Silva Diego Ricardo Xavier, Ignotti Eliane, Souza-Santos Reinaldo, Hacon Sandra de Souza
Universidade do Estado de Mato Grosso, Cáceres, MT, Brasil.
Rev Panam Salud Publica. 2010 Apr;27(4):268-75. doi: 10.1590/s1020-49892010000400005.
To analyze the association between social and environmental indicators and the Hansen's disease new case detection rate (HNCDR) in the Brazilian Amazon.
This ecological study was based on the new cases of Hansen's disease reported to the Brazilian Disease Surveillance System SINAN in 2006. Analyses were performed considering 105 micro-regions formed by adjacent municipalities with economic and social similarities. HNCDRs per 10 000 people were calculated. Independent variables were total area deforested (km(2)) in each micro-region until 2006; proportion of people living in households with rudimentary septic tanks; proportion of people living in households with water supply from wells; and human development index (HDI) in 2000. Local empirical Bayes smoothing was applied to HNCDR. Analyses were carried out to determined correlations and differences between means (analysis of variance) for a significance level of 5%. The Kernel technique was used to investigate the geographic distribution of events of interest for all the study indicators.
A positive correlation was observed between HNCDR and total deforested area (r = 0.50; P < 0.000) and percent of households with rudimentary septic tanks (r = 0.49; P < 0.000). HDI was inversely correlated with HNCDR: the higher the HDI, the lower the HNCDR (r = -0.36; P < 0.000). Considering the entire region, proportion of households with water from wells was not associated with NCDR.
The Hansen's disease new case detection rate, which reflects the magnitude of disease, is associated with social conditions and land settlement practices in the Brazilian Amazon.
分析巴西亚马逊地区社会和环境指标与麻风病新病例检出率（HNCDR）之间的关联。
本生态研究基于2006年向巴西疾病监测系统SINAN报告的麻风病新病例。分析是在由经济和社会情况相似的相邻市镇组成的105个微型区域基础上进行的。计算了每万人的HNCDR。自变量包括截至2006年每个微型区域的森林砍伐总面积（平方公里）；居住在有简易化粪池家庭中的人口比例；居住在以井水为供水来源家庭中的人口比例；以及2000年的人类发展指数（HDI）。对HNCDR应用了局部经验贝叶斯平滑法。进行分析以确定相关性以及均值之间的差异（方差分析），显著性水平为5%。采用核技术研究所有研究指标中感兴趣事件的地理分布。
观察到HNCDR与森林砍伐总面积（r = 0.50；P < 0.000）以及有简易化粪池家庭的比例（r = 0.49；P < 0.000）呈正相关。HDI与HNCDR呈负相关：HDI越高，HNCDR越低（r = -0.36；P < 0.000）。就整个区域而言，以井水为水源家庭的比例与NCDR无关。
反映疾病严重程度的麻风病新病例检出率与巴西亚马逊地区的社会状况和土地定居方式有关。
