Revista Panamericana de Salud Pública
Print version ISSN 1020-4989
SILVA, Diego Ricardo Xavier; IGNOTTI, Eliane; SOUZA-SANTOS, Reinaldo and HACON, Sandra de Souza. Hansen's disease, social conditions, and deforestation in the Brazilian Amazon. Rev Panam Salud Publica [online]. 2010, vol.27, n.4, pp. 268-275. ISSN 1020-4989. http://dx.doi.org/10.1590/S1020-49892010000400005.
OBJECTIVE: To analyze the association between social and environmental indicators and the Hansen's disease new case detection rate (HNCDR) in the Brazilian Amazon. METHODS: This ecological study was based on the new cases of Hansen's disease reported to the Brazilian Disease Surveillance System SINAN in 2006. Analyses were performed considering 105 micro-regions formed by adjacent municipalities with economic and social similarities. HNCDRs per 10 000 people were calculated. Independent variables were total area deforested (km2) in each micro-region until 2006; proportion of people living in households with rudimentary septic tanks; proportion of people living in households with water supply from wells; and human development index (HDI) in 2000. Local empirical Bayes smoothing was applied to HNCDR. Analyses were carried out to determined correlations and differences between means (analysis of variance) for a significance level of 5%. The Kernel technique was used to investigate the geographic distribution of events of interest for all the study indicators. RESULTS: A positive correlation was observed between HNCDR and total deforested area (r = 0.50; P < 0.000) and percent of households with rudimentary septic tanks (r = 0.49; P < 0.000). HDI was inversely correlated with HNCDR: the higher the HDI, the lower the HNCDR (r = -0.36; P < 0.000). Considering the entire region, proportion of households with water from wells was not associated with NCDR. CONCLUSIONS: The Hansen's disease new case detection rate, which reflects the magnitude of disease, is associated with social conditions and land settlement practices in the Brazilian Amazon.
Keywords : Leprosy; social conditions; deforestation; health inequalities; environmental health; Brazil.