title: Temporal trends of leprosy in a Brazilian state capital in Northeast Brazil: epidemiology and analysis by joinpoints, 2001 to 2012.
abstract: The objective of this study was to characterize epidemiological and temporal trends of leprosy in the city of Fortaleza, Ceará, Brazil, from 2001 to 2012. A total of 9,658 new cases were reported. Their temporal trend was analyzed by the jointpoint regression model. The overall detection rate showed a declining trend, with annual percent change (APC) of -4.0 and 95% confidence interval (95%CI) -5.6 - -2.3. The detection rate in children under 15 years of age (APC = -1.4; 95%CI -5.4 - 2.8) and the detection rate of disability grade 2 (APC = -0.8; 95%CI -4.5 - 3.1) were stable. The proportion of female patients was descending (APC = -1,5; 95%CI -2.3 - -0.8). The proportion of multibacillary cases from 2005 to 2012 (APC = 1.4; 95%CI 0.6 - 2.3) and among them, lepromatous cases from 2004 to 2012 (APC = 6.0; 95%CI 3.4 - 8.6) were increasing. There was stability in the proportion of cases with grade 1 (APC = 1.4; 95%CI -0.9 - 3.7) and grade 2 disability (APC = 3.7; 95%CI -0.1 - 7.8). Despite the trend towards a reduction in detection, the disease transmission persists in the city. The data also suggest late diagnosis.
authors.affiliation: Departamento de Saúde Comunitária, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil.
authors.forename: Aline Lima
authors.initials: AL
authors.lastname: Brito
authors.affiliation: Departamento de Saúde Comunitária, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil.
authors.forename: Lorena Dias
authors.initials: LD
authors.lastname: Monteiro
authors.affiliation: Departamento de Saúde Comunitária, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil.
authors.forename: Alberto Novaes
authors.initials: AN
authors.lastname: Ramos Junior
authors.affiliation: Departamento de Saúde Comunitária, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil.
authors.forename: Jorg
authors.initials: J
authors.lastname: Heukelbach
authors.affiliation: Departamento de Saúde Comunitária, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil.
authors.forename: Carlos Henrique
authors.initials: CH
authors.lastname: Alencar
mesh_terms: D000293:Adolescent; D001938:Brazil / Q000453:epidemiology; D002648:Child; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D007918:Leprosy / Q000453:epidemiology*; D008297:Male; D013997:Time Factors; D014504:Urban Health