Indicadores epidemiológicos e operacionais da Hanseníase no Estado do Amapá, 2005 a 2015

Abstract

Leprosy is a slowly evolving infectious disease that mainly affects the skin and peripheral nerves. Despite the important advances in disease control in Brazil, this is still very high in most Brazilian states. The objective of the study was to characterize the epidemiological and operational indicators of leprosy in the state of Amapá, from 2005 to 2015. A quantitative, descriptive, population-based study was carried out through the collection of secondary information from data from the System of Information of Notification. For the characterization of the study population, the information in the notification sheets was collected and three epidemiological indicators and four operational indicators were analyzed. The analysis of the temporal evolution of the epidemiological indicators, the operational indicators and the proportions was made through linear regression models, carried out with the software Statistical Package for the Social Sciences (SPSS). A total of 1662 new cases was reported in the state during the study period. The prevalence of reported cases in the city of Macapá (86.8%), urban area (85%), reference center (83.6%), male sex (61.8%), in the age group between 15 and 45 years (59%), with more than five cutaneous lesions (37.4%), multibacillary (60.2%), dimorphic clinical form (44%). The rate of new cases per hundred thousand inhabitants showed a significant decreasing trend, however, endemicity in the state of Amapá is still "high", according to the Ministry of Health benchmarks. The rate of new cases in children under fifteen years of age and the proportion of cases with grade two of physical incapacity in diagnosis did not present a clear trend of evolution, but the State presented continuity of new cases in children and a high proportion of new cases with degree two of physical incapacity at the time of diagnosis, indicative of transmission active and late diagnosis. There was a significant upward trend for all the operational indicators surveyed: proportion of cure, proportion of contacts examined and proportion of newly assessed cases regarding the degree of physical incapacity in discharge and cure, signaling the improvement of the quality of health services to patients affected by leprosy. Leprosy remains high in the state of Amapá, and inspite of the advances achieved for control, the epidemiological indicators analyzed indicate a possible hidden endemic disease, with persistent late diagnosis and maintenance of bacilliferous sources.