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Am. J. Trop. Med. Hyg., 82(2), 2010, pp. 306-314
doi:10.4269/ajtmh.2010.08-0675;
Copyright © 2010 by The American Society of Tropical Medicine and Hygiene

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Geographic Information Systems and Applied Spatial Statistics Are Efficient Tools to Study Hansen's Disease (Leprosy) and to Determine Areas of Greater Risk of Disease

José Wilton Queiroz, Gutemberg H. Dias, Maurício Lisboa Nobre, Márcia C. De Sousa Dias, Sérgio F. Araújo, James D. Barbosa, Pedro Bezerra da Trindade-Neto, Jenefer M. Blackwell, AND Selma M. B. Jeronimo*
Health Post-Graduate Program, Department of Internal Medicine, Health Science Center; Department of Biochemistry, Bioscience Center, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil; Hospital Giselda Trigueiro, Secretaria de Saúde do Estado do Rio Grande do Norte, Natal, RN, Brazil; Universidade do Estado do Rio Grande do Norte, Mossoró, RN, Brazil; Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, West Perth, Western Australia, Australia

Applied Spatial Statistics used in conjunction with geographic information systems (GIS) provide an efficient tool for the surveillance of diseases. Here, using these tools we analyzed the spatial distribution of Hansen's disease in an endemic area in Brazil. A sample of 808 selected from a universe of 1,293 cases was geocoded in Mossoró, Rio Grande do Norte, Brazil. Hansen's disease cases were not distributed randomly within the neighborhoods, with higher detection rates found in more populated districts. Cluster analysis identified two areas of high risk, one with a relative risk of 5.9 (P = 0.001) and the other 6.5 (P = 0.001). A significant relationship between the geographic distribution of disease and the social economic variables indicative of poverty was observed. Our study shows that the combination of GIS and spatial analysis can identify clustering of transmissible disease, such as Hansen's disease, pointing to areas where intervention efforts can be targeted to control disease.

Received December 29, 2008. Accepted for publication October 26, 2009.

We thank Maria das Dores B. de Lima, Health Secretariat of the municipality of Mossoró, and Adelmaro Cavalcanti Cunha Jr, Health Secretariat of the State of Rio Grande do Norte, for their help in providing support for the field work. We also thank Mércia Sousa and Larissa M. Medeiros for their assistance during the field studies and Alysson Cook, University of Texas, for her helpful suggestions.

Financial support: Conselho Nacional de Desenvolvimento Tecnológico [CNPq 401200/2005-1].

Authors' addresses: José Wilton Queiroz, Sérgio F. Araújo, James D. Barbosa, and Selma M. B. Jeronimo, Department of Biochemistry, Bioscience Center, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil, E-mails: jwq{at}supercabo.com.bn, srfernandesaraujo{at}gmail.com, jamesdary{at}oi.com.br, and smbj{at}cb.ufrn.br. Gutemberg H. Dias and Márcia C. De Sousa Dias, Universidade do Estado do Rio Grande do Norte, Mossoró, Rio Grande do Norte, E-mails: gutemberg{at}progel.com.br and mceres{at}terra.com.br. Maurício Lisboa Nobre, Hospital Giselda Trigueiro, Secretaria de Saúde do Estado do Rio Grande do Norte, Natal, RN, Brazil, E-mail: nobreml{at}gmail.com. Pedro Bezerra da Trindade-Neto, Department of Internal Medicine, Division of Dermatology, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil, E-mail: ptrindade{at}uol.com.br. Jenefer M. Blackwell, Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, West Perth, Western Australia, Australia, E-mail: jblackwell{at}ichn.uwa.edu.au.

*Address correspondence to Selma M. B. Jeronimo, Department of Biochemistry, Bioscience Center, Universidade Federal do Rio Grande do Norte, PO Box 1624, Natal, RN, 59078-970, Brazil. E-mail: smbj{at}cb.ufrn.br






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Copyright © 2010 by the American Society of Tropical Medicine and Hygiene.