Spatial clustering and local risk of leprosy in São Paulo, Brazil.
BACKGROUND:Although the detection rate is decreasing, the proportion of new cases with WHO grade 2 disability (G2D) is increasing, creating concern among policy makers and the Brazilian government. This study aimed to identify spatial clustering of leprosy and classify high-risk areas in a major lep...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2017-02-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | http://europepmc.org/articles/PMC5344525?pdf=render |
| _version_ | 1819024655688663040 |
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| author | Antônio Carlos Vieira Ramos Mellina Yamamura Luiz Henrique Arroyo Marcela Paschoal Popolin Francisco Chiaravalloti Neto Pedro Fredemir Palha Severina Alice da Costa Uchoa Flávia Meneguetti Pieri Ione Carvalho Pinto Regina Célia Fiorati Ana Angélica Rêgo de Queiroz Aylana de Souza Belchior Danielle Talita Dos Santos Maria Concebida da Cunha Garcia Juliane de Almeida Crispim Luana Seles Alves Thaís Zamboni Berra Ricardo Alexandre Arcêncio |
| author_facet | Antônio Carlos Vieira Ramos Mellina Yamamura Luiz Henrique Arroyo Marcela Paschoal Popolin Francisco Chiaravalloti Neto Pedro Fredemir Palha Severina Alice da Costa Uchoa Flávia Meneguetti Pieri Ione Carvalho Pinto Regina Célia Fiorati Ana Angélica Rêgo de Queiroz Aylana de Souza Belchior Danielle Talita Dos Santos Maria Concebida da Cunha Garcia Juliane de Almeida Crispim Luana Seles Alves Thaís Zamboni Berra Ricardo Alexandre Arcêncio |
| author_sort | Antônio Carlos Vieira Ramos |
| collection | DOAJ |
| description | BACKGROUND:Although the detection rate is decreasing, the proportion of new cases with WHO grade 2 disability (G2D) is increasing, creating concern among policy makers and the Brazilian government. This study aimed to identify spatial clustering of leprosy and classify high-risk areas in a major leprosy cluster using the SatScan method. METHODS:Data were obtained including all leprosy cases diagnosed between January 2006 and December 2013. In addition to the clinical variable, information was also gathered regarding the G2D of the patient at diagnosis and after treatment. The Scan Spatial statistic test, developed by Kulldorff e Nagarwalla, was used to identify spatial clustering and to measure the local risk (Relative Risk-RR) of leprosy. Maps considering these risks and their confidence intervals were constructed. RESULTS:A total of 434 cases were identified, including 188 (43.31%) borderline leprosy and 101 (23.28%) lepromatous leprosy cases. There was a predominance of males, with ages ranging from 15 to 59 years, and 51 patients (11.75%) presented G2D. Two significant spatial clusters and three significant spatial-temporal clusters were also observed. The main spatial cluster (p = 0.000) contained 90 census tracts, a population of approximately 58,438 inhabitants, detection rate of 22.6 cases per 100,000 people and RR of approximately 3.41 (95%CI = 2.721-4.267). Regarding the spatial-temporal clusters, two clusters were observed, with RR ranging between 24.35 (95%CI = 11.133-52.984) and 15.24 (95%CI = 10.114-22.919). CONCLUSION:These findings could contribute to improvements in policies and programming, aiming for the eradication of leprosy in Brazil. The Spatial Scan statistic test was found to be an interesting resource for health managers and healthcare professionals to map the vulnerability of areas in terms of leprosy transmission risk and areas of underreporting. |
| first_indexed | 2024-12-21T04:58:15Z |
| format | Article |
| id | doaj.art-732374ce1e8e49ba84d3259bb1678b99 |
| institution | Directory Open Access Journal |
| issn | 1935-2727 1935-2735 |
| language | English |
| last_indexed | 2024-12-21T04:58:15Z |
| publishDate | 2017-02-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj.art-732374ce1e8e49ba84d3259bb1678b992022-12-21T19:15:19ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352017-02-01112e000538110.1371/journal.pntd.0005381Spatial clustering and local risk of leprosy in São Paulo, Brazil.Antônio Carlos Vieira RamosMellina YamamuraLuiz Henrique ArroyoMarcela Paschoal PopolinFrancisco Chiaravalloti NetoPedro Fredemir PalhaSeverina Alice da Costa UchoaFlávia Meneguetti PieriIone Carvalho PintoRegina Célia FioratiAna Angélica Rêgo de QueirozAylana de Souza BelchiorDanielle Talita Dos SantosMaria Concebida da Cunha GarciaJuliane de Almeida CrispimLuana Seles AlvesThaís Zamboni BerraRicardo Alexandre ArcêncioBACKGROUND:Although the detection rate is decreasing, the proportion of new cases with WHO grade 2 disability (G2D) is increasing, creating concern among policy makers and the Brazilian government. This study aimed to identify spatial clustering of leprosy and classify high-risk areas in a major leprosy cluster using the SatScan method. METHODS:Data were obtained including all leprosy cases diagnosed between January 2006 and December 2013. In addition to the clinical variable, information was also gathered regarding the G2D of the patient at diagnosis and after treatment. The Scan Spatial statistic test, developed by Kulldorff e Nagarwalla, was used to identify spatial clustering and to measure the local risk (Relative Risk-RR) of leprosy. Maps considering these risks and their confidence intervals were constructed. RESULTS:A total of 434 cases were identified, including 188 (43.31%) borderline leprosy and 101 (23.28%) lepromatous leprosy cases. There was a predominance of males, with ages ranging from 15 to 59 years, and 51 patients (11.75%) presented G2D. Two significant spatial clusters and three significant spatial-temporal clusters were also observed. The main spatial cluster (p = 0.000) contained 90 census tracts, a population of approximately 58,438 inhabitants, detection rate of 22.6 cases per 100,000 people and RR of approximately 3.41 (95%CI = 2.721-4.267). Regarding the spatial-temporal clusters, two clusters were observed, with RR ranging between 24.35 (95%CI = 11.133-52.984) and 15.24 (95%CI = 10.114-22.919). CONCLUSION:These findings could contribute to improvements in policies and programming, aiming for the eradication of leprosy in Brazil. The Spatial Scan statistic test was found to be an interesting resource for health managers and healthcare professionals to map the vulnerability of areas in terms of leprosy transmission risk and areas of underreporting.http://europepmc.org/articles/PMC5344525?pdf=render |
| spellingShingle | Antônio Carlos Vieira Ramos Mellina Yamamura Luiz Henrique Arroyo Marcela Paschoal Popolin Francisco Chiaravalloti Neto Pedro Fredemir Palha Severina Alice da Costa Uchoa Flávia Meneguetti Pieri Ione Carvalho Pinto Regina Célia Fiorati Ana Angélica Rêgo de Queiroz Aylana de Souza Belchior Danielle Talita Dos Santos Maria Concebida da Cunha Garcia Juliane de Almeida Crispim Luana Seles Alves Thaís Zamboni Berra Ricardo Alexandre Arcêncio Spatial clustering and local risk of leprosy in São Paulo, Brazil. PLoS Neglected Tropical Diseases |
| title | Spatial clustering and local risk of leprosy in São Paulo, Brazil. |
| title_full | Spatial clustering and local risk of leprosy in São Paulo, Brazil. |
| title_fullStr | Spatial clustering and local risk of leprosy in São Paulo, Brazil. |
| title_full_unstemmed | Spatial clustering and local risk of leprosy in São Paulo, Brazil. |
| title_short | Spatial clustering and local risk of leprosy in São Paulo, Brazil. |
| title_sort | spatial clustering and local risk of leprosy in sao paulo brazil |
| url | http://europepmc.org/articles/PMC5344525?pdf=render |
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