02125nas a2200361   4500000000100000008004100001260001300042653001100055653002100066653002800087653002500115653002100140653002000161653001100181653002400192653001200216653002400228653002100252100001600273700001900289700001700308700001200325700001600337700001500353700001700368245011600385856005500501300001200556490000700568050001700575520115700592022001401749       2012                            d  c2012 Sep10aBrazil10aCluster Analysis10aCross-Sectional Studies10aDisease Notification10aEndemic Diseases10aHuman Migration10aHumans10aInformation Systems10aleprosy10aPrimary Health Care10aSpatial analysis1 aAlencar CHM1 aNovaes Ramos A1 aSena Neto SA1 aMurto C1 aAlencar MJF1 aBarbosa JC1 aHeukelbach J00a[Leprosy diagnosis in municipalities other than the patients' place of residence: spatial analysis, 2001-2009].  uhttp://www.scielosp.org/pdf/csp/v28n9/v28n9a08.pdf  a1685-980 v28  aALENCAR 20123 a<p>The study analyzed the flow of persons with leprosy from their municipality (county) of residence to that of their diagnosis in a highly endemic area in Brazil. The study was based on data from the National Information System for Notifiable Diseases from 2001 to 2009 in the States of Maranhão, Pará, Tocantins, and Piauí. Of the 373 municipalities, 349 (93.6%) had at least one resident with leprosy that had been diagnosed in a different municipality (4,325 cases, or 5.2% of the total). The municipalities with the most cases reported elsewhere were Timon (248) and São José de Ribamar (201), Maranhão State. The municipalities that received the most exogenous cases for diagnosis were São Luís (719), capital of Maranhão, and Teresina (516), capital of Piauí. Goiânia (146), capital of Goiás, and the Federal District (42) also reported numerous cases, even though they are located more than 1,000 km from the endemic area. The flow indicates gaps in the decentralization of comprehensive care for persons with leprosy and calls attention to the difficulties associated with patient monitoring during and after multidrug therapy.</p>  a1678-4464