Francisco Rogerlândio Martins-Melo1, Adriana Valéria Assunção-Ramos2, Alberto Novaes Ramos3, Carlos Henrique Alencar3, Renan Magalhães Montenegro3, Maria Leide Wand-Del-Rey de Oliveira4, Jorg Heukelbach5. 1. Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil Federal Institute of Education, Science and Technology of Ceará, Caucaia, Brazil. 2. School of Medicine, Health Sciences Center, University of Fortaleza, Fortaleza, Brazil Municipal Secretary of Health of Fortaleza, Ceará, Brazil. 3. Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil. 4. Training Center on Dermatology, University Hospital Clementino Fraga Filho, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. 5. Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil Anton Breinl Centre for Public Health and Tropical Medicine, School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Australia heukelbach@web.de.
Abstract
BACKGROUND: Leprosy is a public health problem and a neglected condition of morbidity and mortality in several countries of the world. We analysed time trends and spatiotemporal patterns of leprosy-related mortality in Brazil. METHODS: We performed a nationwide population-based study using secondary mortality data. We included all deaths that occurred in Brazil between 2000 and 2011, in which leprosy was mentioned in any field of death certificates. RESULTS: Leprosy was identified in 7732/12 491 280 deaths (0.1%). Average annual age-adjusted mortality rate was 0.43 deaths/100 000 inhabitants (95% CI 0.40-0.46). The burden of leprosy deaths was higher among males, elderly, black race/colour and in leprosy-endemic regions. Lepromatous leprosy was the most common clinical form mentioned. Mortality rates showed a significant nationwide decrease over the period (annual percent change [APC]: -2.8%; 95% CI -4.2 to -2.4). We observed decreasing mortality rates in the South, Southeast and Central-West regions, while the rates remained stable in North and Northeast regions. Spatial and spatiotemporal high-risk clusters for leprosy-related deaths were distributed mainly in highly endemic and socio-economically deprived regions. CONCLUSIONS: Leprosy is a neglected cause of death in Brazil since the disease is preventable, and a cost-effective treatment is available. Sustainable control measures should include appropriate management and systematic monitoring of leprosy-related complications, such as severe leprosy reactions and adverse effects to multidrug therapy.
BACKGROUND: Leprosy is a public health problem and a neglected condition of morbidity and mortality in several countries of the world. We analysed time trends and spatiotemporal patterns of leprosy-related mortality in Brazil. METHODS: We performed a nationwide population-based study using secondary mortality data. We included all deaths that occurred in Brazil between 2000 and 2011, in which leprosy was mentioned in any field of death certificates. RESULTS: Leprosy was identified in 7732/12 491 280 deaths (0.1%). Average annual age-adjusted mortality rate was 0.43 deaths/100 000 inhabitants (95% CI 0.40-0.46). The burden of leprosy deaths was higher among males, elderly, black race/colour and in leprosy-endemic regions. Lepromatous leprosy was the most common clinical form mentioned. Mortality rates showed a significant nationwide decrease over the period (annual percent change [APC]: -2.8%; 95% CI -4.2 to -2.4). We observed decreasing mortality rates in the South, Southeast and Central-West regions, while the rates remained stable in North and Northeast regions. Spatial and spatiotemporal high-risk clusters for leprosy-related deaths were distributed mainly in highly endemic and socio-economically deprived regions. CONCLUSIONS: Leprosy is a neglected cause of death in Brazil since the disease is preventable, and a cost-effective treatment is available. Sustainable control measures should include appropriate management and systematic monitoring of leprosy-related complications, such as severe leprosy reactions and adverse effects to multidrug therapy.
Authors: Francisco Rogerlândio Martins-Melo; Alberto Novaes Ramos; Carlos Henrique Alencar; Jorg Heukelbach Journal: Bull World Health Organ Date: 2015-11-24 Impact factor: 9.408
Authors: Rosalba V G Silva; Rafael S de Araújo; Tinara L S Aarão; Paulo Diovanne da Silva Costa; Jorge R Sousa; Juarez A S Quaresma Journal: Infect Dis Poverty Date: 2017-05-01 Impact factor: 4.520
Authors: Francisco Rogerlândio Martins-Melo; Alberto Novaes Ramos; Carlos Henrique Alencar; Jorg Heukelbach Journal: Parasite Epidemiol Control Date: 2016-04-07
Authors: Anderson Fuentes Ferreira; Eliana Amorim de Souza; Mauricélia da Silveira Lima; Gabriela Soledad Márdero García; Francesco Corona; Elaine Silva Nascimento Andrade; Sebastião Alves de Sena Neto; Carmelita Ribeiro Filha; Adriana da Silva Dos Reis; Léia Gadelha Teixeira; Alberto Novaes Ramos Journal: Rev Panam Salud Publica Date: 2019-11-06
Authors: Marineia Porto de Oliveira; Jorge Rodrigues de Sousa; Rafael Silva de Araujo; Tinara Leila de Sousa Aarão; Juarez Antonio Simões Quaresma Journal: Infect Dis Poverty Date: 2017-09-04 Impact factor: 4.520