Abordagem epidemiológica, dinâmica e espaço-temporal da hanseníase e incapacidades física em um estado do Nordeste brasileiro - 2009 a 2019

Abstract

Leprosy is caused by Mycobacterium leprae, an acid-fast bacillus (AFB) with a predilection for skin and peripheral nerve cells. When in contact with the host, this bacillus can cause dermatoneurological lesions and, consequently, physical, functional and psychological impairments. This study analyzed the space-time epidemiological dynamics of leprosy and its disabilities in the state of Alagoas in the period 2009-2019. Therefore, this is an ecological retrospective research, of a quantitative nature, involving confirmed cases of leprosy in the years 2009 to 2019 reported in the state of Alagoas. Data were obtained from the Notifiable Diseases Information System (SINAN) in Brazil. Based on the Database of the Department of Informatics of the Brazilian Unified Health System (DATASUS). Initially, the main epidemiological indicators for leprosy were obtained and their temporal trend was analyzed in Alagoas and microregions, using the Joinpoint software. The indicators were also analyzed in relation to spatial distribution by municipalities in Alagoas, using Moran statistics and LISA (Local Index of Spatial Association). During the analyzed period, 4739 new cases of leprosy were reported in Alagoas, with an average of 430.81 cases/year and an annual detection rate of 13.27/100,000 in habitants, demonstrating high endemicity. Through temporal analysis, it was possible to infer that new cases of leprosy in the general population showed a decreasing trend (APC/AAPC = - 3.0), however, it remained stationary in the public under 15 years old. The indicator of degree of physical disability at diagnosis showed a decreasing trend within the state of Alagoas, but for degree 2 of physical disability there was a stationary profile. The grade 2 indicator of physical disability in healing, in turn, showed a stationary pattern in Alagoas. As for the spatial analysis, 8.82% (n=9) municipalities were hyperendemic for the detection of new cases in the general population. As for the coefficient of detection of new cases in children under 15 years of age, the rate of silent municipalities was 47.05% (n=48), but 3.92% (n=4) showed hyperendemicity for the disease in this age group. The findings of this study, presented in products, alert to a probable late diagnosis of the disease in the state linked to an active transmission chain. Furthermore, it was possible to identify pockets of leprosy infection distributed throughout the state of Alagoas. In this context, the present research contributed to the identification of areas with greater vulnerability for the development of leprosy in Alagoas, in order to help define and guide priority areas for fighting the disease.