Assessment of integration of the leprosy program into primary health care in Aracaju, state of Sergipe, Brazil

INTRODUCTION: The aim of this study was to assess the epidemiological and operational characteristics of the Leprosy Program before and after its integration into the Primary healthcare Services of the municipality of Aracaju-Sergipe, Brazil. METHODS: Data were drawn from the national database. The...

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Main Authors: Marcos Túlio Raposo, Maria Ines Battistella Nemes
Format: Article
Language:English
Published: Sociedade Brasileira de Medicina Tropical (SBMT) 2012-04-01
Series:Revista da Sociedade Brasileira de Medicina Tropical
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822012000200013&lng=en&tlng=en
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author Marcos Túlio Raposo
Maria Ines Battistella Nemes
author_facet Marcos Túlio Raposo
Maria Ines Battistella Nemes
author_sort Marcos Túlio Raposo
collection DOAJ
description INTRODUCTION: The aim of this study was to assess the epidemiological and operational characteristics of the Leprosy Program before and after its integration into the Primary healthcare Services of the municipality of Aracaju-Sergipe, Brazil. METHODS: Data were drawn from the national database. The study periods were divided into preintegration (1996-2000) and postintegration (2001-2007). Annual rates of epidemiological detection were calculated. Frequency data on clinico-epidemiological variables of cases detected and treated for the two periods were compared using the Chi-squared (χ2) test adopting a 5% level of significance. RESULTS: Rates of detection overall, and in subjects younger than 15 years, were greater for the postintegration period and were higher than rates recorded for Brazil as a whole during the same periods. A total of 780 and 1,469 cases were registered during the preintegration and postintegration periods, respectively. Observations for the postintegration period were as follows: I) a higher proportion of cases with disability grade assessed at diagnosis, with increase of 60.9% to 78.8% (p < 0.001), and at end of treatment, from 41.4% to 44.4% (p < 0.023); II) an increase in proportion of cases detected by contact examination, from 2.1% to 4.1% (p < 0.001); and III) a lower level of treatment default with a decrease from 5.64 to 3.35 (p < 0.008). Only 34% of cases registered from 2001 to 2007 were examined. CONCLUSIONS: The shift observed in rates of detection overall, and in subjects younger than 15 years, during the postintegration period indicate an increased level of health care access. The fall in number of patients abandoning treatment indicates greater adherence to treatment. However, previous shortcomings in key actions, pivotal to attaining the outcomes and impact envisaged for the program, persisted in the postintegration period.
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spelling doaj.art-a05769d7952e41d9b4dfba2008bb73672022-12-22T02:30:35ZengSociedade Brasileira de Medicina Tropical (SBMT)Revista da Sociedade Brasileira de Medicina Tropical1678-98492012-04-0145220320810.1590/S0037-86822012000200013S0037-86822012000200013Assessment of integration of the leprosy program into primary health care in Aracaju, state of Sergipe, BrazilMarcos Túlio Raposo0Maria Ines Battistella Nemes1Universidade Estadual do Sudoeste da BahiaUniversidade de São PauloINTRODUCTION: The aim of this study was to assess the epidemiological and operational characteristics of the Leprosy Program before and after its integration into the Primary healthcare Services of the municipality of Aracaju-Sergipe, Brazil. METHODS: Data were drawn from the national database. The study periods were divided into preintegration (1996-2000) and postintegration (2001-2007). Annual rates of epidemiological detection were calculated. Frequency data on clinico-epidemiological variables of cases detected and treated for the two periods were compared using the Chi-squared (χ2) test adopting a 5% level of significance. RESULTS: Rates of detection overall, and in subjects younger than 15 years, were greater for the postintegration period and were higher than rates recorded for Brazil as a whole during the same periods. A total of 780 and 1,469 cases were registered during the preintegration and postintegration periods, respectively. Observations for the postintegration period were as follows: I) a higher proportion of cases with disability grade assessed at diagnosis, with increase of 60.9% to 78.8% (p < 0.001), and at end of treatment, from 41.4% to 44.4% (p < 0.023); II) an increase in proportion of cases detected by contact examination, from 2.1% to 4.1% (p < 0.001); and III) a lower level of treatment default with a decrease from 5.64 to 3.35 (p < 0.008). Only 34% of cases registered from 2001 to 2007 were examined. CONCLUSIONS: The shift observed in rates of detection overall, and in subjects younger than 15 years, during the postintegration period indicate an increased level of health care access. The fall in number of patients abandoning treatment indicates greater adherence to treatment. However, previous shortcomings in key actions, pivotal to attaining the outcomes and impact envisaged for the program, persisted in the postintegration period.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822012000200013&lng=en&tlng=enhanseníaseEpidemiologiaAvaliação de programas e projetosSaúde da famíliaAtenção primária
spellingShingle Marcos Túlio Raposo
Maria Ines Battistella Nemes
Assessment of integration of the leprosy program into primary health care in Aracaju, state of Sergipe, Brazil
Revista da Sociedade Brasileira de Medicina Tropical
hanseníase
Epidemiologia
Avaliação de programas e projetos
Saúde da família
Atenção primária
title Assessment of integration of the leprosy program into primary health care in Aracaju, state of Sergipe, Brazil
title_full Assessment of integration of the leprosy program into primary health care in Aracaju, state of Sergipe, Brazil
title_fullStr Assessment of integration of the leprosy program into primary health care in Aracaju, state of Sergipe, Brazil
title_full_unstemmed Assessment of integration of the leprosy program into primary health care in Aracaju, state of Sergipe, Brazil
title_short Assessment of integration of the leprosy program into primary health care in Aracaju, state of Sergipe, Brazil
title_sort assessment of integration of the leprosy program into primary health care in aracaju state of sergipe brazil
topic hanseníase
Epidemiologia
Avaliação de programas e projetos
Saúde da família
Atenção primária
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822012000200013&lng=en&tlng=en
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