Eliana Amorim de Souza1, Jorg Heukelbach2,3, Maria Leide Wand-Del-Rey Oliveira4, Anderson Fuentes Ferreira2, Sebastiao Alves de Sena Neto5, Marcos Tulio Raposo6, Alberto Novaes Ramos2. 1. Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Campus Anísio Teixeira - Vitória da Conquista (BA), Brasil. 2. Departamento de Saúde Comunitária, Faculdade de Medicina, Universidade Federal do Ceará - Fortaleza (CE), Brasil. 3. College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University - Townsville, Queensland, Austrália. 4. Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho - Rio de Janeiro (RJ), Brasil. 5. Programa de Controle da Hanseníase, Secretaria Estadual de Saúde - Porto Velho (RO), Brasil. 6. Departamento de Saúde, Universidade Estadual do Sudoeste da Bahia - Jequié (BA), Brasil.
Abstract
OBJECTIVE: To characterize spatiotemporal patterns of operational indicators for leprosy control in the state of Bahia from 2001 to 2014. METHODS: This is a population-based ecological study, with spatial distribution and autocorrelation of operational indicators for leprosy control. RESULTS: From 2001 to 2007, 42.7% (n=178) of the municipalities presented a cure rate lower than 75%, increasing to 61.4% (n =291) from 2009 to 2014. Between 2001 and 2007, 32.5% (n=54) of the municipalities reported more than 10% of the total number of relapses in the state, increasing to 36.9% (n=75) between 2008 and 2014. From 2001 to 2014, 38% (n=159) of the municipalities presented an assessment index of disability grading at the time of diagnosis within the regular performance parameter. Between 2009 and 2014, the number of municipalities with a high incidence of grade 2 disability (G2D) at the time of diagnosis increased, reaching 55.3% (n=230) of the municipalities. Most municipalities in the state of Bahia showed poor performance in the implementation of planned actions for leprosy control, with little change or relative worsening in the patterns of operational indicators throughout the historical series. CONCLUSION: The operational context in Bahia indicates significant institutional vulnerability, leading to the need for expansion and qualification of the surveillance and health care network in the different regions and conditions analyzed in the public health system (Sistema Único de Saúde - SUS).
OBJECTIVE: To characterize spatiotemporal patterns of operational indicators for leprosy control in the state of Bahia from 2001 to 2014. METHODS: This is a population-based ecological study, with spatial distribution and autocorrelation of operational indicators for leprosy control. RESULTS: From 2001 to 2007, 42.7% (n=178) of the municipalities presented a cure rate lower than 75%, increasing to 61.4% (n =291) from 2009 to 2014. Between 2001 and 2007, 32.5% (n=54) of the municipalities reported more than 10% of the total number of relapses in the state, increasing to 36.9% (n=75) between 2008 and 2014. From 2001 to 2014, 38% (n=159) of the municipalities presented an assessment index of disability grading at the time of diagnosis within the regular performance parameter. Between 2009 and 2014, the number of municipalities with a high incidence of grade 2 disability (G2D) at the time of diagnosis increased, reaching 55.3% (n=230) of the municipalities. Most municipalities in the state of Bahia showed poor performance in the implementation of planned actions for leprosy control, with little change or relative worsening in the patterns of operational indicators throughout the historical series. CONCLUSION: The operational context in Bahia indicates significant institutional vulnerability, leading to the need for expansion and qualification of the surveillance and health care network in the different regions and conditions analyzed in the public health system (Sistema Único de Saúde - SUS).
Authors: Gabriela Soledad Márdero García; Eliana Amorim de Souza; Vigna Maria de Araújo; Mariana Sousa Santos Macedo; Rosélly Mascarenhas Amaral de Andrade; Paulo Rogers da Silva Ferreira; Maria Cristina Soares Guimarães; José Alexandre Menezes da Silva; Alberto Novaes Ramos Júnior Journal: Rev Saude Publica Date: 2022-04-22 Impact factor: 2.106