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Publication

Social determinants of leprosy in a hyperendemic State in North Brazil.

Translated Title
Determinantes socias da hanseníase em um estado hiperendêmico da reião Norte do Brasil
Abstract

OBJECTIVE: To identify the socioeconomic, demographic, operational, and health service-related factors associated with the occurrence of leprosy in a hyperendemic State in North Brazil.

METHODS: This is an ecological study based on secondary data from the Sistema de Informações de Agravos de Notificação in municipalities of the State of Tocantins from 2001 to 2012. Units of analysis were the 139 municipalities of the State. Negative binomial log linear regression models were used to estimate incidence rate ratios.

RESULTS: In bivariate analysis, the incidence rate ratios were significantly higher for municipalities with higher income ratio of the poorest 20.0% (1.47; 95%CI 1.19-1.81) and better Municipal Human Development Index (1.53; 95%CI 1.14-2.06). In multivariate analysis, the incidence rate ratios were significantly higher in municipalities with higher proportion of immigrants (1.31; 95%CI 1.11-1.55) and higher proportion of households with waste collection (1.37; 95%CI 1.11-1.69). There was a significant reduction in the incidence rate ratio with increased coverage of the Bolsa Família Program (0.98; 95%CI 0.96-0.99).

CONCLUSIONS: Control programs need to focus on activities in municipalities of greater social vulnerability with intersectoral investment for the improvement of the living conditions of the population.

More information

Type
Journal Article
Author
Monteiro LD
Mota RMS
Martins-Melo FR
Alencar CH
Heukelbach J
Year of Publication
2017
Journal
Revista de saude publica
Volume
51
Number of Pages
70
Language
eng, por
ISSN Number
1518-8787
DOI
10.1590/S1518-8787.2017051006655
Alternate Journal
Rev Saude Publica
Publication Language
eng, por