Schneider Priscila Barros, Freitas Bruna Hinnah Borges Martins de
Faculdade de Enfermagem, Universidade Federal de Mato Grosso, Cuiabá, Brasil.
Cad Saude Publica. 2018 Mar 12;34(3):e00101817. doi: 10.1590/0102-311X00101817.
The aim of this study was to analyze trends in the detection rate of leprosy in children under 15 years of age in Brazil from 2001 to 2016. A time series study used the Prais-Winsten procedure for generalized linear regression analysis, with significance set at 5%. The mean detection rate was 5.77 per 100,000 inhabitants. However, a downward trend was observed in this rate, with an annual percent change (APC) of -5% (95%CI: -6.7; -3.3). There was a downward trend in all regions of Brazil. Among the regions, the North maintained a hyperendemic mean detection rate (≥ 10.00 per 100,000 inhabitants). The time series was downward in 19 states of Brazil. However, many states maintained a hyperendemic mean rate, such as Mato Grosso, Pará, Maranhão, Rondônia, Roraima, Pernambuco, Piauí, and Acre. Among the eight states that maintained a stationary trend, Tocantins had a hyperendemic mean rate during the period analyzed. Of the 24 Brazilian state capitals included in the study, 14 showed downward trends and 10 stationary trends. Despite the downward trend in new cases, some state capitals maintained hyperendemic mean rates (Teresina, Recife, Cuiabá, Boa Vista, Rio Branco, and Belém). Despite stationary trends, the state capital cities Palmas and São Luís recorded hyperendemic mean rates. In conclusion, although the analysis showed a downward trend in Brazil, there were stationary trends and hyperendemicity in some states and in some state capitals, highlighting the persistence of sources of transmissibility and difficulty in eliminating leprosy from the country.
本研究旨在分析2001年至2016年巴西15岁以下儿童麻风病检出率的趋势。一项时间序列研究采用普雷斯-温斯坦程序进行广义线性回归分析,显著性设定为5%。平均检出率为每10万居民5.77例。然而,该比率呈下降趋势,年变化百分比(APC)为-5%(95%CI:-6.7;-3.3)。巴西所有地区均呈下降趋势。在各地区中,北部地区的平均检出率维持在高度流行水平(≥每10万居民10.00例)。巴西19个州的时间序列呈下降趋势。然而,许多州维持着高度流行的平均比率,如马托格罗索州、帕拉州、马拉尼昂州、朗多尼亚州、罗赖马州、伯南布哥州、皮奥伊州和阿克里州。在保持平稳趋势的八个州中,托坎廷斯州在分析期间的平均检出率处于高度流行水平。在纳入研究的24个巴西州首府中,14个呈下降趋势,10个呈平稳趋势。尽管新发病例呈下降趋势,但一些州首府的平均检出率仍维持在高度流行水平(特雷西纳、累西腓、库亚巴、博阿维斯塔、里奥布兰科和贝伦)。尽管趋势平稳,但州首府城市帕尔马斯和圣路易斯的平均检出率处于高度流行水平。总之,尽管分析显示巴西呈下降趋势,但一些州及一些州首府存在平稳趋势和高度流行情况,这突出表明传播源持续存在,且在该国消除麻风病存在困难。