Residents of the North and Midwest regions of Brazil are 5 to 8 times more likely to get leprosy. For children living in the north of the country, the risk is 34 times higher compared to those living in the southern region. The warning is from a study recently published in The Lancet Global Health, one of the most prestigious journals in the medical field. of the world. The research was also one of the winners of the prize for best scientific work at the 55th edition of the Congress of the Brazilian Society of Tropical Medicine, MedTrop, held between July 28 and 31, in Belo Horizonte, Minas Gerais.
With a database of 100 million Brazilians, the research is the largest ever conducted on the disease to date. The study confirmed that people in typical poverty conditions are more at risk of illness. “Worse housing conditions, income, education, food, regional and racial inequities increase the risk of illness for individuals who are infected with Mycobacterium leprae, the cause of leprosy,” explains Joilda Nery, a professor at the Institute of Collective Health (ISC / UFBA) and one of the main authors of the research.
The odds are doubled when there is no income, education and inadequate housing conditions, such as the absence of a public sanitation network or for those who live in houses built with mud and wood. Also according to the study, people with no income or individual income below $ 250 per month had a 40% higher risk compared to those who earn above a salary.
The analysis also found that black children are 92% more at risk of leprosy than white children. According to the researchers, the crowding of people in the same house and the absence of electricity were also considered risk factors for this age group. According to the survey, the incidence of the disease is also higher among men.
Data from the Ministry of Health indicate about 30,000 leprosy cases per year in Brazil. The country is the second with most cases of the disease in the world, behind only India. For Joilda Nery, research may contribute to the adoption of measures that seek to reverse this scenario. “The study provides managers with evidence to support decision making and promote more equitable public policies,” he says.
The work is led by the Health Knowledge and Data Integration Center (Cidacs / Fiocruz Bahia) in partnership with researchers from the Institute of Collective Health (ISC) of the Federal University of Bahia (UFBA), from the University of Brasília (UnB), Fiocruz Brasilia, London School of Hygiene & Tropical Medicine (LSHTM) and Fluminense Federal University (UFF).
100 million cohort
To produce the study, the researchers used a platform that gathers data from 100 million Brazilians. The bank is fed with information from the Cadastro Único – used to register candidates for any of the Federal Government’s more than 20 social programs – and data from the Sinan Disease Information System (Sinan) – which records leprosy cases in Brazil. From this base, data were collected from 33 million people who used any social benefit between 2007 and 2014. Of this total, nearly 24,000 were individuals diagnosed with leprosy.
“The 100 Million Cohort database provides a unique opportunity for the scientific community to study in detail the diseases that affect the poorest portion of the Brazilian population and which social policies have been most effective for their control,” he says. Cidacs researcher Julia Pescarini, also one of the lead authors of the study.
The group’s research is funded by the Federal District Research Support Foundation, National Council of State Research Support Foundations (Confap), National Council for Scientific and Technological Development (CNPq), Higher Education Personnel Improvement Coordination (Capes). ), Medical Research Council, Wellcome Trust, Economic and Social Research Council and Biotechnology and Biological Sciences Research Council.
In addition to this work, the group of researchers is developing a series of studies, which are being finalized, which seek to evaluate the effect of determinants and the impact of social programs on the incidence, physical disabilities and outcomes of leprosy. Another research, funded by CNPq and coordinated by Professor Joilda Nery, will discuss the barriers to access in the diagnosis and treatment of leprosy. “Our goal is to work on the available data in more detail and make a different analysis of these population groups,” he concludes.