[Epidemiological aspects of leprosy: a spatial approach]

The objective of this study was to identify spatial patterns in the occurrence of leprosy in Duque de Caxias, a municipality (county) with high endemicity for the disease in the State of Rio de Janeiro, Brazil. The authors selected all new leprosy cases reported to the Brazilian National Database on Diseases of Notification (SINAN) from 1998 to 2006. The analysis was performed according to three-year periods, followed by spatial analysis according to the local empirical Bayesian method and calculation of global (Moran) and local (LISA) spatial autocorrelation. The analysis showed marked improvement in the epidemiological situation associated with earlier diagnosis. There was a reduction in the proportion of cases with grade II leprosy, from 13.6% to 8.6% (p = 0.04), and increased detection of cases with the indeterminate form, from 10.3% to 18% (p = 0.00). Spatial analysis identified a cluster in the South-Northwest of the municipality, not directly related to the actions or decentralization campaign, proving to be an important tool for identifying critical areas for the endemic and assessing the impact of strategic measures to combat the disease.