title: The context of leprosy in Brazil-Paraguay border.
abstract: In Brazil, leprosy is endemic in three regions: the North, Northeast, and Mid-West. Counties with contiguous binational urban areas are characterized by a constant flow of people, goods, and services, which facilitates the transmission of diseases and influences the epidemiological profile of leprosy. The purpose of this study was to examine territorial differences in relation to the incidence of leprosy, focusing on border counties with contiguous binational urban areas or otherwise. Each county was taken as an information unit for leprosy cases reported during 2001-2011, based on data from original notification records of the state's Department of Health. In counties with contiguous binational urban areas detection rates showed tendency to increase, Virchowian (lepromatous) disease and disability grade II predominated when compared with Groups II and III: 0.64 and 0.54/100,000 inhabitants for Virchowian disease and 0.14 and 0.27/100,000 inhabitants for disability grade II respectively, and were associated with higher transmission rates. The findings demonstrate the role of border areas in maintaining the endemicity of leprosy.
authors.affiliation: Departamento de Saúde Pública, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil, mabeajalla@gmail.com.
authors.forename: Maria Elizabeth Araujo
authors.initials: ME
authors.lastname: Ajalla
authors.affiliation: Departamento de Saúde Pública, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil, mabeajalla@gmail.com.
authors.forename: Sonia Maria Oliveira de
authors.initials: SM
authors.lastname: Andrade
authors.affiliation: Departamento de Saúde Pública, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil, mabeajalla@gmail.com.
authors.forename: Edson Mamoru
authors.initials: EM
authors.lastname: Tamaki
authors.affiliation: Escola Nacional de Saúde Pública, Fiocruz, Brasil.
authors.forename: William
authors.initials: W
authors.lastname: Waissmann
authors.affiliation: Departamento de Saúde Pública, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil, mabeajalla@gmail.com.
authors.forename: Sandra Helena Correia
authors.initials: SH
authors.lastname: Diettrich
authors.affiliation: Universidade Federal do Piauí, Brasil.
authors.forename: Baldomero Antônio Kato da
authors.initials: BA
authors.lastname: Silva
mesh_terms: D001938:Brazil / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007918:Leprosy / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission; D010239:Paraguay / Q000453:epidemiology