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.
BT - Acta leprologica C1 - http://www.ncbi.nlm.nih.gov/pubmed/9259884?dopt=Abstract DA - 1997 IS - 3 J2 - Acta Leprol LA - eng N2 -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.
PY - 1997 SP - 131 EP - 9 T2 - Acta leprologica TI - The importance of operational factors for the interpretation of indicators in the Hansen's disease endemic in Brazil. VL - 10 SN - 0001-5938 ER -