title: The influence of increased access to basic healthcare on the trends in Hansen's disease detection rate in Brazil from 1980 to 2006.
abstract: Brazilian Hansen's disease detection rate rose during the 80s and 90s of the 20th century. The Brazilian health system reform happened during the same period. Detection rate is a function of the real incidence of cases and the diagnostic agility of the health system. Coverage of BCG immunization in infants was used as a proxy variable for primary healthcare coverage. A log-normal regression model of detection rate as a function of BCG coverage, time and time square was adjusted to data. The detection rate presents an upward trend throughout the period and with a downturn beginning in 2003. The model showed a statistically significant positive regression coefficient for BCG coverage, suggesting that detection rate behavior reflects the improvement of access to health care. The detection rate began a trend towards decline in 2003, indicating a new phase of Hansen's disease control.
authors.affiliation: Brazilian National Hansen's Disease Control Program, Secretariat of Health Surveillance, Federal Ministry of Health, DF, Brazil. mlfpenna@terra.com.br
authors.forename: Maria Lucia Fernandes
authors.initials: ML
authors.lastname: Penna
authors.forename: Maria Leide W
authors.initials: ML
authors.lastname: Oliveira
authors.forename: Eduardo Hage
authors.initials: EH
authors.lastname: Carmo
authors.forename: Gerson Oliveira
authors.initials: GO
authors.lastname: Penna
authors.forename: José Gomes
authors.initials: JG
authors.lastname: Temporão
mesh_terms: D001938:Brazil / Q000453:epidemiology; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007918:Leprosy / Q000175:diagnosis / Q000453:epidemiology*; D011159:Population Surveillance; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012044:Regression Analysis