Leprosy epidemiology and the decentralization of control actions in Brazil

Abstract

Objective: to analyze the epidemiological situation of leprosy in Brazil and its association with the decentralization of control actions. Method: mixed ecological study with secondary data from the Sistema de Informação de Agravos de Notificação (Brazilian Information System on Notifiable Diseases) of Brazilian municipalities. A negative binomial regression model was used between 2001 and 2015. Results: The analysis of geographic and temporal variations showed heterogeneous behavior of the three epidemiological indicators of leprosy. The significant increase in these was associated with the proportion of cases diagnosed in Primary Health Care (p<0.001; p=0.003; p=0.015); whereas the proportion of population coverage estimated by the Family Health Strategy (FHS) was associated only with the significant reduction in the indicator detection rate among children under fifteen (p=0.017). Conclusion: the simultaneous interpretation of the main epidemiological indicators of leprosy in Brazil reinforced the gravity of the situation and evidenced that the satisfactory availability of the FHS is insufficient for the control of the disease.