title: Leprosy and pregnancy in the State of Pará: an epidemiological perspective.
abstract: BACKGROUND
  A few older publications describe leprosy associated with pregnancy, a situation that has been linked to leprosy exacerbation. This study aimed to describe the detection rate of this association in the State of Pará by county and Integration Region (IR) from 2007 to 2009 via an analysis of socio demographic, epidemiological and operational indices.
  
  
  METHODS
  This was a descriptive study using information generated by the SINAN. The Detection Coefficient of the Leprosy and Pregnancy Association (DCLP) epidemiological index was constructed to help interpret the endemicity parameters. The disease was considered hyperendemic when greater than two cases per 10,000 inhabitants were identified.
  
  
  RESULTS
  During the study period,149 associations were detected, with 14 hyperendemic counties: seven in 2007, fi ve in 2008 and two in 2009. The Carajás Integrated Region displayed the highest DCLP index in the period. Eldorado dos Carajás had the single highest DCLP index(5.7/10,000 inhabitants, 2008), whereas the DCLP index in Conceição do Araguaia was very high in all three years. However,most counties displayed low or medium DCLP indices. The annual averages were 0.31 DCLP (2007), bass; 0.30 (2008), bass and 0.19 (2009), bass. The average DCLP index was 0.26, which is considered low. Three clusters of medium endemicity were identified by the average DCLP in the study period.
  
  
  CONCLUSIONS
  The analyses indicated that the surveillance program is still unsatisfactory in Pará. The interpretation of the endemicity parameters enabled qualitative and quantitative analyses to determine the epidemiological panorama of this association. The identification of high endemicity requires further clarification.
authors.affiliation: Departamento de Clínica Médica, Hospital das Clínicas, Faculdade de Medicina de Ribeiro Preto, Universidade de São Paulo, Ribeirão Preto, SP.
authors.forename: Vera Regina da Cunha Menezes
authors.initials: VR
authors.lastname: Palácios
authors.forename: Cléa Nazaré Carneiro
authors.initials: CN
authors.lastname: Bichara
authors.forename: Jarbas Barbosa da
authors.initials: JB
authors.lastname: Silva Junior
authors.forename: Rodrigo da Silva
authors.initials: Rda S
authors.lastname: Dias
authors.forename: Nelson Veiga
authors.initials: NV
authors.lastname: Gonçalves
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002648:Child; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D007918:Leprosy / Q000453:epidemiology*; D008137:Longitudinal Studies; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D055815:Young Adult