Evolução da endemia hansênica no Estado do Ceará : características epidemiológicas e operacionais no período de 1970 a 1996

Abstract

In the last years we can observe, in Ceara, an increase in the detection rates of hanseniase. The dates from 1970 to 1996, show that the rates increased from 0.23/ 10 thousand inhabitant in 1970 to 2,77/ 10 thousand inhabitant in 1996, reaching an increase of 1,104.34%. The rise, is often explained, as an evidence in the expand of the endemic disease, as an increase in the transmission of the disease, and also as operational factors though the rise in the coverage of the health services, mainly in the country side of Ceara. This work has as objective to study, analyse the epidemiologic and operational situation of hanseniase, in the state of Ceara from 1970 to 1996, though their records, in order to evaluate the greatness of this patyology in Ceara, spreaded in the 14 Health Regional Departments of the state and also in Fortaleza. It is studied the tendency of these rates by sex and age as the proportions of the different clinic forms of the disease making a comparison with other studies of Brasilian and foreign authors. As the analysed period includes important signs in the evolution of the therapy and in the evolution of the therapy and in the focus politics used in the control of hanseniase, it is necessary to make a shot history, correlating the epidemiological phenomenon with the operational results. The global tendency in the rates of detection of leper in the studied period is of increase. We also observe a continuing fall of prevalence since 1990, with an expressive fall of 60%, due to a new treatment (MDT-OMS) and cleaness of file, through righ statistics making an impact of the endemic leper. We study the existence of the active record, your reasons and levels of incapacities at the moment of heal, as also the cohorts of multibacillaries and paucibacillaries. The actions plan to extringuish the leper as a health public problem is analysed, taking into consideration the projection to 2000 year. That based in the observed ascention in the study period and in the continuation of politics to the control and extinction of leper, keeping the same rapidity and using the same strategies, we will reach the OMS, goal only in 2008 year. Therefore, if there is no change in the actions of diagnostic and control, making sensible the health workers and above all the priority by the managers, with definite politics, we will need 12 years more to get the goal of 1 inhabitant to 10 thousand inhabitants.