Ceará (UFC)
• Texto Completo: http://www.repositorio.ufc.br/handle/riufc/13605
• topic: Hanseníase; Modelos Lineares; Análise Espacial

The city of Fortaleza, Ceará state capital, is presented a s priority city for the combat against leprosy in Brazil. This study aimed to characterize the epidemiological, clinical and operational leprosy patterns and time trends in temporal and spat ial distribution cuts of its main indicators, in Fortaleza, from 2001 to 2012. The city of Forta leza is subd ivided into 114 districts ( IBGE 2000) and six Regional Executive Secretariats (SER). They were analyzed by studying the epidemiological and operational indicators of leprosy, and their tendency, th rough the method of inflection points, and esti mation of hidden prevalence. Three techniques of spatial analysis were used (Descriptive approach, Bayesian Statistics and Local Space Scan) indicators: detection rate , detection rate children under 15 years and detection rate in cases with grade 2 disabil ities (visible disabilities), to find neighborhoods aggregates at high risk for the presence, slow transmission and diagnosis of the endemic. During the study period, there were 9,658 new cases of the disease, and 677 (7.0%) were less than 15 years. The oc currence of 197.7 hidden leprosy cases per 100 thousand inhabitants in the municipality in the last five years (average of 39.5 cases per 100,000 per year) was estimated. The detection rate decreased in the period, ranging from 40.07 (2001) to 23.39 (2012) cases per 100 000 inhabitants (Average Annual Percent Change - AAPC: - 4.0, 95% ; IC : - 5.6 to - 2.3). De spite decreases in the values of the other two indicators studied coefficients, they remained stable. The detection rate in children under 15 years of age decreased from 8.56 / 100,000 inhabitants in 2001 to 5.49 / 100,000 inhabitants in 2012 (AAPC: - 1.4, 95% ; IC : - 5.4 to 2.8), and the degree of coefficient 2, with 2.28 / 100,000 inhabitants in 2001 1 to 1.95 / 100,000 inhabita nts in 2012 (AAPC: - 0.8, 95% ; IC : - 4.5 to 3.1). Were identified in the spatio - temporal analysis spatial aggregates at high risk for disease transmission, especiall y in neighborhoods located in SER 3 and 5 that are west of the city, with the aggregate principal involving 22 districts. In addition, there was the existence of activ e transmission by high values for detection rates in children under 15 years, mainly in the SER 3 and 5. The spatiotemporal analysis identified for this indicator, the main cluster, three neighborhoods, all located in SER 5. It has been found al so delayed diagnosis in those SER's (3 and 5 ), as well as for evidence in SER 's who had not presented significant risk to de tection, as some districts of SER 's 4 and 6, which are further east of the city. It was identified th at the SER's that stood out as a risk for the occurrence of leprosy consist of large social inequalities, and high levels of poverty and population centers. These characteristics underline the close relationship that leprosy has poverty as well as its uneq ual distribution in Fortaleza