02487nas a2200265   4500000000100000008004100001260001000042653001900052653003600071653001700107653001200124653001900136653003500155100001300190700001200203700001200215700001500227700001200242245010100254856005200355300001200407490000700419520178100426022001402207       2023                            d  bLepra10aGeneral Energy10aPublic health services research10aEpidemiology10aleprosy10ageoreferencing10aGeographic Information Systems1 aFranca J1 aAires C1 aNobre M1 aSakamoto S1 aDias GH00aSpatial analysis reveals failures in leprosy control activities in a hyperendemic city in Brazil  uhttps://leprosyreview.org/article/94/4/20-23065  a276-2850 v943 a<p><strong>Introduction:&nbsp;</strong>Leprosy is an infectious disease that affects skin and peripheral nervous tissue and, if not timely diagnosed and treated, can evolve to different degrees of physical disability. Mossoró, in the west of Rio Grande do Norte, has a high historical endemicity for the disease, and current indices suggesting a local transmission chain, requiring the acquisition of accurate information to enable better handling of the problem.</p>

<p><strong>Objective:&nbsp;</strong>To analyze leprosy trends in an endemic Brazilian municipality (Mossoró) and the distribution patterns of cases diagnosed with Grade 2 disability (G2D), considering their relationship with the basic health units in the urban area.</p>

<p><strong>Methods:&nbsp;</strong>This is an ecological study with a descriptive analysis of notified cases of leprosy, focusing on mapping cases that presented G2D at diagnosis. The data were collected from the municipal health department. The statistical software SPSS<sup>®</sup>&nbsp;Statistics v.27 and the spatial analysis tool ArcGIS 9.2 were used.</p>

<p><strong>Results:&nbsp;</strong>Among the cases with peripheral nerve impairment, those of male sex, multibacillary leprosy, and low education predominated. In addition, a higher concentration of cases with G2D was found in five health units, in particular: Sinharinha Borges, Dr. Joaquim Saldanha, Ilha de Santa Luzia, Liberdade II, and Dr. Cid Salém Duarte. Finally, it was noted that 38.5% of the health units had cases of G2D residing up to 431 m from the care setting.</p>

<p><strong>Conclusions:&nbsp;</strong>The indicated units need support measures to intensify surveillance activities and act more effectively in combating the leprosy endemic.</p>
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