Neurological disability in leprosy: incidence and gender association in Sergipe, Brazil

Abstract

Leprosy remains a public health problem in many countries. The disease affects skin and peripheral nerves and can cause irreversible disabilities. In Brazil, the detection rate of new cases is 18.2/100,000 inhabitants and leprosy control is considered a priority in the state of Sergipe. Studies showing the epidemiological profile and geographical distribution of leprosy cases are needed for effective epidemiological control measures. The objective of this study was to assess the detection rate of new cases, the geographical distribution and association with gender and clinical forms in Sergipe. Data were obtained from the Brazilian Institute of Geography and Statistics and the Information System for Notifiable Diseases. Maps indicating the geographical distribution of leprosy cases and the degree of neurological disabilities of all municipalities of the state were created using Spring, version 5.1.8 and ArcGIS, version 9.3.1. Hyper-endemic leprosy municipalities exist in Sergipe, indicating that the disease remains a major public health problem. The leprosy cases were found to be in municipalities with a higher number of dwellings with nine people per house. A detection rate of 33.0/100,000 inhabitants was noted in 2005, followed by a progressive reduction in the number of new cases until 2010. However, in the same period, an increase of cases with neurological disability was observed. A significant association of males with the multi-bacillary form and neurological disability was observed. This predisposition to severe forms of leprosy in males may be due to a delay in diagnosis and treatment emphasising the need for special attention by the leprosy control programme.