02174nas a2200373   4500000000100000008004100001260000900042653001500051653001000066653002100076653000900097653001100106653001000117653002100127653002100148653002900169653001100198653001100209653001200220653001400232653002400246653002800270653001500298653003100313653001700344100001400361700003100375700002700406245012200433300001000555490000700565520121400572022001401786       1997                            d  c199710aAdolescent10aAdult10aAge Distribution10aBias10aBrazil10aChild10aChild, Preschool10aEndemic Diseases10aHealth Status Indicators10aHumans10aInfant10aleprosy10aMorbidity10aOperations Research10aPopulation Surveillance10aRegistries10aReproducibility of Results10aTime Factors1 aAndrade V1 aMilitao de Albuquerque M D1 aChagastelles Sabroza P00aThe importance of operational factors for the interpretation of indicators in the Hansen's disease endemic in Brazil.  a131-90 v103 a<p>In Brazil, an increase has been recorded in recent years in the magnitude of detection coefficients for new cases of Hansen's disease, which is frequently interpreted as evidence of the endemic's expansion. The objective of this work is the determine the role of operational factors for interpreting the trend displayed by the morbidity coefficients for Hansen's disease from 1982 to 1995 in the country. We observed a strong correlation between the adjusted detection coefficients and the number of technicians trained (r = 0.80), a decrease in the proportion of new cases with disabilities at the time of diagnosis (r = 0.86), and a downward trend in tuberculoid forms (r = -0.70). Patient time on the active register is correlated negatively with MDT-WHO coverage (r = -0.95) and the percentage of patients discharged from treatment due to cure (r = -0.91). These results suggest that the increase in the potential for detection of new cases of Hansen's disease resulting from new strategies adopted by the program, i.e., mainly extensive training of health personnel, could be a coherent explanation for the increase in detection coefficients for new cases observed in Brazil in the last ten years.</p>  a0001-5938