Rodrigues-Júnior Antonio Luiz, do O Vinícius Tragante, Motti Vivian Genaro
Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Rev Saude Publica. 2008 Dec;42(6):1012-20. doi: 10.1590/s0034-89102008000600006.
To assess the temporal and spatial evolution of the leprosy endemy in the state of São Paulo, Southeastern Brazil.
This is an ecological-social study that used the number of leprosy cases reported to the Brazilian Ministry of Health from January 2004 to December 2006. Monthly series were generated in each regional health department, and their sequences were adjusted by a Markovian model for the leprosy detection coefficients. The detection coefficient with the number of cases accumulated in the period in each municipality was used to produce the spatial distribution of the endemy; a correlation analysis was carried out with the leprosy detection coefficients and the components of the Social Responsibility Index of the state of São Paulo.
Of the 645 municipalities of the state of São Paulo, 22 did not detect leprosy cases in the period. In the majority of regions, the endemy showed a decreasing trend; the time series presented random fluctuation around expected values. The decline was influenced by a generalized decrease in the detection coefficients at the end of 2005. There was a positive correlation between the detection coefficients and the components "schooling" and "longevity", of the Social Responsibility Index of the state of São Paulo, and a negative correlation with "wealth", another component of the same Index.
The result of the time series analysis suggests that the endemy is on the decline in the majority of regions of the state of São Paulo, while the spatial analysis shows that the coefficients are high in the northern part of the state.
评估巴西东南部圣保罗州麻风病流行的时空演变情况。
这是一项生态社会研究，利用了2004年1月至2006年12月向巴西卫生部报告的麻风病病例数。在每个地区卫生部门生成月度序列，并通过马尔可夫模型对麻风病检测系数进行序列调整。利用各城市该时期累计病例数的检测系数来绘制流行情况的空间分布图；对麻风病检测系数与圣保罗州社会责任指数的组成部分进行了相关分析。
在圣保罗州的645个城市中，有22个在该时期未检测到麻风病病例。在大多数地区，流行情况呈下降趋势；时间序列围绕预期值呈现随机波动。2005年底检测系数的普遍下降影响了这种下降趋势。圣保罗州社会责任指数的“教育程度”和“寿命”组成部分与检测系数呈正相关，与该指数的另一个组成部分“财富”呈负相关。
时间序列分析结果表明，圣保罗州大多数地区的流行情况正在下降，而空间分析表明该州北部的系数较高。
