[Hansen's disease, social conditions, and deforestation in the Brazilian Amazon].
OBJECTIVE
To analyze the association between social and environmental indicators and the Hansen's disease new case detection rate (HNCDR) in the Brazilian Amazon.


METHODS
This ecological study was based on the new cases of Hansen's disease reported to the Brazilian Disease Surveillance System SINAN in 2006. Analyses were performed considering 105 micro-regions formed by adjacent municipalities with economic and social similarities. HNCDRs per 10 000 people were calculated. Independent variables were total area deforested (km(2)) in each micro-region until 2006; proportion of people living in households with rudimentary septic tanks; proportion of people living in households with water supply from wells; and human development index (HDI) in 2000. Local empirical Bayes smoothing was applied to HNCDR. Analyses were carried out to determined correlations and differences between means (analysis of variance) for a significance level of 5%. The Kernel technique was used to investigate the geographic distribution of events of interest for all the study indicators.


RESULTS
A positive correlation was observed between HNCDR and total deforested area (r = 0.50; P < 0.000) and percent of households with rudimentary septic tanks (r = 0.49; P < 0.000). HDI was inversely correlated with HNCDR: the higher the HDI, the lower the HNCDR (r = -0.36; P < 0.000). Considering the entire region, proportion of households with water from wells was not associated with NCDR.


CONCLUSIONS
The Hansen's disease new case detection rate, which reflects the magnitude of disease, is associated with social conditions and land settlement practices in the Brazilian Amazon.
Universidade do Estado de Mato Grosso, Cáceres, MT, Brasil.
Diego Ricardo Xavier
DR
Silva
Eliane
E
Ignotti
Reinaldo
R
Souza-Santos
Sandra de Souza
Sde S
Hacon
D001938:Brazil / Q000453:epidemiology; D003247:Conservation of Natural Resources; D004197:Disease Reservoirs; D005191:Family Characteristics; D006803:Human Development; D006801:Humans; D015994:Incidence; D007918:Leprosy / Q000453:epidemiology*; D050296:Microbial Viability; D008962:Models, Theoretical; D009166:Mycobacterium leprae / Q000502:physiology; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012498:Sanitary Engineering / Q000706:statistics & numerical data; D012924:Social Conditions; D014881:Water Supply / Q000706:statistics & numerical data