In several clusters, situations were identified where cases were neighbors with their homes contiguously linked (either back to back or side to side) often with entrances in different streets and without the residents ever having had any type of relationship or even knowledge U0126 1173097-76-1 of each other’s existence and definitely without knowledge of the disease or the form of contagion [22].One of the causes of the strong tendency of infection of this disease may be related to the precarious quality of life demonstrated by the overpopulation of poorer neighborhoods, exacerbated occupation not only of the urban infrastructure but also, in particular, of the occupation of areas not officially allocated for urbanization.
When urban indexes exceed those predicted by calculations of civil engineering, architecture, and urbanism, there is a lack of all social amenities in the area, including public health, social assistance, schools, play schools, and community facilities. In many situations, people are obliged to move to other neighborhoods for the basic infrastructure. Thus, they are exposed to all kinds of human clustering.All related aspects, especially the overpopulation of regions, whether planned urban neighborhoods or unofficial housing areas, constitute elements that can be regarded as ingredients of a series of conditions that increase the likelihood of the spread of leprosy. And thus, the unsanitary conditions and subhuman modus vivendi may be one factor that contributes to the emergence of this disease [22].
The identification of the formation of urban clusters of leprosy determined by territorial space and characterized by clinical form together with the time at onset of the disease seems to be innovative in research. The same innovation occurred in other studies that used geotechnology as an important tool to demonstrate findings. Sakamuri et al. [23] demonstrated the geographic distribution and genetic frequency of Mycobacterium leprae using polymerase chain reaction (PCR). Moreover, Duarte-Cunha et al. [24] analyzed the spatial pattern of the occurrence of leprosy in relation to the decentralization of treatment centers and campaign strategies, and Cury et al. [19] evaluated the relationship between the presence of leprosy cases and low socioeconomic conditions rather than population density.
The discussion of the fragility of health information in some Brazilian states is related to two fundamental points. Initially, it is expected that inequalities in the reporting of vital and healthcare events are an indicator of the organization of epidemiological surveillance systems and are not subordinate to the computer tools used. Brefeldin_A In fact, at a local level, it is possible to have an adequate surveillance system even without the digitalization of data.