Spatial analysis reveals failures in leprosy control activities in a hyperendemic city in Brazil

Introduction Leprosy is an infectious disease that affects skin and peripheral nervous tissue and, if not timely diagnosed and treated, can evolve to different degrees of physical disability. Mossoro, in the west of Rio Grande do Norte, has a high historical endemicity for the disease, and current indices suggesting a local transmission chain, requiring the acquisition of accurate information to enable better handling of the problem. Objective To analyze leprosy trends in an endemic Brazilian municipality (Mossoro) and the distribution patterns of cases diagnosed with Grade 2 disability (G2D), considering their relationship with the basic health units in the urban area. Methods This is an ecological study with a descriptive analysis of notified cases of leprosy, focusing on mapping cases that presented G2D at diagnosis. The data were collected from the municipal health department. The statistical software SPSS[R] Statistics v.27 and the spatial analysis tool ArcGIS 9.2 were used. Results Among the cases with peripheral nerve impairment, those of male sex, multibacillary leprosy, and low education predominated. In addition, a higher concentration of cases with G2D was found in five health units, in particular: Sinharinha Borges, Dr. Joaquim Saldanha, Ilha de Santa Luzia, Liberdade II, and Dr. Cid Salem Duarte. Finally, it was noted that 38.5% of the health units had cases of G2D residing up to 431 m from the care setting. Conclusions The indicated units need support measures to intensify surveillance activities and act more effectively in combating the leprosy endemic. Keywords: Public health services research, epidemiology, leprosy, georeferencing, geographic information systems