Recurrence of leprosy cases in the State of Mato Grosso, Central-West Brazil

OBJETIVO: Comparar as novas entradas por recidiva de hansen??ase em unidades b??sicas de sa??de (UBS) e em unidades especializadas (UE) no estado de Mato Grosso. M??TODOS: Estudo transversal com base em todos os registros (N = 323) de recidivas de hansen??ase do Sistema de Informa????o de Agravos de Noti???ca????o (Sinan) de 2004 a 2006, noti???cados no estado de Mato Grosso. Os casos diagnosticados foram comparados quanto ao sexo, idade, aspectos cl??nico laboratoriais e distribui????o geogr?????ca nos munic??pios. Para a compara????o e c??lculo das propor????es das vari??veis utilizou-se o teste qui-quadrado ao n??vel de signi???c??ncia de 5%. RESULTADOS: Das novas entradas de recidiva, 20% foi con???rmado nas UE e 80% em UBS; entretanto, a maioria dos diagn??sticos em UBS tinham baciloscopia negativa (?? 2 =12,34; p = 0,002). O sexo masculino atingiu 71%, com idade m??dia de 43 anos. N??o foi observada diferen??a nos percentuais das entradas entre as unidades de sa??de segundo forma cl??nica, classi??? ca????o operacional e grau de incapacidade f??sica. Do total de munic??pios do estado, 64,7% apresentou recidiva, com percentual entre 6% e 20% de todas as entradas. CONCLUS??ES: As novas entradas de casos de recidiva em Mato Grosso s??o in??? uenciadas pelos diagn??sticos feitos em UBS, sugerindo que h?? de??? ci??ncia na rede de servi??os de sa??de em reconhecer casos de recidivaOBJECTIVE: To compare new registrations of recurrences of leprosy cases in primary healthcare units (PHUs) and in specialized units in the State of Mato Grosso. METHODS: This was a cross-sectional study based on all new registrations (N = 323) of recurrences of leprosy cases within the Noti???able Disease Information System (SINAN) between 2004 and 2006 that were made in the State of Mato Grosso, Central-West Brazil. The cases diagnosed were compared regarding sex, age, clinical-laboratory characteristics and geographical distribution among the municipalities. To compare and calculate the proportions of the variables, the chi-square test at the signi???cance level of 5% was used. RESULTS: Among the new registrations of recurrences, 20% were con??? rmed at specialized units and 80% at PHUs. However, most of the diagnoses at PHUs presented negative bacilloscopy ???ndings (c2 = 12.34; p = 0.002). Seventyone per cent of the cases were among males; the mean age was 43 years. No differences in the percentages of registrations were observed between the healthcare units with regard to clinical form, operational classi???cation or degree of physical incapacity. Out of the total number of municipalities in the state, 64.7% presented recurrences and these accounted for 6 to 20% of all registrations. CONCLUSIONS: The new registrations of cases of recurrence in Mato Grosso were in???uenced by the diagnoses made at PHUs, thus suggesting that there is a de???ciency within the healthcare services in recognizing cases of recurrenc