Mapeamento e análise multitemporal de casos notificados de hanseniase na 11ª rede regional de atenção de saúde do estado de São Paulo

Abstract

Leprosy is a chronic, contagious disease caused by a micro bacterium (Mycobacterium leprae). Brazil, still, is one of the countries that have this disease as a public health problem. The definition of health measures for leprosy control depends, among others, on the spatio-temporal analysis of the numbers of cases by geographic area, since each region has characteristics that may or may not favor its dissemination. The state of São Paulo has areas of high socioeconomic vulnerability, such as the region of Pontal do Paranapanema, in the extreme west of the state. In the health context, Pontal is part of the 11th Regional Health Care Network (RRAS-11), formed by 45 municipalities. Many of these places have a conflicting scenario of a dispute over land and a low-income population. The spread of leprosy is associated with high population density and areas of rural settlements, close to rivers and streams covered by tree vegetation, as temperature and humidity help the microbacterium to survive. However, until now, there is no mapping and analysis of the occurrence of this disease over the years in the cities of RRAS-11, consisting of a gap to be filled. This work, therefore, proposes to characterize the epidemiological aspects of leprosy and its spatio-temporal distribution in RRAS-11 from 2007 to 2017. For this purpose, the numbers of cases available per municipality were obtained from the National Diseases and Notifications System, and the data population in the 2010 demographic census. Thus, the disease incidence rate was calculated, and geoprocessing tools were applied, in a geographic information system environment, which allowed the production of spatial-temporal diagnosis maps of the disease. Heterogeneous distribution of leprosy cases was found in the cities of RRAS-11. Some locations have a high incidence rate, while others are effective in understanding epidemiology and in ordering actions that block the spread of the disease. Spatialization of the incidence rate by a multitemporal approach, as well as its epidemiological description, helps in planning public health actions. It is concluded that the results of this research support the targeting of intervention measures aimed at eradicating or minimizing leprosy.