Indicadores epidemiológicos da hanseníase e sua relação com a cobertura da estratégia saúde da família e o índice de desenvolvimento humano em Minas Gerais - período: 1998-2013.

Abstract

Leprosy is a public health problem of great importance, due to its magnitude and high crippling power, affecting mainly the economically active population. It is distributed unevenly in the territory, where socio-economic and environmental factors showed significant predictors of disease. Recent data show that Brazil remains in second place in absolute number of cases. The decentralization process of leprosy control activities for primary health care seeks to achieve improved access, solving and overcoming inequalities that affect health. Therefore, it is important to evaluate the consequences of this process on the results of the actions of health services. The objective of this study was to analyze the relationship between the epidemiological indicators of leprosy, coverage of the Family Health Strategy (ESF) and the Municipal Human Development Index (IDHM) in Minas Gerais from 1998 to 2013. It is an ecological study. The way to measure the living conditions of the population is through IDHM. Data on the disease were removed from the System for Notification Diseases Information System (SINAN) and the ESF coverage of the Primary Care Information System (SIAB). Two analyzes were conducted, one based on the average of each indicator in the periods 1998 to 2005 and another from 2006 to 2013. Initially it was made a descriptive analysis of the epidemiological situation of leprosy, the ESF coverage and IDHM in Minas Gerais. Then it was established a relationship between the rates of general detections, in children under 15 years and with grade 2 disabilities; with ESF coverage and IDHM, using the Poisson test with zero inflation and the Deviance. Analyses were performed in the statistical program SPSS version 19.0 and Stata version 10.0. The results suggest reducing endemic in Minas Gerais, identified by the fall of the disease indicators. The increased ESF coverage contributed to the increase in cases of detection of the disease, reduction of cases in children under 15 years and with grade 2 disabilities. Furthermore, increased IDHM contributed to reducing illness and disability. Despite improved access to health services and the population's living conditions policy, it is observed that is a process that occurs unevenly in the territory, persisting hyper-endemic municipalities in the state, which reinforces the importance of maintaining efforts to disease control.