British Leprosy Relief Association
Correlation between the spatial distribution of leprosy and socioeconomic indicators in the city of Vitória, State of ES, Brazil
MacielEthel Leonor Noiaa
aGraduate Program in Public Health, Federal University of Espríto Santo (Universidade Federal do Espríto Santo (UFES)), Vitória, ES, Brazil
bExact Sciences Center of the UFES (Centro de Ciências Exatas da UFES), Vitória, ES, Brazil
Correspondence to: Poliane Barbosa Sampaio, Rua Maria Eleonora Pereira 605/302 Bl15 Ed: Fênix II, 29060180, Jardim da Penha, Vitória ES, Brazil (Tel: +(55) 27-81533565; e-mail: firstname.lastname@example.org)
Leprosy is a disease that is directly linked to poverty. The number of cases in Vitória, the capital city of Espríto Santo, has been decreasing in recent years, but the disease remains highly endemic. This research aimed to identify relationships between the epidemiological status of leprosy and socioeconomic indicators during the period from 2005 to 2009.
An ecological study was performed based on the spatial distribution of leprosy in Vitória, Espírito Santo, between 2005 and 2009. The source data used were records available at the Secretary of State for Health of the Espírito Santo. We used the Urban Quality Index (IQU) as the leprosy-associated socioeconomic variable. The data were analysed with covariate and spatial effects by the WinBugs programme (Version 1.4) and R (Version 2.12).
The spatial distribution of leprosy in the district is not uniform. By studying the geographic distribution of leprosy cases, and the risks estimated by the complete Bayesian model, it was possible to gain further insight into the distribution of leprosy cases. It was noted that neighbourhoods with a low IQU have a higher leprosy case detection rate than neighbourhoods with a higher IQU. This result reinforced the theory that a low IQU is associated with the emergence of leprosy.
The model methodology adopted enabled the verification of the effect of the influence of covariates related to the social determinants of health as well as the spatial structure, in contrast to the gross rate method that does not aggregate this information. The results obtained suggest that leprosy control may be promoted by improving the socioeconomic indicators of neighbourhoods, and highlights the need for implementation of health policies aimed at people who live in areas where they are at greatest risk of getting sick.