Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/36031
Title: Socioeconomic determinants of leprosy new case detection in the 100 Million Brazilian Cohort: a population-based linkage study
Authors: Nery, Joilda Silva
Ramond, Anna
Pescarini, Julia Moreira
Alves, André
Strina, Agostino
Ichihara, Maria Yury
Penna, Maria Lucia Fernandes
Smeeth, Liam
Rodrigues, Laura Cunha
Barreto, Mauricio Lima
Brickley, Elizabeth B.
Penna, Gerson Oliveira
Affilliation: Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil.
London School of Hygiene & Tropical Medicine. Department of Infectious Disease Epidemiology. London, UK.
Federal University Fluminense. Epidemiology and Biostatistics Department. Rio de Janeiro, RJ, Brazil.
Federal University Fluminense. Epidemiology and Biostatistics Department. Rio de Janeiro, RJ, Brazil.
Federal University Fluminense. Epidemiology and Biostatistics Department. Rio de Janeiro, RJ, Brazil.
Federal University Fluminense. Epidemiology and Biostatistics Department. Rio de Janeiro, RJ, Brazil.
University of Brasília. Tropical Medicine Centre. Brasília, DF, Brazil / Oswaldo Cruz Foundation. School of Goverment Brasília. Brasília, DF, Brazil.
London School of Hygiene & Tropical Medicine. Department of Infectious Disease Epidemiology. London, UK.
London School of Hygiene & Tropical Medicine. Department of Infectious Disease Epidemiology. London, UK.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
London School of Hygiene & Tropical Medicine. Department of Infectious Disease Epidemiology. London, UK.
Federal University Fluminense. Epidemiology and Biostatistics Department. Rio de Janeiro, RJ, Brazil.
Abstract: Although leprosy is recognised as a disease of poverty, there is little evidence on the specific socioeconomic factors associated with disease risk. To inform targeted strategies for disease elimination, we investigated socioeconomic markers of leprosy risk in Brazil. Methods Socioeconomic data from the 100 Million Brazilian Cohort were linked to the Brazilian national disease registry (Sistema de Informação de Agravos de Notificação) for leprosy from Jan 1, 2007, to Dec 31, 2014. Using Poisson regression, we assessed the association of socioeconomic factors with risk of incident leprosy in the full cohort and in children (aged 0–15 years), by leprosy subtype and region of residence. Findings In an analysis of 23 899 942 individuals including 18 518 patients with leprosy, increased levels of deprivation were associated with an increased risk of leprosy in Brazil. Directions of effect were consistent in children younger than 15 years and across disease subtypes. Individuals residing in regions with the highest poverty in the country (central-west, north, and northeast regions) had a risk of leprosy incidence five-to-eight times greater than did other individuals. Decreased levels of income and education and factors reflecting unfavourable living conditions were associated with an up to two-times increase in leprosy incidence (incidence rate ratio 1·46, 95% CI 1·32–1·62, for lowest vs highest quartile of income per capita; 2·09, 95% CI 1·62–2·72, for lowest vs highest level of education). Interpretation Within the poorest half of the Brazilian population, the most deprived individuals have the greatest risk of leprosy. Strategies focusing on early detection and treatment in the poorest populations could contribute substantially to global disease control.
Keywords: Leprosy
Risk Factors
Social Class
Vulnerable Populations
Humans
Brazil
keywords: Hanseniase
Fatores de risco
Condições Socioeconómicas
População Carente
Humanos
Brasil
Issue Date: 2019
Publisher: Elsevier
Citation: NERY, Joilda Silva et al. Socioeconomic determinants of leprosy new case detection in the 100 Million Brazilian Cohort: a population-based linkage study. Lancet Glob Health, v. 7, n. 9, p. 1-11, 2019.
DOI: 10.1016/S2214-109X(19)30260-8
ISSN: 2214-109X
Copyright: open access
Appears in Collections:BSB - Artigos de Periódicos
BA - IGM - Artigos de Periódicos

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