GEOGRAPHIC ACCESS TO HEALTH AND LEPROSY DISTRIBUTION IN SANTARÉM-PA: ANALYSIS OF THE COVERAGE OF PRIMARY CARE UNITS IN A HYPERENDEMIC AREA OF THE AMAZON

Abstract

The objective of this study was to spatially analyze the distribution of leprosy cases and their relationship with the areas covered by the Basic Health Units (BHU) in Santarém-Pará. An epidemiological, descriptive and retrospective study was carried out based on data from the Brazilian Institute of Geography and Statistics, the Notifiable Diseases Information System (SINAN), and the Municipal Health Department of Santarém. For the elaboration, comparison, and analysis of the spatial distributions of the cases, data from the 2022 census and the QGIS were used. The most prevalent clinical form was dimorphic (49.62%), followed by virchowian (26.31%). Regarding the operational classification, most patients (78.19%) were multibacillary. It was observed that the UBSs in the Jaderlândia, Matinha and Maracanã neighborhoods are located on the borders of their coverage areas, making it difficult for the population to access them. It is concluded that the spatial analysis revealed a heterogeneous distribution of leprosy cases in the city, also highlighting a discrepancy in the distribution of the UBSs in relation to their areas of operation. This imbalance can generate difficulties in accessing health services in some areas of the city, evidencing the need to review the location of the UBSs. The study highlights the challenge represented by the positioning of the UBSs on the borders of their areas of operation. In view of these findings, it is imperative to strengthen leprosy surveillance and control actions, concentrating efforts on early diagnosis, appropriate treatment, and health education, in order to reduce the incidence of the disease and ensure equitable access to health services for the entire affected population.