Perfil epidemiológico da haseníase na infância no período de 1996 a 2006 na 21 célula regional de saúde do estado do Ceará

Abstract

In Ceará, Hansen’s disease presents a growing tendency in the age group under fifteen years old. The disease is considered a priority in twelve municipalities in Ceará by the Health Ministry because of the great number of cases in children. The aim of this work is to evaluate the situation of Hansen’s children in the 21 ª Ceará State Regional Health Department (CERES) through epidemiologic and operational indicators, considering the period from 1996 to 2006. The 21ª CERES encompasses six municipalities: Juazeiro do Norte, Jardim, Missão Velha, Grangeiro, Barbalha and Caririaçu. Juazeiro do Norte was defined as a priority by the Health Ministry. Materials and Methods: This is a transversal descriptive study that made use of the SINAN notification cards, considering a ten years period. A roadmap was organizes containing information about case numbers, sex, age, clinical and operational classification, impairment evaluation in the notification and cure phases, kinds of discharge, diagnose mode, prevalence, detection and municipality of origin. The results were transformed in percentiles. Results: From 3.135 diagnosed patients, 198 (6.3%) belonged to the age group under 15 years old. In this research prevailed the male sex patients (56%), the group age between 10 and 14 years old (75%), the paucibacillus-infected form of the disease (75%), the undetermined classification (39%), the incapacity evaluation with zero level of notification and cure, although there were cases with level 1 (13%) and II (3%), the discharge by cure (88%), the diagnose mode of spontaneous demand (59%), the detection of the disease between 2,71 and 0,89 (very high to high endemic). The prevalence decreased from 12,89 to 5,07 (very high to high) and the municipality of Juazeiro do Norte had the greater case number (87%). The Grangeiro municipality had no identified cases during the ten years of the research period. Conclusion: The activities of the Hansen program, including the decentralization of the Basic Health Assistance (Family Health Program) that occurred in November 2000 in the studied CERES, are still not effective. The following facts support this affirmative: existence of multibacillus-infected patients of age under than 15 years old, progressive decrease of cases number, children with level II of incapacity, the higher number of diagnoses made from spontaneous demand and a municipality still silent even after training courses in Hansen diagnose being delivered. The decentralization alone does not guarantee change in the pattern of health attention. It is necessary joint measures of the public service and professionals from the educational and health area to the control of this the disease become a reality.