Programa de Pós-Graduação em Saúde Pública da Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Departamento de Estatística, Instituto de Matemática e Estatística, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil.
Public Health. 2024 Nov;236:307-314. doi: 10.1016/j.puhe.2024.07.035. Epub 2024 Sep 16.
To analyze the occurrence of leprosy in Brazil and its states between 1990 and 2019, according to Global Burden of Disease (GBD) estimates, and its correlation with development status.
A descriptive and analytical ecological epidemiological study.
Rates of incidence, prevalence, and years lived with disability (YLD) due to leprosy, standardized by age, per 100,000 inhabitants, were analyzed. The trend analysis consisted of the joinpoint regression model and the average annual percentage change. The correlation between the incidence rate and the sociodemographic index (SDI) was investigated (Spearman test) at a 5% significance level. Incidence, prevalence and YLD rates were presented by country's states, sex, and age.
There was an average percentage decrease of -1.1% per year (P < 0.001) in the incidence rate in the country and, between 1990 and 2019, a decline from 4.8 to 3.5 per 100,000 inhabitants; prevalence from 26.1 to 22.2, and YLD from 1.1 to 1.0. The incidence rate was higher among men and the elderly. Maranhão (7.0 in 1990; 4.2 in 2019), Alagoas (6.6 in 1990; 4.1 in 2019), Acre (6.1 in 1990; 4.0 in 2019), Mato Grosso (5.2 in 1990 and 3.7 in 2019), and Mato Grosso do Sul (4.8 in 1990 and 3.7 in 2019) presented the highest incidence rates. A negative correlation was observed between SDI levels and leprosy incidence rates in 1990 (R = -0.71; P < 0.0001) and 2019 (R = -0.81; P < 0.0001).
Despite the decrease in the rates of leprosy incidence, prevalence, and YLDs over the analyzed period, Brazil has a long way towards achieving its eradication. The greater burden of the disease in males stands out. The estimated risk of the disease was higher in the states with the lowest SDI levels. Therefore, interventions must consider the heterogeneity of the disease burden geographically and between sociodemographic groups.
根据全球疾病负担（GBD）估计，分析 1990 年至 2019 年巴西及其各州麻风病的发病情况及其与发展状况的关系。
描述性和分析性生态流行病学研究。
分析发病率、患病率和因麻风病导致的伤残生命年（YLD）的标准化率（按年龄标准化，每 10 万人）。趋势分析包括连接点回归模型和平均年变化百分比。在 5%的显著性水平下，对发病率与社会人口指数（SDI）的相关性（Spearman 检验）进行了分析。发病率、患病率和 YLD 率按国家、性别和年龄呈现。
该国的发病率平均每年下降 1.1%（P<0.001），1990 年至 2019 年期间，发病率从每 10 万人 4.8 例下降至 3.5 例；患病率从 26.1 例降至 22.2 例，伤残生命年从 1.1 例降至 1.0 例。发病率在男性和老年人中较高。1990 年发病率最高的是马拉尼昂州（7.0）、阿拉戈斯州（6.6）、阿克雷州（6.1）、马托格罗索州（5.2）和马托格罗索州南部（4.8），2019 年发病率最高的是马拉尼昂州（4.2）、阿拉戈斯州（4.1）、阿克雷州（4.0）、马托格罗索州（3.7）和马托格罗索州南部（3.7）。1990 年和 2019 年，SDI 水平与麻风病发病率之间呈负相关（1990 年 R=-0.71；P<0.0001；2019 年 R=-0.81；P<0.0001）。
尽管在此期间麻风病的发病率、患病率和 YLDs 有所下降，但巴西在实现其消除目标方面还有很长的路要走。男性中疾病负担较大。在 SDI 水平最低的州，估计疾病风险更高。因此，干预措施必须考虑疾病负担在地理和社会人口群体之间的异质性。
