Nobre Mauricio Lisboa, Dupnik Kathryn Margaret, Nobre Paulo José Lisboa, Freitas De Souza Márcia Célia, Dűppre Nádia Cristina, Sarno Euzenir Nunes, Jerŏnimo Selma Maria Bezerra
Lepr Rev. 2015 Dec;86(4):335-44.
Leprosy is a public health problem in Brazil where 31,044 new cases were detected in 2013. Rio Grande do Norte is a small Brazilian state with a rate of leprosy lower than other areas in the same region, for unknown reasons.
We present here a review based on the analysis of a database of registered leprosy cases in Rio Grande do Norte state, comparing leprosy's geographic distribution among municipalities with local socio-economic and public health indicators and with historical documents about human migration in this Brazilian region.
The current distribution of leprosy in Rio Grande do Norte did not show correlation with socio-economic or public health indicators at the municipal level, but it appears related to economically emerging municipalities 100 years ago, with spread facilitated by railroads and train stations. Drought-related migratory movements which occurred from this state to leprosy endemic areas within the same period may be involved in the introduction of leprosy and with its present distribution within Rio Grande do Norte.
Leprosy may disseminate slowly, over many decades in certain circumstances, such as in small cities with few cases. This is a very unusual situation currently and a unique opportunity for epidemiologic studies of leprosy as an emerging disease.
麻风病是巴西的一个公共卫生问题，2013年该国发现了31,044例新病例。北里奥格兰德州是巴西的一个小州，麻风病发病率低于同一地区的其他地区，原因不明。
我们在此基于对北里奥格兰德州登记的麻风病病例数据库的分析进行综述，将各城市中麻风病的地理分布与当地社会经济和公共卫生指标以及该巴西地区人类迁移的历史文献进行比较。
北里奥格兰德州目前的麻风病分布与市级社会经济或公共卫生指标没有相关性，但似乎与100年前经济新兴的城市有关，铁路和火车站促进了其传播。同期从该州向麻风病流行地区发生的与干旱相关的迁徙活动可能与麻风病的传入及其在北里奥格兰德州内的当前分布有关。
在某些情况下，例如在病例较少的小城市中，麻风病可能会在几十年的时间里缓慢传播。这是目前一种非常特殊的情况，也是将麻风病作为一种新出现疾病进行流行病学研究的独特机会。
