Epidemiology of Leprosy in Sobral Municipality, State of Ceará-Brazil, from 1997 to 2003

Abstract

Leprosy is still a public health problem in Brazil. Sobral Municipality in the Central-North region of the State of Ceará(Northeast Brazil) is considered by the Ministry of Health one of the priority municipalities for leprosy control. To analyze the epidemiologic situation of leprosy in Sobral from 1997 to 2003, a descriptive longitudinal study was conducted. Data were obtained from the database of SINAN (Sistema de Informação de Agravos de Notificação - Information System of Notifiable Diseases). In the study period, 1,305 new cases of leprosy were notified; 661 (50.3%) were females and 644 (49.7%) were males. In 2003, the detection rate in the female sex was 23.8/10,000 women, an increase of 9.6% as compared to the male sex. The ighest
percentage of new cases was detected in 2003, with values above the expected when compared to the previous years. Borderline leprosy increased continuously, representing 67.5% of the notified cases in 2003. In 1997, most cases (70.4%) were paucibacillary. However, in the following years, multibacillary leprosy turned to be the predominant form, with proportions varying from 62.1% to 85.9% in the years 2002 and 2003, respectively. The detection rate increased from 10.0 cases/10.000 inhabitants in 1997 to 21.6 cases/10.000 inhabitants in 2003. The health services improved the detection of cases in the period; however, inconsistencies regarding age, sex, clinical form and operational classes were identified which indicate inadequate diagnosis of leprosy, mainly in 2003. The data emphasize the importance of critical analysis and monitoring of the epidemiologic situation in areas in which successful integration of leprosy control on the primary health care level has been reported.