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Spatial clustering, social vulnerability and risk of leprosy in an endemic area in Northeast Brazil: an ecological study.

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de Souza, Carlos D F, Rocha, Viviane S, Santos, Natanael F, Leal, Thiago C, de Paiva, João P, Oliveira, Cristiane C C, Martins-Filho, Paulo R S, Magalhães, Mônica A F M, Cuevas, Luis ORCID: https://orcid.org/0000-0002-6581-0587 and Santos, Victor S (2019) 'Spatial clustering, social vulnerability and risk of leprosy in an endemic area in Northeast Brazil: an ecological study.'. Journal of the European Academy of Dermatology and Venereology. (In Press)

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Abstract

BACKGROUND
Despite the global decline in the detection of leprosy cases, its incidence has remains unchanged in certain settings and requires the determination of the factors linked to its persistence. We examined the spatial and space-time distribution of leprosy and the influence of social vulnerability on the occurrence of the disease in an endemic area of Northeast Brazil.
METHODS
We performed an ecological study of all leprosy cases reported by Sergipe state, Northeast Brazil from 2001 to 2015, to examine the association of the social vulnerability index and the prevalence and persistence of leprosy among the State's municipalities. Socioeconomic and leprosy surveillance information were collected from the Brazilian information systems and a Bayesian Empirical Local model was used to identify fluctuations of the indicators. Spatial and space-time clusters were identified using Scan Spatial statistic tests and to measure the municipalities Relative Risk of leprosy.
RESULTS
Leprosy clusters and burden of disease had a strong statistical association with the municipalities social vulnerability index. Municipalities with a high social vulnerability had higher leprosy incidence, MB leprosy and newly diagnosed cases with grade 2 disability than areas with low social vulnerability.
CONCLUSION
Social vulnerability is strongly associated with leprosy transmission and maintenance of disease incidence. Leprosy control programs should be targeted to the populations with high social vulnerability. This article is protected by copyright. All rights reserved.

Item Type: Article
Subjects: WA Public Health > WA 100 General works
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Infection. Bacterial Infections > Other Bacterial Infections. Zoonotic Bacterial Infections > WC 335 Leprosy
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1111/jdv.15596
Depositing User: Stacy Murtagh
Date Deposited: 29 Mar 2019 12:18
Last Modified: 11 Apr 2019 14:26
URI: http://archive.lstmed.ac.uk/id/eprint/10499

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