02131nas a2200277 4500000000100000008004100001260001300042653001100055653002100066653001100087653001200098653001300110653002300123653002700146653002100173100001600194700001900210700001300229700001900242245010900261856005100370300001100421490000700432520140000439022001401839 2010 d c2010 Sep10aBrazil10aEndemic Diseases10aHumans10aleprosy10aPolitics10aProgram evaluation10aQuality of Health Care10aUrban Population1 aFuzikawa PL1 aDe Acúrcio FA1 aVelema J1 aCherchiglia ML00aDecentralisation of leprosy control activities in the municipality of Betim, Minas Gerais State, Brazil. uhttps://leprosyreview.org/article/81/3/18-4195 a184-950 v813 a

OBJECTIVES: The present study aims at evaluating the decentralisation of the leprosy control activities in the municipality of Betim, Minas Gerais, Brazil.

DESIGN: A quantitative study was undertaken using data from SINAN (Sistema Nacional de Agravos de Notificação) and patient records. The study included 435 new cases registered and living in Betim. The pre (1995-2000) and post (2001-2005) decentralisation periods were compared using the chi-square test. Besides this, units which already had leprosy control activities were compared to those which implemented them from 2001 on.

RESULTS: There was a decrease in the percentage of cases diagnosed with deformities after decentralisation, as well as an increase in the number of cases detected through self-reporting. More patients were notified closer to home after decentralisation. The selected indicators did not show any difference between the quality of assistance regarding prevention of disabilities when comparing health units which already had leprosy activities to those which implemented them from 2001 onwards.

CONCLUSIONS: Decentralisation, in Betim, did not lead to an increase in the number of cases, but led to earlier diagnosis and patients being treated closer to their homes. The study did not show evidence of decrease in the quality of care after decentralisation.

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