Tendências e padrões espaço-temporais da mortalidade relacionada à hanseníase no Estado da Bahia, Nordeste do Brasil, 1999-2014

Abstract

Background: Leprosy is a neglected condition with a high mortality burden, especially in poorer areas. The objective of this study was to analyze temporal trends and spatiotemporal patterns of mortality related to leprosy in the state of Bahia, 1999-2014. Objective: To analyze the spatiotemporal trends and patterns of mortality associated with leprosy in the state of Bahia, Brazil, from 1999 to 2014. Method: Population-based study utilizing secondary mortality data including all deaths, in which leprosy was mentioned, recorded in the state of Bahia from 1999 to 2014. Results: From a total of 1,152,262 deaths, leprosy was identified in 481 (0.04%) cases, resulting in a mean annual gross mortality rate of 0.21 deaths/100,000 inhabitants (95% confidence interval [CI]: 0.13-0.29). Unspecified leprosy (87.73%; 422/481) and leprosy complications (6.44%; 31/484) were the most commonly reported clinical forms. Risk of death associated with leprosy was higher among men (relative risk [RR]: 2.38; 95% CI; 0.19-0.46), elderly (RR: 74.79; 95% CI; 9.57-582.20), and in the eastern region of the state (RR: 4.08; 95% CI; 2.33-7.15). Overall mortality rates showed a significant increase during the observation period (Average Annual Percentage Change [AAPC] 7.3, 95% CI; 4.5-10.3), as well as proportional mortality (AAPC 5.3; 95% CI; 2.2-8.3). Conclusion: Leprosy is a neglected cause of death in the state of Bahia. The disease presents unequal regional spatiotemporal trends, with risks associated mainly in males and older age groups.