title: Spatial analysis of leprosy incidence and associated socioeconomic factors.
abstract: OBJECTIVE
  To identify clusters of the major occurrences of leprosy and their associated socioeconomic and demographic factors.
  
  
  METHODS
  Cases of leprosy that occurred between 1998 and 2007 in São José do Rio Preto (southeastern Brazil) were geocodified and the incidence rates were calculated by census tract. A socioeconomic classification score was obtained using principal component analysis of socioeconomic variables. Thematic maps to visualize the spatial distribution of the incidence of leprosy with respect to socioeconomic levels and demographic density were constructed using geostatistics.
  
  
  RESULTS
  While the incidence rate for the entire city was 10.4 cases per 100,000 inhabitants annually between 1998 and 2007, the incidence rates of individual census tracts were heterogeneous, with values that ranged from 0 to 26.9 cases per 100,000 inhabitants per year. Areas with a high leprosy incidence were associated with lower socioeconomic levels. There were identified clusters of leprosy cases, however there was no association between disease incidence and demographic density. There was a disparity between the places where the majority of ill people lived and the location of healthcare services.
  
  
  CONCLUSIONS
  The spatial analysis techniques utilized identified the poorer neighborhoods of the city as the areas with the highest risk for the disease. These data show that health departments must prioritize politico-administrative policies to minimize the effects of social inequality and improve the standards of living, hygiene, and education of the population in order to reduce the incidence of leprosy.
authors.affiliation: Secretaria Municipal de Saúde e Higiene, São José do Rio Preto, SP, Brasil.
authors.forename: Maria Rita de Cassia Oliveira
authors.initials: MR
authors.lastname: Cury
authors.forename: Vania Del'Arco
authors.initials: VD
authors.lastname: Paschoal
authors.forename: Susilene Maria Tonelli
authors.initials: SM
authors.lastname: Nardi
authors.forename: Ana Patrícia
authors.initials: AP
authors.lastname: Chierotti
authors.forename: Antonio Luiz
authors.initials: AL
authors.lastname: Rodrigues Júnior
authors.forename: Francisco
authors.initials: F
authors.lastname: Chiaravalloti-Neto
mesh_terms: D001938:Brazil / Q000453:epidemiology; D040362:Geographic Information Systems; D006801:Humans; D015994:Incidence; D007918:Leprosy / Q000453:epidemiology* / Q000517:prevention & control; D015995:Prevalence; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D013029:Space-Time Clustering; D014505:Urban Population