Dataset Information

Clinical and epidemiological indicators and spatial analysis of leprosy cases in patients under 15 years old in an endemic area of Northeast Brazil: an ecological and time series study.

ABSTRACT:

Objective

This study aimed to analyse the clinical and epidemiological indicators, temporal trends and the spatial distribution of leprosy in patients under 15 years old in an endemic area of Northeast Brazil.

Design

Regional surveillance study of all reported cases.

Setting

State of Sergipe, endemic area of Northeast Brazil.

Methods

An ecological and time series study was conducted, based on secondary data reported by the Brazilian Information System on Notifiable Diseases for leprosy cases diagnosed in Sergipe state (2002-2015). The analysis of temporal trends was performed using the Joinpoint Regression Programme through Poisson regression. We performed spatial analysis by Kernel estimator and Moran index.

Results

The incidence rate was reduced from 6.29 to 3.78 cases per 100?000 inhabitants in 2002 and 2015, respectively. However, Sergipe was still classified as highly endemicity in 2015. The mean number of household contacts (HHC) examined was significantly lower than those registered. Clinical data indicated that 21.4% of the patients developed leprosy reactions, and 31.3% presented with some physical disability in the multibacillary groups. Patients diagnosed by examination within the HHC presented better indicators, such as lower percentage of leprosy reaction and physical disability. Spatial analysis showed the most risk areas distributed on the northeast and cities around the capital, Aracaju.

Conclusion

The data indicate that there is a persistence of active Myobacterium leprae transmission and a delay in disease detection, following a pattern of high endemicity in many municipalities. The early detection by HHC examination is important to stop transmission and also to detect the cases in a less severe state.

SUBMITTER: Santos MB

PROVIDER: S-EPMC6661616 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Clinical and epidemiological indicators and spatial analysis of leprosy cases in patients under 15 years old in an endemic area of Northeast Brazil: an ecological and time series study.

Santos Márcio Bezerra MB Santos Allan Dantas Dos ADD Barreto Aline Silva AS Souza Mariana do Rosário MDR Goes Marco Aurélio de Oliveira MAO Barreto Alves José Antônio JA Barreto Ikaro Daniel Carvalho IDC Silva José-Rodrigo S JS Oliveira Daniela Teles de DT Araújo Karina C G Machado de KCGM Duthie Malcolm S MS Jesus Amélia Ribeiro de AR

BMJ open 20190727 7

<h4>Objective</h4>This study aimed to analyse the clinical and epidemiological indicators, temporal trends and the spatial distribution of leprosy in patients under 15 years old in an endemic area of Northeast Brazil.<h4>Design</h4>Regional surveillance study of all reported cases.<h4>Setting</h4>State of Sergipe, endemic area of Northeast Brazil.<h4>Methods</h4>An ecological and time series study was conducted, based on secondary data reported by the Brazilian Information System on Notifiable D ...[more]

PMID: 31352408

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Project description:Leprosy continues to be detected at near stable rates in China even with established control programs, necessitating new knowledge and alternative methods to interrupt transmission. A molecular epidemiology investigation of 190 patients was undertaken to define Mycobacterium leprae strain types and discern genetic relationships and clusters in endemic and non-endemic regions spanning seventeen provinces and two autonomous regions. The findings support multiple locus variable number of tandem repeat (VNTR) analysis as a useful tool in uncovering characteristic patterns across the multiethnic and divergent geographic landscape of China. Several scenarios of clustering of leprosy from township to provincial to regional levels were recognized, while recent occupational or remote migration showed geographical separation of certain strains. First, prior studies indicated that of the four major M. leprae subtypes defined by single nucleotide polymorphisms (SNPs), only type 3 was present in China, purportedly entering from Europe/West/Central Asia via the Silk Road. However, this study revealed VNTR linked strains that are of type 1 in Guangdong, Fujian and Guangxi in southern China. Second, a subset of VNTR distinguishable strains of type 3, co-exist in these provinces. Third, type 3 strains with rpoT VNTR allele of 4, detected in Japan and Korea were discovered in Jiangsu and Anhui in the east and in western Sichuan bordering Tibet. Fourth, considering the overall genetic diversity, strains of endemic counties of Qiubei, Yunnan; Xing Yi, Guizhou; and across Sichuan in southwest were related. However, closer inspection showed distinct local strains and clusters. Altogether, these insights, primarily derived from VNTR typing, reveal multiple and overlooked paths for spread of leprosy into, within and out of China and invoke attention to historic maritime routes in the South and East China Sea. More importantly, new concepts and approaches for prospective case finding and tracking of leprosy from county to national level have been introduced.

Dataset Information

Clinical and epidemiological indicators and spatial analysis of leprosy cases in patients under 15 years old in an endemic area of Northeast Brazil: an ecological and time series study.

Objective

Design

Setting

Methods

Results

Conclusion

Publications

Clinical and epidemiological indicators and spatial analysis of leprosy cases in patients under 15 years old in an endemic area of Northeast Brazil: an ecological and time series study.

Similar Datasets

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