Social determinants, their relationship with leprosy risk and temporal trends in a tri-border region in Latin America

Ivaneliza Simionato de Assis, Marcos Augusto Moraes Arcoverde, Antônio Carlos Viera Ramos, Luana Seles Alves, Thais Zamboni Berra, Luiz Henrique Arroyo, Ana Angélica Rêgo de Queiroz, Danielle Talita dos Santos, Aylana de Souza Belchior, Josilene Dália Alves, Flávia Meneguetti Pieri, Reinaldo Antônio Silva-Sobrinho, Ione Carvalho Pinto, Clodis Maria Tavares, Mellina Yamamura, Marco Andrey Cipriani Frade, Pedro Fredemir Palha, Francisco Chiaravalloti-Neto and Ricardo Alexandre Arcêncio

PLOS Neglected Tropical Diseases, 2018, vol. 12, issue 4, 1-17

Abstract: Background: Brazil is the only country in Latin America that has adopted a national health system. This causes differences in access to health among Latin American countries and induces noticeable migration to Brazilian regions to seek healthcare. This phenomenon has led to difficulties in the control and elimination of diseases related to poverty, such as leprosy. The aim of this study was to evaluate social determinants and their relationship with the risk of leprosy, as well as to examine the temporal trend of its occurrence in a Brazilian municipality located on the tri-border area between Brazil, Paraguay and Argentina. Methods: This ecological study investigated newly-diagnosed cases of leprosy between 2003 and 2015. Exploratory analysis of the data was performed through descriptive statistics. For spatial analysis, geocoding of the data was performed using spatial scan statistic techniques to obtain the Relative Risk (RR) for each census tract, with their respective 95% confidence intervals calculated. The Bivariate Moran I test, Ordinary Least Squares (OLS) and Geographically Weighted Regression (GWR) models were applied to analyze the spatial relationships of social determinants and leprosy risk. The temporal trend of the annual coefficient of new cases was obtained through the Prais-Winsten regression. A standard error of 5% was considered statistically significant (p

Date: 2018
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pntd00:0006407

DOI: 10.1371/journal.pntd.0006407

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