02636nas a2200397   4500000000100000008004100001260001200042653002300054653002300077653001700100653002500117653001200142653002200154653003400176100001400210700001300224700001200237700001300249700001400262700001500276700001200291700001700303700001500320700001400335700001500349700001300364700001800377700002400395700001300419700001600432245013000448300001100578490000800589520162700597022001402224       2021                            d  c03/202110aEcological studies10aEducational status10aEpidemiology10aEthnicity and health10aleprosy10aPer capita income10aSocial determinants of health1 aRamos ACV1 aAlonso J1 aBerra T1 aAlves LS1 aJúnior J1 aSantos FLD1 aAlves Y1 ade Andrade H1 aCosta FBPD1 aCrispim J1 aYamamura M1 aAlves JD1 aSantos Neto M1 aFuentealba-Torres M1 aPinto IC1 aArcêncio R00aSocial inequalities and their association with the leprosy burden in a Brazilian city of low endemicity: An ecological study.  a1058840 v2183 a<p><b>OBJECTIVE: </b>To analyse the association between social inequalities and the leprosy burden in a low endemicity scenario in the state of São Paulo, Brazil.</p><p><b>METHODS: </b>This ecological study was carried out in the city of Ribeirão Preto, state of São Paulo, Brazil, considering leprosy cases notified from 2006 to 2016. Regarding social inequalities, dimensions related to high household density, literacy, home occupation conditions, health conditions, household income, ethnicity and age were considered. The generalised additive model for location, scale and shape (GAMLSS) was used to verify the association between the social inequalities and leprosy burden.</p><p><b>RESULTS: </b>The increase in men and women with no education and people with an income of 1 to 2 minimum wages was associated with a relative increase in the number of leprosy cases (7.37%, 7.10% and 2.44%, respectively). Regarding the ethnicity variables, the increase in the proportion of men (black) and women (mixed race) with no schooling was associated with a relative increase in the number of cases of the disease (10.77% and 4.02%, respectively). Finally, for people of mixed race or ethnicity, the increase in the proportion of households with 1/2 to 1 minimum wage was related to a relative decrease in the total number of cases (-4.90%).</p><p><b>CONCLUSION: </b>The results show that the determinants associated with the increase in leprosy cases are similar to those in Brazilian hyperendemic regions, and that even in cities with low endemicity, social inequality is one of the main determinants of the disease.</p>  a1873-6254