Magnitude and temporal trends of leprosy relapse in the state of Ceará, Brazil in the period 2001-2018

Boigny, Reagan Nzundu; Florêncio, Caroline Mary Gurgel Dias; Cavalcante, Kellyn Kessiene de Sousa; Moreno, Jarier de Oliveira; Almeida, Pedro José de; Almondes, Jardel Gonçalves de Sousa; Nogueira, Paula Sacha Frota; Alencar, Carlos Henrique

doi:10.1590/0037-8682-0389-2020

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Revista da Sociedade Brasileira de Medicina Tropical

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Short Communication • Rev. Soc. Bras. Med. Trop. 54 • 2021 • https://doi.org/10.1590/0037-8682-0389-2020 copy

Magnitude and temporal trends of leprosy relapse in the state of Ceará, Brazil in the period 2001-2018

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

INTRODUCTION:

This study analyzed the magnitude and temporal trends of leprosy relapse in Ceará in 2001-2018.

METHODS:

Descriptive cross-sectional and ecological-time trend studies were performed.

RESULTS:

We diagnosed 1,777 leprosy relapse cases. Higher prevalence of relapse was observed in men, illiterates, mixed race, multibacillary leprosy, lepromatous leprosy, and persons with visible disabilities. The proportion of relapse increased throughout the study period.

CONCLUSIONS:

Leprosy relapse is prevalent in certain groups.

Keywords:
Leprosy; Epidemiology; Cross-sectional; Recurrence

Variables	Total	Relapse		PR	95% CI
		n	%
Ano
2001	2663	84	3.1	Ref
2002	2524	87	3.5	1.09	0.81-1.47
2003	2852	106	3.7	1.18	0.89-1.56
2004	2724	101	3.7	1.17	0.88-1.56
2005	2796	93	3.3	1.05	0.79-1.41
2006	2486	89	3.6	1.13	0.85-1.52
2007	2532	74	2.9	0.93	0.68-1.26
2008	2608	81	3.1	0.98	0.73-1.33
2009	2336	78	3.3	1.06	0.78-1.43
2010	2231	89	4.0	1.26	0.94-1.69
2011	2084	97	4.6	1.47	1.11-1.96
2012	2196	88	4.0	1.27	0.94-1.70
2013	2164	111	5.2	1.63	1.23-2.15
2014	2139	112	5.2	1.66	1.26-2.19
2015	1913	100	5.2	1.66	1.25-2.20
2016	1824	122	6.7	2.12	1.62-2.78
2017	1678	128	7.6	2.42	1.85-3.16
2018	1821	137	7.5	2.38	1.83-3.11
Sex
Feminine	19096	620	3.3	Ref
Male	22475	1157	5.2	1.58	1.44 -1.74
Race/color*
White	7151	262	3.7	Ref
Black	2957	165	5.6	1.52	1.26-1.84
Yellow	422	12	2.8	0.77	0.44-1.37
Brown	19462	908	4.7	1.27	1.11-1.46
Indigenous	93	7	7.5	2.05	0.99-4.23
Education level*
Illiterate	6344	292	4.6	1.99	1.30-3.06
Elementary school	17975	742	4.1	1.79	1.17-2.72
High school	4264	162	3.8	1.64	1.06-2.56
Higher education	955	22	2.3	Ref
Age range
under 15	2034	15	0.4	Ref
15 to 19 years	1859	29	1.6	2.11	1.14-3.93
20 to 29 years	4848	161	3.3	4.50	2.66-7.62
30 to 39 years	6329	311	4.9	6.66	3.97-11.16
40 to 49 years	7620	369	4.8	6.59	3.94-11.03
50 to 59 years	7643	409	5.4	7.26	4.34-12.11
60 to 69 years	5985	283	4.7	6.41	3.82-10.75
70 to 79 years	3648	145	4.0	5.39	3.18-9.15
80 years or older	1605	55	3.4	4.65	2.63-8.19
Clinical form***
Indeterminate	5665	129	2.3	1.49	1.17-1.89
Tuberculoid	8812	134	1.5	Ref
Borderline	14545	691	4.8	3.03	2.52-3.64
Lepromatous	7319	535	7.3	4.55	3.77-5.48
Physical disability grade during diagnosis**
Grade 0	25322	774	3.1	Ref
Grade 1	8142	442	5.4	1.74	1.55-1.95
Grade 2	2861	246	8.6	2.67	2.32-3.07
Operational classification
Paucibacillary	15848	229	1.4	Ref
Multibacillary	25653	1543	6.0	4.16	3.63-4.77
Bacilloscopy***
Positive	8157	581	7.1	2.10	1.83-2.40
Negative	9128	299	3.3	Ref

Group	Period	AAPC	APC	95% CI
Total cases	2001 to 2018	4.9		3.1-6.9
	2001 to 2008		−1.5	−5.2-2.3
	2008 to 2018		9.6	7.2-12.1
Male	2001 to 2018	5.3		3.7-7.2
	2001 to 2009		−0.4	−3.3-2.6
	2009 to 2018		10.7	8.5-13.1
Female	2001 to 2018	3.5		0.0-7.2
	2001 to 2007		−3.4	−11.4-5.4
	2007 to 2018		7.4	3.7-11.3
20 to 29 years	2001 to 2018	7.9		2.5-13.5
	2001 to 2010		2.6	−4.6-10.3
	2010 to 2018		14.1	4.6-24.4
30 to 39 years	2001 to 2018	5		0.2-10.0
	2001 to 2012		0.9	−3.7-5.8
	2012 to 2018		12.9	0.3-27.1
40 to 49 years	2001 to 2018	7		1.1-14.6
	2001 to 2010		0.4	−8.9-10.6
	2010 to 2018		15.1	2.5-29.2
50 to 59 years	2001 to 2018	1.2		−6.3-9.2
	2001 to 2003		−36.4	−67.9-25.9
	2003 to 2018		7.6	4.5-10.8
60 to 69 years	2001 to 2018	7.3		−3.8-19.7
	2001 to 2016		4.1	−0.1-8.5
	2016 to 2018		34.2	−49.5-256.2
70 to 79 years	2001 to 2018	2.9		−3.7-10.1
	2001 to 2007		−5.7	−20.2-11.5
	2007 to 2018		8	1.1-15.4
80 years or older	2001 to 2018	1.2		−9.5-13.2
	2001 to 2009		−13.8	−28.8-4.4
	2009 to 2018		16.7	−0.6-37.1

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[1] Corresponding Author: Carlos Henrique Alencar. e-mail:carllosalencar@ufc.br