Risco de adoecimento por hanseníase no estado de Minas Gerais

• Ano de defesa: 2023
• Autor(a) principal: Isabela de Caux Bueno
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; Brasil; ENFERMAGEM - ESCOLA DE ENFERMAGEM; Programa de Pós-Graduação em Enfermagem; UFMG
• Palavras-chave em Português: Hanseníase; Epidemiologia; Condições socioeconômicas; Atenção Primária à Saúde; Saúde Pública; Análise Espacial; Classe Social
• Link de acesso: http://hdl.handle.net/1843/58976

Introduction: Leprosy remains an important public health problem, especially in Brazil, the second country with the highest number of cases globally. Epidemiological indicators being analyzed in isolation are not enough to estimate the risk of illness from leprosy and to understand the health situation as a process, especially when it comes to an infectious, neglected, socioeconomically influenced disease that requires continuous coping actions by the services of health to achieve its control. Objective: To analyze the risk of leprosy illness in the state of Minas Gerais. Methods: This is an ecological study carried out with new cases of leprosy diagnosed from 2004 to 2019 in the municipalities of the state of Minas Gerais. For the spatial analysis, global and local spatial autocorrelation statistics were used to identify the spatial distribution of the leprosy epidemiological risk, in the periods 2004-2011 and 2012-2019 and classified as High/High, Low/Low, High/Low and Low/High. To identify the indicators of the programmatic actions of health care in leprosy and the socioeconomic conditions relevant to the occurrence of the leprosy epidemiological risk, Moran's bivariate global spatial correlation was used. Independent variables with statistically significant correlation at 5% with the dependent variable were included in the initial model for spatial regression analysis using multivariate linear regression analysis and by Spatial Lag and Spatial error. Spatial analyzes were performed in GeoDa software. Results: The Moran Global Index confirmed the existence of spatial dependence between the municipalities for the two analyzed periods. When performing the local spatial autocorrelation, it was possible to observe that the macro-regions that had the highest number of municipalities with high indices, surrounded by other municipalities also with high indices (high-high), were Northwest, East, Northeast and North. The macroregions that presented low risk were South-Center, Southeast, Central and South. When performing the spatial autocorrelation of the independent variables with the leprosy epidemiological risk, only the variable Proportion of people living in households with access to the sewage system was not statistically associated with the leprosy epidemiological risk in the first period analyzed in the study. The Proportion of new cases of leprosy diagnosed in the PHC of the municipality of residence; the Proportion of people with low income, and the illiteracy rate composed the final model of the spatial regression analysis in both studied periods. Local spatial autocorrelation of the risk of illness from leprosy revealed a greater proportion of high-risk municipalities concentrated in the Northwest, Northeast and West macro-regions. Conclusion: Leprosy persists in endemic areas of Minas Gerais, influenced by socioeconomic and programmatic conditions. Spatial analysis revealed the complexity of disease distribution. Socioeconomic conditions, such as low income and illiteracy, and programmatic actions, such as diagnosis in PHC, also influence the risk of illness from leprosy. It reinforces the importance of combating socioeconomic inequalities and strengthening Leprosy Control Actions within the scope of PHC.