Martelli C M, Moraes Neto O L, Andrade A L, Silva S A, Silva I M, Zicker F
Departmamento de Saúde Coletiva, Universidade Federal de Goiás, Goiânia, Brazil.
Bull World Health Organ. 1995;73(3):315-9.
Reported is the spatial variation of leprosy in an urban area of Brazil and its correlation with socioeconomic indicators. From November 1991 to October 1992 a total of 752 newly diagnosed leprosy patients who were attending all outpatient clinics in Goiânia city, central Brazil, were identified. A database o leprosy cases was set up linking patients' addresses to 64 urban districts. Leprosy cases were detected in 86% of the districts and three risk strata were identified. The highest-risk area for leprosy was in the outskirts of the city and detection rates increased on moving from more developed to poorer areas. The risk of detecting leprosy cases was 5.3-fold greater (95% CI: 3.8-7.4) in the outskirts of the town than in the central zone. Discussed are the methodological issues related to leprosy case ascertainment, completeness and reliability of information, and the interpretation of the spatial distribution of leprosy per unit area. Highlighted also are the lack of leprosy control activities in primary health care units and the usefulness of geographical analysis in planning health services.
报告了巴西某城市地区麻风病的空间变异及其与社会经济指标的相关性。1991年11月至1992年10月，在巴西中部戈亚尼亚市的所有门诊诊所共识别出752例新诊断的麻风病患者。建立了一个麻风病病例数据库，将患者地址与64个城区相联系。在86%的城区发现了麻风病病例，并确定了三个风险层级。麻风病风险最高的区域位于城市郊区，且从较发达地区向较贫困地区移动时，检出率增加。城镇郊区检测到麻风病病例的风险比中心区域高5.3倍（95%置信区间：3.8 - 7.4）。讨论了与麻风病病例确诊、信息的完整性和可靠性以及单位面积麻风病空间分布解释相关的方法学问题。还强调了初级卫生保健单位缺乏麻风病控制活动以及地理分析在规划卫生服务中的作用。
