Falhas operacionais no controle da hanseníase em redes de convívio domiciliar com sobreposição de casos em áreas endêmicas no Brasil*
Reagan Nzundu Boigny, Eliana Amorim de Souza, Anderson Fuentes Ferreira, Jessíca Reco Cruz, Gabriela Soledad Márdero García, Nília Maria de Brito Lima Prado, Gilberto V. Silva, Jaqueline Caracas Barbosa, Rayane Lima da Silva, Maria Leide Wand Del Rey de Oliveira, Maurício Lisboa Nobre, Alberto Novaes Ramos
Abstract
OBJECTIVE: To analyze institutional/programmatic vulnerability of health services in the development of health care actions for people affected by leprosy and contact surveillance. METHODS: This was a cross-sectional study conducted in 2017 based on primary data from a sample of leprosy cases notified between 2001-2014 with overlapping cases in household social networks (HSN) in municipalities in the states of Bahia, Piauí and Rondônia, Brazil. RESULTS: A total of 233 leprosy cases were analyzed, 154 (66.1%) belonged to HSN with 3 or more leprosy cases. In 53.2% of cases, 2 or more generations were affected, this being an outcome associated with absence of dermato-neurological examination (prevalence ratio 1.32; confidence interval [95%CI 1.10;1.59]; p-value=0.004). CONCLUSION: Operational failures in the surveillance of leprosy contacts in areas of high endemicity reinforce the character of institutional/programmatic vulnerability in HSN contexts with more than one case of leprosy in the three states analyzed.