02670nas a2200337 4500000000100000008004100001260001200042653001800054653001200072653002100084100002500105700001200130700001300142700001400155700001400169700001300183700001800196700001300214700001400227700001300241700002100254700001300275700001200288700001600300245017300316856008100489300000800570490000700578520173300585022001402318 2020 d c01/202010aBorder region10aleprosy10aSpatial analysis1 aSimionato de Assis I1 aBerra T1 aAlves LS1 aRamos ACV1 aArroyo LH1 aSantos D1 aArcoverde MAM1 aAlves JD1 aCrispim J1 aPieri FM1 aCipriani Frade M1 aPinto IC1 aNunes C1 aArcêncio R00aLeprosy in urban space, areas of risk for disability and worsening of this health condition in Foz Do Iguaçu, the border region between Brazil, Paraguay and Argentina. uhttps://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-8236-5 a1190 v203 a

BACKGROUND: Leprosy is a public health problem and a challenge for endemic countries, especially in their border regions where there are intense migration flows. The study aimed to analyse the dynamics of leprosy, in order to identify areas of risk for the occurrence of the disease and disability and places where this health condition is worsening.

METHOD: This ecological study considered the new cases of leprosy reported in the municipality of Foz do Iguaçu from 2003 to 2015. Spatial and spatial-temporal scan statistics were used to identify the risk areas for the occurrence of leprosy, as well as the Getis-Ord Gi and Getis-Ord Gi* methods. Areas of risk for disabilities were identified by the scan statistic and kernel density estimation.

RESULTS: A total of 840 cases were reported, of which 179 (21.3%) presented Grade 1 or 2 disabilities at the time of diagnosis. Leprosy risk areas were concentrated in the Southern, Eastern and Northeastern Health Districts of the municipality. The cases of Grade 2 disability were observed with higher intensity in regions characterized by high population density and poverty.

CONCLUSION: The results of the study have revealed changes in the pattern of areas at risk of leprosy according to the investigated periods. In addition, it was possible to verify disabilities as a condition present in the investigated cases, or that may be related to the late diagnosis of the disease. In the areas of risk identified, patients have reported worse physical disability after diagnostic confirmation, or indicate inadequate clinical examination, reinforcing the need for structuring leprosy control services in a qualified manner.

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