Factores socioeconómicos relacionados con la lepra: revisión integrativa de la literatura

BVS-ILACS E MEDLINE	("Social Class" OR "Clase Social" OR "Classe Social" OR "Socioeconomic Factors" OR "Factores Socioeconómicos" OR "Fatores Socioeconômicos" OR "poverty" OR "pobreza" OR "Social Conditions" OR "Condiciones Sociales" OR "Condições Sociais" OR "Social Indicators" OR "Indicadores Sociales" OR "Indicadores Sociais") AND (leprosy OR lepra OR hanseníase) AND (instance: "regional") AND (db: ("MEDLINE" OR "LILACS") AND ( la: "en" OR "pt" OR "es") AND ( year_cluster: "2012" OR "2011" OR "2013" OR "2010" OR "2014" OR "2009" OR "2015" OR "2008" OR "2003" OR "2000") AND ( type: "article" OR "thesis"))
PUBME-MEDLINE	(((("Social Class" [Title/Abstract] OR "Socioeconomic Factors" [Title/Abstract] OR "Poverty" [Title/Abstract] OR "Social Conditions" [Title/Abstract] OR "Social Indicators" [Title/Abstract])) OR (((("Social Class" [Mesh:noexp]) OR "Socioeconomic Factors" [Mesh:noexp]) OR "Poverty" [Mesh:noexp]) OR "Social Conditions" [Mesh:noexp]))) AND (("Leprosy" [Title/Abstract]) OR "Leprosy" [Mesh:noexp])
SCOPUS	("Social Class" OR "Clase Social" OR "Classe Social" OR "Socioeconomic Factors" OR "Factores Socioeconómicos" OR "Fatores Socioeconômicos" OR "poverty" OR "pobreza" OR "Social Conditions" OR "Condiciones Sociales" OR "Condições Sociais" OR "Social Indicators" ) OR TITLEABSKEY ("Indicadores Sociales" OR "Indicadores Sociais" ))) AND ( TITLEABSKEY ("leprosy" OR "lepra" OR "hanseníase")) AND (LIMITTO (LANGUAGE, "English" ) OR LIMITTO (LANGUAGE, "Portuguese") OR LIMITTO (LANGUAGE, "Spanish")) AND (LIMITTO (PUBYEAR, 2016) OR LIMITTO (PUBYEAR, 2015) OR LIMITTO (PUBYEAR, 2014) OR LIMITTO (PUBYEAR, 2013 ) OR LIMITTO (PUBYEAR, 2012) OR LIMITTO (PUBYEAR, 2011) OR LIMITTO (PUBYEAR, 2010) OR LIMITTO (PUBYEAR, 2009) OR LIMITTO (PUBYEAR, 2008) OR LIMITTO (PUBYEAR, 2007) OR LIMITTO (PUBYEAR, 2006) OR LIMITTO (PUBYEAR, 2005) OR LIMITTO (PUBYEAR, 2004) OR LIMITTO (PUBYEAR, 2003) OR LIMITTO (PUBYEAR, 2002) OR LIMITTO (PUBYEAR, 2001) OR LIMITTO (PUBYEAR, 2000)) AND (LIMITTO (DOCTYPE, "ar" ))
SCIELO	("Social Class" OR "Clase Social" OR "Classe Social" OR "Socioeconomic Factors" OR "Factores Socioeconómicos" OR "Fatores Socioeconômicos" OR "poverty" OR "pobreza" OR "Social Conditions" OR "Condiciones Sociales" OR "Condições Sociais" OR "Social Indicators" OR "Indicadores Sociales" OR "Indicadores Sociais") AND ("leprosy" OR "lepra" OR "hanseníase")

References	Country	Year	Type of Study	Sample	Dependent variable	Associated indicators
DIFFEY et al, 2000⁽⁷7 Diffey B, Vaz M, Soares MJ, Jacob AJ, Piers LS. The effect of leprosy-induced deformity on the nutritional status of index cases and their household members in rural South India: a socio-economic perspective. Eur J Clin Nutr [Internet]. 2000 [cited 2017 Jul 27];54(8):643-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/10951513 https://www.ncbi.nlm.nih.gov/pubmed/1095... .	India	1997	Cross-sectional	871 subjects, of these, 155 cases with deformity, 100 cases without deformities and 616 household contacts.	Presence or absence of physical impairment.	Age of the index case (test t p <0.0005), number of wage earners (test t p <0.05), income from inside houses contacts (test t p <0.01), weekly expenses on food (test t p <0.05 ), proportion of deformity in the lowest socioeconomic classes (4 and 5) (x² p <0.01), proportion of male contacts in lower socioeconomic classes (x² p <0.006), educational level among male cases (x² p <0.002), illiteracy among women (x² p <0.001), wage among sex (p <0.01), and unemployment among groups (p <0.0005).
FERREIRA; IGNOTTI.; GAMBA, 2011⁽⁸ 8. Ferreira SM, Ignotti E, Gamba MA. Factors associated to relapse of leprosy in Mato Grosso, Central-Western Brazil. Rev Saude Publica[Internet]. 2011 [cited 2017 Jul 27]; 45(4):756-64. Available from: http://www.scielo.br/pdf/rsp/v45n4/en_2587.pdf http://www.scielo.br/pdf/rsp/v45n4/en_25... .	Brazil.	2005-2007	Case control	53 cases with recurrence from 2005 to 2007. 106 controls with discharge for cure in 2005.	Recurrence cases	They were associated with the recurrence: -those who lived in rented places (OR= 4.1; CI95%: 1.43; 12.04), in a place made of wood/ wattle and daub(OR= 3.2, CI95%: 1.16, 8.76) -they lived with more than five people (OR= 2.1; CI95%: 1.03, 4.36) -with alcohol disorders (OR= 2.8; CI95%: 1.17, 6.79) -with treatment irregularities (OR= 3.8; CI95%: 1.44, 10.02) -without clarification about the disease/treatment (OR= 2.6; CI95%: 1.09, 6.13) -they used public transportation to access the health care unit (OR= 5.5; CI95%: 2.36, 12.63), -clinical form of the disease (OR= 7.1; CI95%: 2.48, 20.52) -therapeutic scheme (OR= 3.7; CI95%: 1.49, 9.11)
FABRI, 2011⁽⁹9 Fabri ACOC. Prevalência de infecção pelo Mycobacterium leprae na população da microrregião de Almenara - [Dissertação] Belo Horizonte (MG): Universidade Federal de Minas Gerais. 2011..	Brazil	2010-2011	Cross-sectional	2,726 people	Seropositivity	-Family income <1 minimum wage (p=0.035, CI95%, 1.06-4.86) -Number of people living in the house 4 - 7 (p=0.04, CI95%, 0.07-0.94) >8 (p=0.075, CI95%, 0.09-1.12) -Number of rooms in the house 1 - 5 (p=0.122, CI95%, 0.85-3.84)
HEGAZY et al., 2002⁽¹⁰10 Hegazy AA, Abdel-Hamid IA, Ahmed el SF, Hammad SM, Hawas SA. Leprosy in a high-prevalence Egyptian village: epidemiology and risk factors. Int J Dermatol [Internet]. 2002 [cited 2017 Jul 27]; 41(10):681-6. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-4362.2002.01602.x https://onlinelibrary.wiley.com/doi/abs/... .	Egypt	1999-2001	Case control	24 Cases of leprosy, 124 contacts inside the house, 30 contacts outside the house	Incidence	Prevalence of leprosy among illiterates (OR= 3.69, CI= 0.83-23.02, p=0.103); regarding elementary education (OR= 1.41, CI= 0.22-11.09, p=1); more than 4 people sharing a room (OR= 1.3, CI= 0.49-3.33, p=0.556), hand pump water supply (OR= 1.39, CI= 0.56-3.54, p=0.444), lower class (OR= 2.43, CI= 0.86-7.44, p=0.067)
NARDI et al., 2012⁽¹¹11 Nardi SMT, Paschoal VD, Chiaravalloti-Neto F, Zanetta DMT. Leprosy-related disabilities after release from multidrug treatment: Prevalence and spatial distribution. Rev Saude Publica [Internet]. 2012 [cited 2017 Jul 27]; 46(6):969-77. Available from: http://www.scielo.br/pdf/rsp/v46n6/en_ao4048.pdf http://www.scielo.br/pdf/rsp/v46n6/en_ao... .	Brazil	1998-2006	Cross-sectional	335 patients treated	Physical impairment	Average of people who are of age (x² p=0.029), education (x² p=0.051)
ARAUJO et al., 2014⁽¹²12 Araujo AERAE, Aquino DMC, Goulart IMB, Pereira SRF, Figueiredo IA, Serra HO, et al. Factors associated with neural alterations and physical disabilities in patients with leprosy in São Luis, State of Maranhão, Brazil. Rev Soc Bras Med Trop [Internet]. 2014 [cited 2017 Jul 27]; 47(4):490-7. Available from http://dx.doi.org/10.1590/0037-8682-0119-2014 http://dx.doi.org/10.1590/0037-8682-0119... .	Brazil	2010-2011	Cross-sectional	155 cases	Neural changes and physical impairment	Education: -No education OR 1 -Low education levels OR 0.75 (p=0.81, 0.07-8.09) -Average education levels OR 1.78 (p=0.30, 0.60-5.27) -High education levels OR 1.23 (p=0.68, 0.43-3.56) Family income (minimum wage) - > 3 OR 1; > 1-2 OR 0.57 (p=0.156, 0.26-1.24); <1 OR 1.20 (p=0.729, 0.42-3.45)
KERR-PONTES et al., 2006⁽¹³13 Kerr-Pontes LR, Barreto ML, Evangelista CM, Rodrigues LC, Heukelbach J, Feldmeier H. Socioeconomic, environmental, and behavioural risk factors for leprosy in North-east Brazil: results of a case-control study. Int J Epidemiol [Internet]. 2006 [cited 2017 Jul 27]; 35(4):994-1000. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16645029 https://www.ncbi.nlm.nih.gov/pubmed/1664... .	Brazil	2002	Case control	200 cases and 800 control	Incidence	High School (OR=1.50, CI= 0.91-2.50), lower education level (OR= 1.87, CI= 1.29-2.74), having experienced food shortages (OR=1.54, CI=1.45-1.63).
MURTO et al., 2014⁽¹⁴14 Murto C, Ariza L, Alencar CH, Chichava OA, Oliveira AR, Kaplan C, et al. Migration among individuals with leprosy: a population-based study in central Brazil. Cad Saude Publica [Internet]. 2014 [cited 2017 Jul 27];30(3):487-501. Available from: http://www.scielo.br/pdf/csp/v30n3/0102-311X-csp-30-3-0487.pdf http://www.scielo.br/pdf/csp/v30n3/0102-... .	Brazil	2009	Cross-sectional	1,074 cases of leprosy	Migration status	Male sex vs. migration after diagnosis (OR= 2.71, CI= 1.26-6.32, p=0.007), age ranging from 30 to 44 vs. migration after birth (OR=3.04, CI= 1.76-5.42, p <0.0001), migration before diagnosis (OR= 2.77, CI= 1.24-7.00, p=0.01), age ranging from 45 to 59 vs. migration before birth (OR= 7.84, CI= 4.23-14.54, p <0.0001), illiteracy vs. migration after birth (OR= 3.86, CI= 2.38-6.53, p <0.0001), retired/pensioner people vs. migration after birth (OR= 4.95, CI= 2.50-10.88, p <0.0001), migration after diagnosis (OR= 0.15, CI= 0.0-0.97, p=0.03), student/housewife/other work status vs. migration after birth (OR= 0.45, CI= 0.32-0.65, p <0.0001), no access to electricity vs. migration after birth (OR= 0.57, CI= 0.33-1.03, p=0.049), vs. migration before diagnosis (OR= 2.05, CI= 1.09-3.72, p=0.02), no access to the service of solid waste collection vs. migration before diagnosis (OR= 1.70, CI= 1.2-2.41, p=0.003), house that is not a brick house vs. migration before diagnosis (OR= 1.57, CI= 1.01-2.32, p=0.022), living alone vs. migration after birth (OR= 4.28, CI= 1.55-16.44, p=0.002), no water supply vs. migration before diagnosis (OR= 1.65, CI= 1.12-2.43, p=0.012).
SANTOS et al., 2013⁽¹⁵15 Santos DS, Duppre NC, Sales AM, Nery JAC, Sarno EN, Hacker MA. Kinship and Leprosy in the Contacts of Leprosy Patients: Cohort at the Souza Araújo Outpatient Clinic, Rio de Janeiro, RJ, 1987-2010. J Trop Med[Internet]. 2013 [cited 2017 Jul 27]; 2013: 596316. Available from: https://www.hindawi.com/journals/jtm/2013/596316/.	Brazil	1987-2010	Prospective cut	7,174 contacts (incidence) 7,012 (prevalence)	Prevalence among contacts	Education (prevalence) > 10 years OR 1; 4 to 10 years OR 1.33 (0.81-2.18); <4 years OR 2.18 (1.42-3.35) Skin color (prevalence): White OR 1; Brown/Black OR 1.32 (1.02-1.70) (incidence): White OR 1; Brown/Black OR 1.66 (1.14-2.42)
SAMUEL et al., 2012⁽¹⁶16 Samuel P, Bushanam JDRS, Ebenezer M, Richard J. Impact of migration on new case detection rates in leprosy in Gudiyatham Taluk, Tamil Nadu, India. Indian J Lepr [Internet]. 2012 [cited 2017 Jul 27]; 84(4):307-16. Available from: https://www.ncbi.nlm.nih.gov/pubmed/23720895 https://www.ncbi.nlm.nih.gov/pubmed/2372... .	India	2004-2008	Cross-sectional survey	222 cases of leprosy were not treated	Migration	Age adult vs. child (x²= 1.635, p=0.200), married vs. single (x²= 1.588, p=0.207), education illiterate people vs. people with some level of education (x²= 0.024, p=0.961)
FEENSTRA et al., 2011⁽¹⁷17 Feenstra SG, Nahar Q, Pahan D, Oskam L, Richardus JH. Recent food shortage is associated with leprosy disease in Bangladesh: a case-control study. PLoS Negl Trop Dis [Internet]. 2011 [cited 2017 Jul 27];5(5):e1029. Available from: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0001029 https://journals.plos.org/plosntds/artic... .	Bangladesh	2009	Case control	99 patients (cases) and 199 controls	Manifestation of leprosy	A recent period of food shortage was identified as the only socioeconomic factor significantly associated with the clinical manifestation of leprosy, not poverty itself (OR 1.79 (1.06-3.02), p=0.030). There is a declining trend in the prevalence of leprosy with a growing socioeconomic status, measured with an active index, but not statistically significant (test for a trend: OR 0.85 (0.71-1.02) p=0.083).
HEUKEL-BACH, et al., 2011 ⁽¹⁸18 Heukelbach J, Chichava OA, Oliveira AR, Häfner K, Walther F, Alencar CHM, et al. Interruption and defaulting of multidrug therapy against leprosy: population-based study in Brazil's Savannah Region. PLoS Negl Trop Dis [Internet]. 2011 [cited 2017 Jul 27];5(5):e1031. Available from: http://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0001031&type=printable http://journals.plos.org/plosntds/articl... .	Brazil	2009	Cross-sectional population study	936 people/patients	Treatment interruption	2.42 (1.02-5.63) - Family income/month less than 465 Brazilian reais
RIBEIRO, 2012⁽¹⁹19 Ribeiro GC. Fatores relacionados à prevalência de incapacidades físicas em Hanseníase na microrregião de Diamantina(MG)[Dissertação]. Belo Horizonte( MG): Universidade Federal de Minas Gerais. 2012..	Brazil	2005-2010	Prospective cut	71 participants	Level of physical impairment in diagnosis	In the bivariate analysis there was a statistical relation between education (p=0.032) Education P=0.031** Fisher's test Family income P=0.860 Number of people in the house P=0.267 Occupation P=0.835 Current occupation P=0.122
SANTOS; CASTRO; FALQUETO, 2008⁽²⁰20 Santos ASD, Castro DSd, Falqueto A. Fatores de risco para transmissão da Hanseníase. Rev Bras Enferm [Internet]. 2008 [cited 2017 Jul 27];61(esp):738-43. Available from: http://www.scielo.br/pdf/reben/v61nspe/a14v61esp.pdf http://www.scielo.br/pdf/reben/v61nspe/a... .	Brazil	2003-2006	Case control	90 cases 270 controls	Incidence of the disease	Education:Elementary school OR:1.092 (0.616-1.937); High school OR: 1.455 (0.684-3.096); Undergraduate school OR: 1.682 (0.289-9.804) Income:Between 1 and 3 OR:0.698 (0.393-1.240); Greater than 3 OR: 1,070 (0,360-3,179)
WAGE-NAAR et al., 2015⁽²¹21 Wagenaar I, van Muiden L, Alam K, Bowers R, Hossain MA, Kispotta K, et al. Diet-related risk factors for leprosy: a case-control study. PLoS Negl Trop Dis [Internet]. 2015 [cited 2017 Jul 27]; 9(5):e0003766. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4428634/ https://www.ncbi.nlm.nih.gov/pmc/article... .	Bangladesh	2013	Case control	52 cases 100 controls	Incidence of the disease	Having higher food expenses per capita(log) (OR: 0.03 - CI 0.00-0.36), being a farmer (OR: 0.24 CI: 0.07, 0.83) and owning a business (OR: 0.31 CI: 0.07-1.34) were protection factors
MONDAL et al., 2015⁽²²22 Mondal A, Kumar P, Das NK, Datta PK. A clinicodemographic study of lepra reaction in patients attending dermatology department of a tertiary care hospital in Eastern India. J Pakistan Assoc Dermatol [Internet]. 2015 [cited 2017 Jul 27];25(4):252-8. Available from: https://www.researchgate.net/publication/296674120_A_clinicodemographic_study_of_lepra_reaction_in_patients_attending_dermatology_department_of_a_tertiary_care_hospital_in_Eastern_India https://www.researchgate.net/publication... .	India	2015	Cut	50 patients with leprosy	Prevalence of reactions	Living in rural areas (x², p=0.9345), socioeconomic condition (x², p=0.6137), education (x², p=0.7842)
SANYAL, et al., 2011⁽²³23 Sanyal D, Gupta D, Mahapatra N, Samanta SK. A process report on physical and psychological determiners of social functioning in leprosy patients. Indian J Lepr [Internet]. 2011 [cited 2017 Jul 27]; 83(4):225-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22783757 https://www.ncbi.nlm.nih.gov/pubmed/2278... .	India	2001-2002	Survey	93 patients with leprosy	Social harm and mental illness	Impairment present vs. living in urban areas vs. rural areas (x²= 5.455, adjusted p=0.02).
COSTA et al., 2012⁽²⁴24 Costa MD, Terra FS, Costa RD, Lyon S, Costa AMDD, Antunes CMF. Assessment of quality of life of patients with leprosy reactional states treated in a dermatology reference center. An Bras Dermatol [Internet]. 2012 [cited 2017 Jul 27];87(1):26-35. Available from: http://www.scielo.br/pdf/abd/v87n1/v87n1a03.pdf http://www.scielo.br/pdf/abd/v87n1/v87n1... .	Brazil	2007 to 2008	Cross-sectional	120 patients	Quality of life of patients with leprosy reactions	People married (p=0.001), education level (p> 0.05), occupation and quality of life regarding physical, psychological and environmental aspects (p <0.05), interference of the disease in occupation (p <0.001), interference in the professional activity and family income (p <0.001), family income and physical aspect (p=0.001), family income and psychological aspect (p=0.026), family income and environmental aspect (p=0.025)
KAR; PAL; BHARATI, 2010⁽²⁵25 Kar S, Pal R, Bharati D. Understanding non-compliance with WHO-multidrug therapy among leprosy patients in Assam, India. J Neurosci Rural Pract [Internet]. 2010 [cited 2017 Jul 27];1(1):9-13. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3137843/ https://www.ncbi.nlm.nih.gov/pmc/article... .	India	2002 to 2005	Retrograde cut	1,020 cases of leprosy	Adherence to pharmacological therapy	Male sex (x²= 5.873, p=0.0154), education level (x²= 32.350, p <0.0001), monthly income per capita (x²= 22.150, p=0.0005), socioeconomic status (x²= 66.735, p <0.0001).
KUMAR et al., 2004⁽²⁶26 Kumar R, Singhasivanon P, Sherchand JB, Mahaisavariya P, Kaewkungwal J, Peerapakorn S, et al. Gender difference in socio-epidemiological factors for leprosy in the most hyper-endemic district of Nepal. Nepal Med Coll J [Internet]. 2004 [cited 2017 Jul 27];6(2):98-105. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16295738 https://www.ncbi.nlm.nih.gov/pubmed/1629... .	Nepal	2001 to 2003	Cross-sectional	580 patients with leprosy	Adherence to treatment	Sex (OR= 2.05, CI= 1.07-3.94), Age (OR= 1.76, CI= 0.81-3.80), Education status (literate vs. illiterate) (OR= 2.37, CI= 1.12-4.99), Caste level (OR= 1.23, CI= 0.40-3.74), Religion (OR= 0.45, CI= 0.14-1.43), Occupation: farmer vs. unemployed (OR= 1.29, CI= 0.49-3.40), employed vs. unemployed (OR= 0.42; CI= 0.14-1.20), business/service vs. unemployed (OR= 1.00, CI= 0.27-3.70), Family type (OR= 0.75, CI= 0.38-1.45), Annual family income (OR= 1.18, CI= 0.29-4.75), Hectares of land belonging to the family (OR= 0.60, CI= 0.29-1.23).
MURTO et al., 2013⁽²⁷27 Murto C, Chammartin F, Schwarz K, Costa LM, Kaplan C, Heukelbach J. Patterns of migration and risks associated with leprosy among migrants in Maranhao, Brazil. PLoS Negl Trop Dis [Internet]. 2013 [cited 2017 Jul 27];7(9):e2422. Available from: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0002422 https://journals.plos.org/plosntds/artic... .	Brazil	2010	Case control	394 cases and 391 controls	Incidence	Monthly income less than 1 minimum wage (OR: 2.12, CI: 0.97-4.71, p= 0.049), little access to public cleaning services (OR: 3.1, CI: 1.1-10.02, p=0.03), illiteracy in family (OR: 2.67, CI: 1.13-6.51, p=0.02).
WITHINGTON et al., 2003⁽²⁸28 Withington SG, Joha S, Baird D, Brink M, Brink J. Assessing socio-economic factors in relation to stigmatization, impairment status, and selection for socio-economic rehabilitation: A 1-year cohort of new leprosy cases in north Bangladesh. Lep rev [Internet]. 2003 [cited 2017 Jul 27];74(2):120-32. Available from: https://www.lepra.org.uk/platforms/lepra/files/lr/June03/06-120.pdf https://www.lepra.org.uk/platforms/lepra... .	India	1996	Cut	2,364 new cases of leprosy	Physical impairment and stigma	Factors associated with physical impairment Female sex (x²= 46.5, p <0.00001), adulthood (x²= 54.1, p <0.00001), dependents (x²= 60.9, p <0.00001), no education (x²= 14.9, p=0.0006), income (x²= 10.4, p=0.006), handwork (x²= 69, p <0.00001), member of credit groups (x²= 1.2, p=0.26), permanent or rented house (x²= 4.2, p=0.23), use of medication (x²= 32.3, p <0.00001), type of water supply (x²= 1.7, p=0.63), use of medication by the female sex (x²= 5.8, p=0.016), impairment and adulthood (p <0.01). Factors associated with Stigma: Male sex (x²= 8, p=0.005), adulthood (x²= 1.4, p=0.23), having dependents (x²= 7.5, p=0.024), no education (x²= 3.7, p=0.16), family income (x²= 1.3, p=0.52), handwork (x²= 5, p=0.08), member of credit groups (x²= 3.2, p=0.07), non-permanent house (x²= 16.5, p=0.001), use of medication (x²= 2.2, p=0.32), water supply (x²= 10.5, p=0.015). Factors associated with selection for socioeconomic assistance: Male sex (x²= 12.3, p=0.0004), adulthood (x²= 19.4, p <0.00001), dependents (x²= 43.2, p <0.00001), no education (x²= 6.65, p=0.04), family income (x²= 1.49, 0=0.47), handwork (x²= 38.8, p <0.00001), member of credit groups (x²= 6.1, p=0.014), non-permanent house (x²= 19.9, p=0.0002), use of medication (x²= 95.8, p <0.00001), water supply (x²= 7.9, p=0.047).

Reference	Country	Year	Type of study	Damage aggregation	Dependent variable	Associated indicators
AMARAL, 2008⁽²⁹29 Amaral EP. Análise espacial da hanseníase na microrregião de Almenara - Minas Gerais: relações entre a situação epidemiológica e as condições socioeconômicas [Dissertação] Belo Horizonte (MG): Universidade Federal de Minas Gerais. 2008..	Brazil	1998 to 2006	Ecological, retrospective	Census Tracts	Average of detection rate	The use of the Kruskal-Wallis test showed that the average of leprosy detection coefficients in the Low Risk category is higher than in the other categories, and that the average of Medium Risk category is higher than that of High-Risk category and Very High (p <0.05). There were no statistically significant differences between the averages of the last two categories.
KERR-PONTES et al., 2004⁽³⁰30 Kerr-Pontes LR, Montenegro AC, Barreto ML, Werneck GL, Feldmeier H. Inequality and leprosy in Northeast Brazil: an ecological study. Int J Epidemiol [Internet]. 2004 [cited 2017 Jul 27]; 33(2):262-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/15082624 https://www.ncbi.nlm.nih.gov/pubmed/1508... .	Brazil	1991 to 1996	Ecological	165 Cities	Incidence	Inequality level - Theil index (β= 1.67, CI= 0.389-2.944, p=0.011), average years of study of the population ≥25 years (β= 1.35, CI= 0.620-2.081, p=0.007), population growth from 1991 to 1996 (β= 0.02, CI= 0.006, 0.038; p=0.028).
QUEIROZ et al., 2010⁽³¹31 Queiroz JW, Dias GH, Nobre ML, Dias MCS, Araújo SF, Barbosa JD, et al. Geographic information systems and applied spatial statistics are efficient tools to study Hansen's disease (leprosy) and to determine areas of greater risk of disease. Am J Trop Med Hyg [Internet]. 2010 [cited 2017 Jul 27];82(2):306-14. Available from: https://www.ncbi.nlm.nih.gov/pubmed/20134009 https://www.ncbi.nlm.nih.gov/pubmed/2013... .	Brazil	1995 to 2006	Ecological	Census Tract	Cases of leprosy	Factor 1 (basic sanitation - existence of piped water, presence of toilets in the house and collection of garbage) β= 0.0978, p=0.0331 Factor 2 (level of literacy and income - average family income, years of education and number of bathrooms in the house) did not associate. Factor 3 (poverty level - lack of access to bank loans, and the number of people living in a house) β= 0.01027, p=0.0240
LANA et al., 2009⁽³²32 Lana FCF, Davi RFL, Lanza FM, Amaral EP. Detecção da hanseníase e índice de desenvolvimento humano dos municípios de Minas Gerais, Brasil. Rev Eletrônica Enferm [Internet]. 2009 [cited 2017 Jul 27];11(3):539-44. Available from: https://www.fen.ufg.br/revista/v11/n3/pdf/v11n3a10.pdf https://www.fen.ufg.br/revista/v11/n3/pd... .	Brazil	2003 to 2006	Cross-sectional	City	Detection rate	Low HDI (p=0.002)
NERY et al., 2014⁽²2 Nery JS, Pereira SM, Rasella D, Penna MLF, Aquino R, Rodrigues LC, et al. Effect of the Brazilian conditional cash transfer and primary health care programs on the new case detection rate of leprosy. PLoS Negl Trop Dis [Internet]. 2014 [cited 2017 Jul 27];8(11):e3357. Available from: http://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0003357&type=printable http://journals.plos.org/plosntds/articl... .	Brazil	2004 to 2011	Ecological	Cities	Detection rate of leprosy	The reduction in the detection rate in cities with consolidated coverage of the Child Benefit Program (Programa Bolsa Família - CBP) was 27% in the period (RR= 0.73, CI95%= 0.69-0.77) in the gross model, and 21% in the adjusted model for selected covariates (RR= 0.79, CI95%= 0.74-0.83). The analysis shows a significant increase in the new case detection rate (NCDR) of leprosy as the Child Benefit program coverage increases. In the adjusted model, compared to the low third of the Family Health Program (FHP) coverage, there was an increase of 5% in the mean third of FHP coverage (72.03-95.08%) (RR= 1.05, CI95%= 1.02-1.09) and for the upper third and 12% increase during the period (RR= 1.12, CI95%= 1.08-1.17). Values adjusted by CBP and FHP: Illiteracy rate> = 20.42% ^RR:1.12, CI95%: 1.07-1.18 Gini coefficient > = 0.54 ^RR: 1.07, CI95%: 1.04-1.11 Unemployment rate> = 7.47% ^RR:1.20, CI95%: 1.16-1.23 Average number of people per house> = 3.6 ^RR: 1.04, CI95%: 1.01-1.08 % of the population under 15> = 31.1%^*, RR: 1.12, CI95%: 1.08-1.15 Percentage of poor people in the city> = 27.42%, RR: 1.13, CI95%: 1.08-1.18
CURY et al., 2012⁽³³33 Cury MR, Paschoal VD, Nardi SM, Chierotti AP, Rodrigues Junior AL, Chiaravalloti-Neto F. Spatial analysis of leprosy incidence and associated socioeconomic factors. Rev Saude Publica [Internet]. 2012 [cited 2017 Jul 27];46(1):110-8. Available from: http://www.scielo.br/pdf/rsp/v46n1/3087.pdf http://www.scielo.br/pdf/rsp/v46n1/3087.... .	Brazil	1998 to 2007	Ecological	Census tracts of São José do Rio Preto City	Spatial distribution of leprosy incidence per 100,000 inhab.	Index composed of socioeconomic conditions: average years of study of the father and mother, average income of the father and mother, percentage of illiterate people, percentage of illiterate women and percentage of houses with 5 or more residents (x²= 180.7; p<0.0001)
IMBIRIBA et al., 2009⁽³⁴34 Imbiriba EN, Silva Neto AL, Souza WV, Pedrosa V, Cunha MG, Garnelo L. Social inequality, urban growth and leprosy in Manaus: a spatial approach. Rev Saude Publica [Internet]. 2009 [cited 2017 Jul 27];43(4):656-65. Available from: http://www.scielo.br/pdf/rsp/v43n4/en_842.pdf http://www.scielo.br/pdf/rsp/v43n4/en_84... .	Brazil	1998 to 2004	Ecological	Census tracts of Manaus City	Detection rate of leprosy	Social deprivation index (ICS) composed of variables: number of people per house, houses without a toilet, without a sewage system, without water supply, illiterate head of household, no education or less than 1 year of study, monthly income of up to 1 minimum wage, head of household with no monthly income, years of education of the head of household and average monthly income. Average life expectancy (OR= 1.665, CI= 1.136–2.441, p=0.009), average to low life expectancy (OR= 3.048, CI= 2.152–4.317, p=0.000), low life expectancy (OR= 4.427, CI= 3.140–6.242, p=0.000).
FREITAS; DUARTE; GARCIA, 2014⁽³⁵35 Freitas LRS, Duarte EC, Garcia LP. Leprosy in Brazil and its association with characteristics of municipalities: ecological study, 2009-2011. Trop Med Int Health [Internet]. 2014 [cited 2017 Jul 27];19(10):1216-25. Available from: http://onlinelibrary.wiley.com/doi/10.1111/tmi.12362/epdf http://onlinelibrary.wiley.com/doi/10.11... .	Brazil	2009 to 2011	Ecological	City	Average smoothed incidence rate	Illiteracy rate: >8 to <13% (IRR: 1.51, CI95%: 1.37, 1.66); >=13% to <24 (IRR: 2.41, CI95%: 2.12, 2.74); 24 (IRR: 2.15, CI95%: 1.83, 2.53) Urbanization rate>=47% to <65% (IRR: 1.27%, CI95%: (1.17, 1.37); >=65% (IRR: 1.53, CI95%: 1.40, 1.67) Gini coefficient: ≥0.50 to <0.55 (IRR: 1.10, CI95%: 1.02, 1.18); ≥0.55 (IRR: 1.26, CI95%: 1.16, 1.37) Average number of people per room ≥0.51 to <0.57 (IRR: 1.14, CI95%: 1.05, 1.24), ≥0.57 to <0.65 (IRR: 1.25, CI95%: 1.14, 1.37) ≥0.65 IRR: 1.41, CI95%: 1.26, 1.58) Family Health Coverage ≥50 to <80% (IRR: 1.19, CI95%: 1.07, 1.32); ≥80% (IRR: 1.29, CI95%: 1.17, 1.41)
SILVA et al., 2010⁽³⁶36 Silva DR, Ignotti E, Souza-Santos R, Hacon Sde S. Hansen's disease, social conditions, and deforestation in the Brazilian Amazon.Rev Panam Salud Publica [Internet]. 2010 [cited 2017 Jul 27];27(4):268-75. Available from: https://www.ncbi.nlm.nih.gov/pubmed/20512229 https://www.ncbi.nlm.nih.gov/pubmed/2051... .	Brazil	2006	Ecological	105 microregions of the Brazilian Amazon forest	Detection rate of leprosy	Proportion of people in houses with rudimentary cesspits (ANOVA Average= 3.979, p=0.000), HDI year 2000 (ANOVA Average= 0.233, p=0.000), proportion of people living in houses with well-water supply (ANOVA Average= 0.056, p=0.880)
CABRAL-MIRANDA; CHIARAVALLOTI NETO; BARROZO, 2014⁽³⁷37 Cabral-Miranda W, Chiaravalloti Neto F, Barrozo LV. Socio-economic and environmental effects influencing the development of leprosy in Bahia, north-eastern Brazil. Trop Med Int Health [Internet]. 2014 [cited 2017 Jul 27];19(12):1504-14. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25244417 https://www.ncbi.nlm.nih.gov/pubmed/2524... .	Brazil	2005 to 2011	Eological study	Cities	Detection rate of leprosy in children under 15	>average number of inhabitants per city (β= 0.43, p=0.04); Gini coefficient (β= 3.84, p<0.001); % of urban population (β= 0.02, p<0.001); % of population born in Bahia State (β= -0.04, p<0.001).

[1] Corresponding Author: Heloisy Alves de Medeiros Leano E-mail: heloisymedeiros@hotmail.com

Brasil

Brasil

Factores socioeconómicos relacionados con la lepra: revisión integrativa de la literatura

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