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Background Dengue is an acute viral disease of major relevance and impact on public health, causing major epidemics around the world, especially in tropical regions. Here we aimed to analyse the temporal trend and spatial risk, as well as social vulnerability factors, associated with the occurrence of dengue in the state of Bahia, Brazil between 2009 and 2018. Methods This is an ecological study carried out with all suspected cases of dengue in Bahia between 2009 and 2018. The data were obtained from the National Notifiable Diseases Information System, available on the website of the Health Department of the State of Bahia, and from the Brazilian Institute of Geography and Statistics. We used the Joinpoint regression model, local empirical Bayesian model for smoothing, global and local Moran statistics and spatial scanning statistics. The relationship between the dengue incidence rate and social determinants was tested using Moran's bivariate correlation. Results During the study period, 451 847 probable dengue cases were registered in Bahia. A declining trend was observed in 39.28% (n=11) of the state's health regions and 60.71% (n=17) showed a stationary tendency. The spatiotemporal scanning statistic showed nine clusters of dengue occurrence. The largest cluster had a radius of 342.14 km, consisting of 160 municipalities, 120 094 cases (710.20 cases/100 000 inhabitants) and a relative risk of 2.80. In the multivariate regression model, 11 variables showed a significant association: Social Vulnerability Index (SVI), Municipal Human Development Index (MHDI), SVI urban infrastructure, SVI human capital, MHDI longevity, MHDI education, proportion of people living in households with per capita income less than half the minimum wage (in 2010) and who spend more than 1 h commuting, proportion of mothers who are heads of household who did not complete elementary school and with children <15 y of age, activity rate of persons ages 10–14 y and per capita income. Conclusions In the analysis of the spatial distribution, areas of risk of disease transmission throughout the state were identified. These results can provide subsidies for the strategic planning of actions, as well as for the implementation of programs and/or public policies in order to control the incidence of dengue in the population. [ABSTRACT FROM AUTHOR]

This study analyzed the impact of the COVID‐19 pandemic on the detection of new cases of leprosy in the state of Bahia, Brazil. The periods January–September 2019 and January–September 2020 were compared. There was a 44.40% reduction in the diagnosis of leprosy when comparing the two periods (1,705 in 2019 and 948 in 2020). There was a reduction in the number of municipalities with reported cases: 251 municipalities in 2019 and 202 in 2020, expressing a reduction of 24.25%. Considering only the months following the arrival of the virus (April–September), the reduction was 51.10%. An inverse correlation was observed between the number of new cases of leprosy and the cumulative number of cases of COVID‐19 (Spearman's correlation coefficient = −0.840; P < 0.001) and the number of new monthly cases of COVID‐19 (Spearman's correlation coefficient = −0.817; P < 0.001). A slight increase was also observed in the proportion of multibacillary cases in the state (70.38% in 2019 and 72.69% in 2020) as well as in the proportion of individuals with the degree of physical disability not assessed at diagnosis, whose proportion rose from 16.39% in 2019 to 22.53% in 2020. The negative impact of COVID‐19 in tackling leprosy should be seen as a warning sign for health and political authorities. [ABSTRACT FROM AUTHOR]

Objective: To describe the epidemiological and neurofunctional profile, as well as the prevalence of factors associated with the occurrence of physical disabilities due to leprosy in a reference center in Northeast Brasil., Methods: A cross-sectional study including 50 leprosy patients diagnosed in Juazeiro-Bahia. Variables analyzed: sex, age, history of leprosy in the family, time to diagnosis, clinical form, operational classification, degree of disability, eyes-hand-foot score, peripheral nerve function, muscle strength and sensitivity. Descriptive statistics and inferential statistics (χ² test or Fisher's exact, Poisson regression with robust estimation and prevalence reason were used. Significance of 5%)., Results: An equal distribution was found between men and women of economically active age and low education; multibacillary forms in men (64%) and paucibacillary forms in women (60%). 78% of individuals had some degree of disability and 64% had a compromised ulnar nerve. Plantar sensitivity was decreased in 66% of patients. The predictors of disability were: age ≥45 years (PR 1.44; p=0.005), no education (PR 1.21; p=0.013) and OMP score ≥6 (PR 1.29; p<0.001)., Conclusion: The findings show the importance of monitoring neural functions and developing measures that allow early diagnosis, the opportune method and the prevention of disabilities, especially in the male population.

This ecological study aims to analyze both the tendency and the characteristics of leprosy in the elderly population in the state of Bahia, 2001-2017. The tendency was analyzed through joinpoint regression. Epidemiological variables were also included in the study. The average detection rate was 38.73/100,000, with prevalence of men (45.19/100,000). A downward trend occurred in both genders, from 2004, with a greater magnitude in women (annual percent change [APC]=-3.4%). Men presented higher proportions of the multibacillary forms and physical disabilities. The epidemiological scenario indicates the need of implementation of actions that stimulate early diagnosis and treatment of the elderly population., (Copyright © 2019 Sociedade Brasileira de Dermatologia. Published by Elsevier España, S.L.U. All rights reserved.)