Neglected diseases in Portuguese-speaking countries, an analysis of Leprosy according to the Global Burden of Disease study, 1990 to 2019
Abstract
Introduction: Leprosy persists as a public health problem in most countries of the Portuguese Speaking Community.Objective: To analyze time series of incidence, prevalence and years of life ordered according to disability (YLD) associated with leprosy in the population of CPLP countries, in addition to comparing the performance of countries according to sociodemographic indices, using data from the Global Burden of Disease (GBD) study) between 1990 and 2019.
Methods: Study of time series using GBD data referring to Leprosy in the period from 1990 to 2019.
We analyzed: prevalence, incidence and YLD, comparing the rates and percentage of change between 1990 and 2019, between Portuguese speaking countries. Trends between 1990 and 2019 are also presented. The correlation between YLD and the Demographic and Social Index (SDI) was tested, which range from 0 to 1, with 0 being the worst score and 1 being the best. Correlation was calculated using simple linear regression.
Results: The incidence rate was highest in Mozambique (13.1/100,000 inhab), followed by East Timor, Equatorial Guinea, Angola and Brazil, with a decline in the incidence rate in all countries, with the smallest decline occurring in Brazil ( -26.9%). Prevalence rates also declined over the period. Portugal had no new cases, nor prevalent cases. As for years lost due to disability, all countries had high rates in 1990, with emphasis on Equatorial Guinea (7.5/100,000 inhab), which had the greatest decline (-97.1%), followed by Mozambique (6.2/ 100,000 inhabitants). All countries showed a decline in the period from 1990 to 2019, Brazil had the lowest (-7.8%). The correlation between SDI and YLD was negative (R= - 0.68 p< 0.0001), that is, as the SDI increased, the disability rates decreased.
Conclusion: Leprosy is a major public health challenge in most CPLP countries and is strongly associated with poverty and social inequality. Although there have been advances, with a reduction in prevalence, incidence and disabilities, leprosy requires priority and appropriate interventions. GBD data can support situation diagnosis and comparison between countries.
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