%0 Journal Article
%T Deformities due to Leprosy in Children under Fifteen Years Old as an Indicator of Quality of the Leprosy Control Programme in Brazilian Municipalities
%A Francisco Carlos F¨¦lix Lana
%A Ang¨¦lica da Concei£¿£¿o Oliveira Coelho Fabri
%A Fabiana Nascimento Lopes
%A Ana Paula Mendes Carvalho
%A Fernanda Moura Lanza
%J Journal of Tropical Medicine
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/812793
%X The present study aims at analysing the degree of deformity in leprosy cases diagnosed in children under 15 years old and its relationship with operational and epidemiological factors. This epidemiological cross-sectional study was carried out at municipalities of three microregions in a Brazilian hyperendemic area. Data between 1998 and 2010 was collected from the Information System for Notifiable Diseases database. The average coefficient of detection was 32.96/100.000 inhabitants; 7.61% of new cases were diagnosed in children under 15 years old; 5% in this age group were grade 2 deformity at diagnosis. Prevalence of leprosy cases in children under 15 years old with deformity was higher in males ( CI 95%: 1.09¨C6.45) and in multibacillary patients ( CI 95%: 3.54¨C60.87) and lower when the detection mode was passive ( CI 95%: 0.31¨C1.73). Such context suggests high transmissibility and early exposure to Mycobacterium leprae since a lot of cases were diagnosed in children under fifteen years old and the incubation period of the leprosy bacillus varies from 02 to 07 years. This situation contributes to maintaining the chain of disease transmission in the area and indicates that health care services should intensify leprosy control. 1. Introduction Notwithstanding the reduction in the number of leprosy cases, the disease remains an important public health issue in many countries. In the Americas, Brazil is still the most endemic country. In 2010 Brazil¡¯s coefficient of detection was of 18.29/100.000 inhabitants in the general population and of 1.29/100.000 in the population under 15 years old. Among the new cases of the disease, 6.4% showed grade 2 deformity [1]. Leprosy Control Programs are constantly changing. The current World Health Organization (WHO) strategy is to reduce the number of cases among those under 15 years old and to achieve a 35% reduction in the new cases detection rate with grade 2 deformity by the end of 2015, 2010 being the baseline. These indicators help to measure quality of care and to monitor the Leprosy Eradication Program [2]. Nevertheless, according to recent studies, Brazil will not meet the WHO leprosy elimination target of reducing the new cases detection rate with grade 2 deformity by 2015 [3]. Leprosy detection in children under 15 years old is a strong indicator of recent transmission by active sources of infection [4] and suggests that the population is being exposed to cases not yet diagnosed by the health services. Conditions of high transmissibility and early exposure to Mycobacterium leprae increase the chances of
%U http://www.hindawi.com/journals/jtm/2013/812793/