Pseudo elimination of leprosy in a brazilian northeast state: analysis from regression by points of inflation and local empirical bayesian model espanhol

Detalhes bibliográficos
Autor(a) principal: Souza, Carlos Dornels Freire de
Data de Publicação: 2019
Outros Autores: Leal, Thiago Cavalcanti, Paiva, João Paulo de, Araújo, Emmylly Maria Correia Ferro de, Santos, Franklin Gerônimo Bispo
Tipo de documento: Artigo
Idioma: por
Título da fonte: Revista de Epidemiologia e Controle de Infecção
Texto Completo: https://online.unisc.br/seer/index.php/epidemiologia/article/view/11649
Resumo: Background and Objectives: Alagoas is a Brazilian state in which leprosy is eliminated, but there is evidence that it is a pseudo-elimination. To analyze the temporal and spatial dynamics of leprosy in the state of Alagoas, Brazil, in between 2010 and 2015. Methods: Ecological study. Six indicators of leprosy monitoring were analyzed. Secondary data from the National System of Notifiable Diseases were used to calculate the indicators. For the temporal analysis we adopted joinpoint regression model. The trend has been ranked in increasing, decreasing or stationary. For the spatial analysis, the Local Empirical Bayesian Model and the Global and Local Moran Statistics were used. Significance was set at 5% and 95% CI. Results: The analysis by joinpoint showed a tendency to reduce the prevalence coefficient (APC=-11.2, p=0.008) and to increase the proportion of contacts examined (APC=7.0, p=0.015). The general detection coefficient, the coefficient of cases with degree II of physical incapacity and the proportion of cure showed a stationary pattern. The coefficient of detection in children under 15 years showed an inversion of the trend from 2013 (APC=7.8, p=0.011). The Moran statistic showed spatial autocorrelation, with municipalities more priority in the hinterland of the state. Conclusion: Althought being considered as eliminated in Alagoas, the high burden in the general population, the presence in children under 15 years of age and of incapacitated individuals, the fragile cure rate, the dubious quality of the contact survey and the geographical location of the state constitute the set of elements that maintain that elimination is a purely virtual process. Keywords: Leprosy. Spatial analysis. Medical informatics.
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spelling Pseudo elimination of leprosy in a brazilian northeast state: analysis from regression by points of inflation and local empirical bayesian model espanholPseudo eliminación de la hanseniasis en estado en el nordeste brasileño: análisis a partir de regresión por puntos de inflexión y modelo bayesiano empírico localPseudo eliminação da hanseníase em estado no nordeste brasileiro: análise a partir de regressão por pontos de inflexão e modelo bayesiano empírico localBackground and Objectives: Alagoas is a Brazilian state in which leprosy is eliminated, but there is evidence that it is a pseudo-elimination. To analyze the temporal and spatial dynamics of leprosy in the state of Alagoas, Brazil, in between 2010 and 2015. Methods: Ecological study. Six indicators of leprosy monitoring were analyzed. Secondary data from the National System of Notifiable Diseases were used to calculate the indicators. For the temporal analysis we adopted joinpoint regression model. The trend has been ranked in increasing, decreasing or stationary. For the spatial analysis, the Local Empirical Bayesian Model and the Global and Local Moran Statistics were used. Significance was set at 5% and 95% CI. Results: The analysis by joinpoint showed a tendency to reduce the prevalence coefficient (APC=-11.2, p=0.008) and to increase the proportion of contacts examined (APC=7.0, p=0.015). The general detection coefficient, the coefficient of cases with degree II of physical incapacity and the proportion of cure showed a stationary pattern. The coefficient of detection in children under 15 years showed an inversion of the trend from 2013 (APC=7.8, p=0.011). The Moran statistic showed spatial autocorrelation, with municipalities more priority in the hinterland of the state. Conclusion: Althought being considered as eliminated in Alagoas, the high burden in the general population, the presence in children under 15 years of age and of incapacitated individuals, the fragile cure rate, the dubious quality of the contact survey and the geographical location of the state constitute the set of elements that maintain that elimination is a purely virtual process. Keywords: Leprosy. Spatial analysis. Medical informatics.Justificación y Objetivos: Alagoas se configura como un estado brasileño en el cual la lepra se encuentra eliminada, sin embargo, hay evidencias de que se trata de una pseudo-eliminación. Analizar la dinámica temporal y espacial de la lepra en el estado de Alagoas-Brasil, entre 2010 y 2015. Métodos: Estudio ecológico mixto. Se analizaron seis indicadores de seguimiento de la lepra. Los datos secundarios del Sistema Nacional de Agravios de Notificación se utilizaron para el cálculo de los indicadores. Para el análisis temporal se adoptó joinpoint regresion model. La tendencia fue clasificada en creciente, decreciente o estacionaria. Para el análisis espacial, se utilizó el Modelo Bayesiano Empírico Local y la Estadística de Moran Global y Local. Se adoptó una significancia del 5% y el intervalo de confianza 95%. Resultados: El análisis por joinpoint mostró una tendencia de reducción del coeficiente de prevalencia (APC=-11,2, p=0,008) y del aumento de la proporción de contactos examinados (APC=7,0, p=0,015). El coeficiente de detección general, el coeficiente de casos con grado II de incapacidad física y la proporción de curado presentaron patrón estacionario. El coeficiente de detección en menores de 15 años mostró inversión de la tendencia a partir de 2013 (APC=7,8, p=0,011). La estadística de Moran mostró autocorrelación espacial, con municipios más prioritarios en el sertão del estado. Conclusiones: A pesar de ser tenida como eliminada en Alagoas, la elevada carga en la población general, la presencia en menores de 15 años, la presencia de individuos incapacitados, la frágil tasa de curación, la calidad dudosa del examen de contactos y la ubicación geográfica del estado constituyen el conjunto de elementos que sostienen que la eliminación se trata de un proceso meramente virtual.Justificativa e Objetivos: Alagoas configura-se como um estado brasileiro no qual a hanseníase encontra-se eliminada, todavia há evidências de que se trata de uma pseudo eliminação. Neste sentido o objetivo do estudo foi analisar a dinâmica temporal e espacial da Hanseníase no estado de Alagoas-Brasil, entre 2010-2015. Métodos: Foi realizado estudo ecológico incluindo seis indicadores de monitoramento da hanseníase obtidos a partir de dados secundários do Sistema Nacional de Agravos de Notificação Para a análise temporal, adotou-se joinpoint regression model. A tendência foi classificada em crescente, decrescente ou estacionária. Para a análise espacial, utilizou-se o Modelo Bayesiano Empírico Local e a Estatística de Moran Global e Local. Resultados: A análise por joinpoint mostrou tendência de redução do coeficiente de prevalência (APC=-11,2; p=0,008) e de aumento da proporção de contatos examinados (APC=7,0; p=0,015). O coeficiente de detecção geral e de indivíduos com grau II de incapacidade física, bem como a proporção de cura apresentaram padrão estacionário. O coeficiente de detecção em menores de 15 anos mostrou inversão da tendência a partir de 2013 (APC=7,8; p=0,011). A estatística de Moran mostrou autocorrelação espacial, com municípios mais prioritários no sertão do estado. Conclusão: Apesar de a hanseníase ser considerada eliminada em Alagoas, a elevada carga na população geral, a presença em menores de 15 anos e de indivíduos incapacitados, a frágil proporção de cura, a qualidade duvidosa do exame de contatos e a localização geográfica do estado constituem elementos que sustentam que a eliminação trata-se de um processo operacional e não real. Descritores: Hanseníase. Análise espacial. Informática médica.Unisc2019-01-03info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://online.unisc.br/seer/index.php/epidemiologia/article/view/1164910.17058/reci.v9i1.11649Revista de Epidemiologia e Controle de Infecção; Vol. 9 No. 1 (2019)Revista de Epidemiologia e Controle de Infecção; v. 9 n. 1 (2019)2238-3360reponame:Revista de Epidemiologia e Controle de Infecçãoinstname:Universidade de Santa Cruz do Sul (UNISC)instacron:UNISCporhttps://online.unisc.br/seer/index.php/epidemiologia/article/view/11649/7910Copyright (c) 2019 Carlos Dornels Freire de Souza, Thiago Cavalcanti Leal, João Paulo de Paiva, Emmylly Maria Correia Ferro de Araújo, Franklin Gerônimo Bispo Santosinfo:eu-repo/semantics/openAccessSouza, Carlos Dornels Freire deLeal, Thiago CavalcantiPaiva, João Paulo deAraújo, Emmylly Maria Correia Ferro deSantos, Franklin Gerônimo Bispo2019-05-09T19:24:26Zoai:ojs.online.unisc.br:article/11649Revistahttps://online.unisc.br/seer/index.php/epidemiologia/indexONGhttp://online.unisc.br/seer/index.php/epidemiologia/oai||liapossuelo@unisc.br|| julia.kern@hotmail.com||reci.unisc@gmail.com2238-33602238-3360opendoar:2019-05-09T19:24:26Revista de Epidemiologia e Controle de Infecção - Universidade de Santa Cruz do Sul (UNISC)false
dc.title.none.fl_str_mv Pseudo elimination of leprosy in a brazilian northeast state: analysis from regression by points of inflation and local empirical bayesian model espanhol
Pseudo eliminación de la hanseniasis en estado en el nordeste brasileño: análisis a partir de regresión por puntos de inflexión y modelo bayesiano empírico local
Pseudo eliminação da hanseníase em estado no nordeste brasileiro: análise a partir de regressão por pontos de inflexão e modelo bayesiano empírico local
title Pseudo elimination of leprosy in a brazilian northeast state: analysis from regression by points of inflation and local empirical bayesian model espanhol
spellingShingle Pseudo elimination of leprosy in a brazilian northeast state: analysis from regression by points of inflation and local empirical bayesian model espanhol
Souza, Carlos Dornels Freire de
title_short Pseudo elimination of leprosy in a brazilian northeast state: analysis from regression by points of inflation and local empirical bayesian model espanhol
title_full Pseudo elimination of leprosy in a brazilian northeast state: analysis from regression by points of inflation and local empirical bayesian model espanhol
title_fullStr Pseudo elimination of leprosy in a brazilian northeast state: analysis from regression by points of inflation and local empirical bayesian model espanhol
title_full_unstemmed Pseudo elimination of leprosy in a brazilian northeast state: analysis from regression by points of inflation and local empirical bayesian model espanhol
title_sort Pseudo elimination of leprosy in a brazilian northeast state: analysis from regression by points of inflation and local empirical bayesian model espanhol
author Souza, Carlos Dornels Freire de
author_facet Souza, Carlos Dornels Freire de
Leal, Thiago Cavalcanti
Paiva, João Paulo de
Araújo, Emmylly Maria Correia Ferro de
Santos, Franklin Gerônimo Bispo
author_role author
author2 Leal, Thiago Cavalcanti
Paiva, João Paulo de
Araújo, Emmylly Maria Correia Ferro de
Santos, Franklin Gerônimo Bispo
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Souza, Carlos Dornels Freire de
Leal, Thiago Cavalcanti
Paiva, João Paulo de
Araújo, Emmylly Maria Correia Ferro de
Santos, Franklin Gerônimo Bispo
description Background and Objectives: Alagoas is a Brazilian state in which leprosy is eliminated, but there is evidence that it is a pseudo-elimination. To analyze the temporal and spatial dynamics of leprosy in the state of Alagoas, Brazil, in between 2010 and 2015. Methods: Ecological study. Six indicators of leprosy monitoring were analyzed. Secondary data from the National System of Notifiable Diseases were used to calculate the indicators. For the temporal analysis we adopted joinpoint regression model. The trend has been ranked in increasing, decreasing or stationary. For the spatial analysis, the Local Empirical Bayesian Model and the Global and Local Moran Statistics were used. Significance was set at 5% and 95% CI. Results: The analysis by joinpoint showed a tendency to reduce the prevalence coefficient (APC=-11.2, p=0.008) and to increase the proportion of contacts examined (APC=7.0, p=0.015). The general detection coefficient, the coefficient of cases with degree II of physical incapacity and the proportion of cure showed a stationary pattern. The coefficient of detection in children under 15 years showed an inversion of the trend from 2013 (APC=7.8, p=0.011). The Moran statistic showed spatial autocorrelation, with municipalities more priority in the hinterland of the state. Conclusion: Althought being considered as eliminated in Alagoas, the high burden in the general population, the presence in children under 15 years of age and of incapacitated individuals, the fragile cure rate, the dubious quality of the contact survey and the geographical location of the state constitute the set of elements that maintain that elimination is a purely virtual process. Keywords: Leprosy. Spatial analysis. Medical informatics.
publishDate 2019
dc.date.none.fl_str_mv 2019-01-03
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://online.unisc.br/seer/index.php/epidemiologia/article/view/11649
10.17058/reci.v9i1.11649
url https://online.unisc.br/seer/index.php/epidemiologia/article/view/11649
identifier_str_mv 10.17058/reci.v9i1.11649
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://online.unisc.br/seer/index.php/epidemiologia/article/view/11649/7910
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Unisc
publisher.none.fl_str_mv Unisc
dc.source.none.fl_str_mv Revista de Epidemiologia e Controle de Infecção; Vol. 9 No. 1 (2019)
Revista de Epidemiologia e Controle de Infecção; v. 9 n. 1 (2019)
2238-3360
reponame:Revista de Epidemiologia e Controle de Infecção
instname:Universidade de Santa Cruz do Sul (UNISC)
instacron:UNISC
instname_str Universidade de Santa Cruz do Sul (UNISC)
instacron_str UNISC
institution UNISC
reponame_str Revista de Epidemiologia e Controle de Infecção
collection Revista de Epidemiologia e Controle de Infecção
repository.name.fl_str_mv Revista de Epidemiologia e Controle de Infecção - Universidade de Santa Cruz do Sul (UNISC)
repository.mail.fl_str_mv ||liapossuelo@unisc.br|| julia.kern@hotmail.com||reci.unisc@gmail.com
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