ABSTRACT
OBJECTIVE: To characterize the temporal trend and spatial behavior of leprosy in Brazil, from 2011 to 2021. METHODS: This is an ecological study, with data from the Notifiable Diseases Information System, obtained in June 2022. The annual detection rate of new leprosy cases per 100 thousand inhabitants was calculated. To estimate the trend of the 2011-2019 and 2011-2021 series, the polynomial regression model was used, testing first-, second-, and third-order polynomials. For spatiality, natural breaks were used and, later, the univariate global and local Moran's indexes. A significance level of 5% was adopted and the analyses were performed using SPSS®, GeoDa®, and QGIS® software. RESULTS: The findings indicated an upward trend in the incidence of leprosy in Brazilian regions and in 20 federative units between 2011 and 2019. However, there was a decrease in most of the country when considering the COVID-19 pandemic years. Spatiality showed that the highest detection rates throughout the period were observed in the North, Midwest, and Northeast regions, with high-risk clusters, and the lowest detection rates in the South and Southeast regions, with low-risk clusters. CONCLUSION: The leprosy detection rate showed an upward trend in Brazil between 2011 and 2019, with greater spatial concentration in the North, Northeast, and Midwest regions. Nevertheless, the study raises an alert for the programmatic sustainability of leprosy control in Brazil, considering the drop in the COVID-19 pandemic, presumably due to the influence of the reorganization of the development of initiatives and provision of services in face of COVID-19.
Subject(s)
COVID-19 , Pandemics , Humans , Brazil/epidemiology , COVID-19/epidemiology , Spatial AnalysisABSTRACT
INTRODUCTION During the gestational period, the woman experiences important emotional changes that need to be considered by family members and also by health professionals, so that a relationship of trust and security can be established.1 Although there is no evidence that the involvement of the partner in perinatal care has a direct relationship in reducing maternal deaths, his involvement is recommended by the World Health Organization, because it has shown benefits for the health of the mother-child binomial.2 In most low- and middle-income countries, as is the case of Brazil, the man has a significant role in family decision making, including in the life of his partner, in relation to behaviors and health care. [...]during the gestational period, men can encourage visits to health care facilities, support good nutrition, reduce the workload, assist in preparation for childbirth, and provide emotional support.2 To do so, they need to feel welcomed by the health professionals responsible for prenatal care. According to the National Policy of Integral Attention to Men's Health, paternity should not be seen only in the perspective of legal obligation, but, above all, as a man's right, i.e., he has the right to participate in the whole process, to decide whether or not to have children, how and when to have them, to monitor pregnancy, childbirth, the postpartum period, and to participate in the child's education. Regarding the companion's presence in the childbirth process, Federal Law #11108 of April 7, 2005, guarantees to pregnant women the right to a companion of their free choice during the entire period of labor, delivery, and immediate postpartum,3 thus guaranteeing the father's right to participate in this symbolic and important moment of his life. Since fathers do not experience the same physiological changes as women, they may have more difficulty in perceiving the fetus as a real baby;however, a closer experience of pregnancy from its beginning helps prepare men for the demands and challenges that arise during the child's different stages of growth and development.4 Therefore, their participation in prenatal care should be encouraged and favored.5 In this context, the role of nurses, as members of the health team, to welcome and encourage the participation of men in the partner's prenatal care, minimizing the barriers experienced by many men in access to health services, stands out. [...]the participation of the partner during prenatal consultations brings benefits to partners, favoring the facing of changes generated by paternity and strengthening the family bond.
ABSTRACT
OBJECTIVE: To characterize the temporal trend and spatial behavior of leprosy in Brazil, from 2011 to 2021. METHODS: This is an ecological study, with data from the Notifiable Diseases Information System, obtained in June 2022. The annual detection rate of new leprosy cases per 100 thousand inhabitants was calculated. To estimate the trend of the 2011-2019 and 2011-2021 series, the polynomial regression model was used, testing first-, second-, and third-order polynomials. For spatiality, natural breaks were used and, later, the univariate global and local Moran's indexes. A significance level of 5% was adopted and the analyses were performed using SPSS®, GeoDa®, and QGIS® software. RESULTS: The findings indicated an upward trend in the incidence of leprosy in Brazilian regions and in 20 federative units between 2011 and 2019. However, there was a decrease in most of the country when considering the COVID-19 pandemic years. Spatiality showed that the highest detection rates throughout the period were observed in the North, Midwest, and Northeast regions, with high-risk clusters, and the lowest detection rates in the South and Southeast regions, with low-risk clusters. CONCLUSION: The leprosy detection rate showed an upward trend in Brazil between 2011 and 2019, with greater spatial concentration in the North, Northeast, and Midwest regions. Nevertheless, the study raises an alert for the programmatic sustainability of leprosy control in Brazil, considering the drop in the COVID-19 pandemic, presumably due to the influence of the reorganization of the development of initiatives and provision of services in face of COVID-19.