Clusters of leprosy transmission and of late diagnosis in a highly endemic area in Brazil: Focus on different spatial analysis approaches

Tropical Medicine and International Health

Volumn 17, Issue 4, 2012, Pages 518-525

  Alencar, Carlos H ^a   Ramos, Alberto N ^a   dos Santos, Emerson S ^b   Richter, Joachim ^c   Heukelbach, Jorg ^a,d  

^a FEDERAL UNIVERSITY OF CEARÁ   (Brazil)

^b UNIVERSITY OF SÃO PAULO   (Brazil)

^c UNIVERSITY HOSPITAL DÜSSELDORF   (Germany)

^d JAMES COOK UNIVERSITY   (Australia)

Author keywords

Brazil; Control; Epidemiology; Leprosy; Public health; Spatial analysis

Indexed keywords

BACTERIAL DISEASE; DISEASE CONTROL; DISEASE TRANSMISSION; EPIDEMIOLOGY; POPULATION STRUCTURE; PUBLIC HEALTH; STATISTICAL ANALYSIS; VULNERABILITY;

ANALYTIC METHOD; ARTICLE; BAYES THEOREM; BRAZIL; DISABILITY; DISEASE TRANSMISSION; ENDEMIC DISEASE; GEOGRAPHIC DISTRIBUTION; HIGH RISK POPULATION; HUMAN; LEPROSY;

BRAZIL; CLUSTER ANALYSIS; COMMUNICABLE DISEASE CONTROL; DELAYED DIAGNOSIS; ENDEMIC DISEASES; FEMALE; HEALTH STATUS; HUMANS; LEPROSY; MALE; MYCOBACTERIUM LEPRAE; POPULATION SURVEILLANCE; RISK ASSESSMENT; RISK FACTORS; RURAL POPULATION;

BRAZIL;

EID: 84859000230     PISSN: 13602276     EISSN: 13653156     Source Type: Journal    
DOI: 10.1111/j.1365-3156.2011.02945.x     Document Type: Article

References (40)

1. Alberts CJ, Smith WCS, Meima A, Wang L & Richardus JH (2011) Potential effect of the World Health Organization's 2011-2015 global leprosy strategy on the prevalence of grade 2 disability: a trend analysis. Bulletin of the World Health Organization 89, 487-495.
2. Alencar CHM, Barbosa JC, Ramos AN Jr et al. (2008) Hanseníase no município de Fortaleza, CE, Brasil: aspectos epidemiológicos e operacionais em menores de 15 anos (1995-2006). Revista Brasileira de Enfermagem 61, 694-700.
3. Alencar CH, Ramos AN Jr, Barbosa JC et al. (2011) Persisting leprosy transmission despite increased control measures in an endemic cluster in Brazil: the unfinished agenda. Leprosy Review. in press.
4. Assunção RM (2003) Estimadores Bayesianos Empíricos Espaciais de Taxas [Online]. Available: [Accessed 2011].
5. Assunção RM, Schmertmann CP, Potter JE & Cavenaghi SM (2005) Empirical Bayes estimation of demographic schedules for small areas. Demography 42, 537-558.
6. Bailey TC, Carvalho MS, Lapa TM, Souza WV & Brewer MJ (2005) Modeling of under-detection of cases in disease surveillance. Annals of Epidemiology 15, 335-343.
7. Bakker MI, Hatta M, Kwenang A et al. (2004) Population survey to determine risk factors for Mycobacterium leprae transmission and infection. International Journal of Epidemiology 33, 1329-1336.
8. Bakker MI, May L, Hatta M et al. (2005) Genetic, household and spatial clustering of leprosy on an island in Indonesia: a population-based study. BMC Medical Genetics 6, 40.
9. Bakker M, Scheelbeek P, Beers SM & Richardus J (2009) The use of GIS in leprosy control. Leprosy Review 80, 327-331.
10. Castro MC & Singer BH (2007) Environment and health: a methodological approach for spatial assessment of malaria transmission in colonization projects in the Brazilian Amazon. Revista Brasileira de Estudos de Populacão 24, 247-262.
11. DATASUS (2011), [Accessed at 1/7/2011].
12. Declercq E (2011) Reflections on the new WHO leprosy indicator: the rate of new cases with grade 2 disabilities per 100000 population per year. Leprosy Review 82, 3-5.
13. Dias MCS, Dias GH & Nobre ML (2007) The use of Geographical Information System (GIS) to improve active leprosy case finding campaigns in the municipality of Mossoro, Rio Grande do Norte State, Brazil. Leprosy Review 78, 261-269.
14. ESRI (2010) ArcGis9.3, Environmental Systems Research Institute, Inc 1982-2011.
15. Feenstra SG, Nahar Q, Pahan D, Oskam L & Richardus JH (2011) Recent food shortage is associated with leprosy disease in bangladesh: a case-control study. PLoS Neglected Tropical Diseases 5, e1029.
16. Fischer E, Pahan D, Chowdhury S & Richardus J (2008) The spatial distribution of leprosy cases during 15years of a leprosy control program in Bangladesh: an observational study. BMC Infectious Diseases 8, 126.
17. Gatrell A & Bailey T (1996) Interactive spatial data analysis in medical geography. Social Science and Medicine 42, 843-855.
18. Gauy JS, Hino P & Santos CB (2007) Spatial distribution of leprosy cases in Ribeirao Preto, Brazil, 2004. Revista Latino-americana de Enfermagem 15, 460-465.
19. Heukelbach J, Chichava AO, Oliveira AR et al. (2011) Interruption and defaulting of multidrug therapy against leprosy: population-based study in Brazil's Savannah region. PLoS Neglected Tropical Diseases 5, e1031.
20. Holveck J, Ehrenberg J, Ault S et al. (2007) Prevention, control, and elimination of neglected diseases in the Americas: pathways to integrated, inter-programmatic, inter-sectoral action for health and development. BMC Public Health 7, 6.
21. Imbiriba ENB, Neto Silva AL, Souza WV et al. (2009) Desigualdade social, crescimento urbano e hanseníase em Manaus: abordagem espacial. Revista de Saude Publica 43, 656-665.
22. Kerr-Pontes LR, Barreto ML, Evangelista CM et al. (2006) Socioeconomic, environmental, and behavioural risk factors for leprosy in North-east Brazil: results of a case-control study. International Journal of Epidemiology 35, 994-1000.
23. Kulldorff M (1997) A spatial scan statistic. Comm Statist - Theory Meth 26, 1481-1496.
24. Kulldorff M (2010a) SaTScan User Guide for version 3.1. disponivel em. Acessado em 12 de setembro de.
25. Kulldorff M (2010b) SaTScan v 9.0.1: Software for the Spatial and Space-Time Scan Statistics. Information Management Services Inc., Silver Spring, MD.
26. Kulldorff M & Nagarwalla N (1995) Spatial disease clusters: detection and inference. Statistics in Medicine 14, 799-810.
27. Lapa T, Ximenes R, Silva NN et al. (2001) Vigilância da hanseníase em Olinda, Brasil, utilizando técnicas de análise espacial. Cadernos de saúde pública 17, 1153-1162.
28. Magalhães MCC & Rojas LI (2007) Spatial differentiation of leprosy in Brazil. Epidemiol Serv Saúde 16, 75-84.
29. Martelli CM, Neto Moraes OL, Andrade AL et al. (1995) Spatial patterns of leprosy in an urban area of central Brazil. Bulletin of the World Health Organization 73, 315-319.
30. Ministry of Health of Brazil (2008) Relatório Executivo do PNCH Ministério da Saúde. Período Maio de 2007 a Junho de 2008, Brasília, Secretaria de Vigilância em Saúde. Programa Nacional de Controle da Hanseníase. Mimeo.
31. Oliveira MLW, Grossi MAF, Oliveira CF et al. (2010) Commitment to reducing disability: the Brazilian experience. Leprosy Review 81, 342-345.
32. Penna ML, Oliveira ML & Penna G (2009a) Spatial distribution of leprosy in the Amazon region of Brazil. Emerging Infectious Diseases 15, 650-652.
33. Penna ML, Oliveira ML & Penna GO (2009b) The epidemiological behaviour of leprosy in Brazil. Leprosy Review 80, 332-344.
34. Rodrigues LC & Lockwood DNJ (2011) Leprosy now: epidemiology, progress, challenges, and research gaps. Lancet Infect Diseases 11, 464-470.
35. Sankoh OA, Ye Y, Sauerborn R, Muller O & Becher H (2001) Clustering of childhood mortality in rural Burkina Faso. International Journal of Epidemiology 30, 485-492.
36. Santos SM & Souza WV (2007) Introdução á Estatística Espacial para a Saúde Pública, Brasília, Ministério da Saúde.
37. Silva DRX, Ignotti E, Souza-Santos R & Hacon SS (2010) Hanseníase, condições sociais e desmatamento na Amazônia brasileira. Revista Panamericana de Salud Publica 27, 268-275.
38. TerraView 3.6.0. (2010). São José dos Campos, SP: INPE: 2010 [Online]. Available: [Accessed 07/12/2010].
39. World Health Organization (2009) Enhanced Global Strategy for Further Reducing the Disease Burden due to Leprosy (Plan Period: 2011-2015). 28.
40. World Health Organization (2010) Global leprosy situation, 2009. Weekly Epidemiological Record, 85, 337-348.