The influence of increased access to basic healthcare on the trends in Hansen's disease detection rate in Brazil from 1980 to 2006

Rev Soc Bras Med Trop. 2008:41 Suppl 2:6-10. doi: 10.1590/s0037-86822008000700003.

Abstract

Brazilian Hansen's disease detection rate rose during the 80s and 90s of the 20th century. The Brazilian health system reform happened during the same period. Detection rate is a function of the real incidence of cases and the diagnostic agility of the health system. Coverage of BCG immunization in infants was used as a proxy variable for primary healthcare coverage. A log-normal regression model of detection rate as a function of BCG coverage, time and time square was adjusted to data. The detection rate presents an upward trend throughout the period and with a downturn beginning in 2003. The model showed a statistically significant positive regression coefficient for BCG coverage, suggesting that detection rate behavior reflects the improvement of access to health care. The detection rate began a trend towards decline in 2003, indicating a new phase of Hansen's disease control.

MeSH terms

  • Brazil / epidemiology
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Incidence
  • Leprosy / diagnosis
  • Leprosy / epidemiology*
  • Population Surveillance
  • Primary Health Care / statistics & numerical data*
  • Regression Analysis