<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1679-4974</journal-id>
<journal-title><![CDATA[Epidemiologia e Serviços de Saúde]]></journal-title>
<abbrev-journal-title><![CDATA[Epidemiol. Serv. Saúde]]></abbrev-journal-title>
<issn>1679-4974</issn>
<publisher>
<publisher-name><![CDATA[Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1679-49742020000400011</article-id>
<article-id pub-id-type="doi">10.5123/s1679-49742020000400004</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Falhas operacionais no controle da hanseníase em redes de convívio domiciliar com sobreposição de casos em áreas endêmicas no Brasil]]></article-title>
<article-title xml:lang="es"><![CDATA[Fallas operacionales en el control de la lepra en redes de convivencia domiciliar con sobreposición de casos en zonas endémicas de Brasil]]></article-title>
<article-title xml:lang="en"><![CDATA[Operational failures of leprosy control in household social networks with overlapping cases in endemic areas in Brazil]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Boigny]]></surname>
<given-names><![CDATA[Reagan Nzundu]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Souza]]></surname>
<given-names><![CDATA[Eliana Amorim de]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferreira]]></surname>
<given-names><![CDATA[Anderson Fuentes]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cruz]]></surname>
<given-names><![CDATA[Jessica Reco]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García]]></surname>
<given-names><![CDATA[Gabriela Soledad Márdero]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Prado]]></surname>
<given-names><![CDATA[Nília Maria Brito de Lima]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[Gilberto Valentim]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Barbosa]]></surname>
<given-names><![CDATA[Jaqueline Caracas]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[Rayane Lima da]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Oliveira]]></surname>
<given-names><![CDATA[Maria Leide Wand Del Rey de]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Nobre]]></surname>
<given-names><![CDATA[Mauricio Lisboa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramos Júnior]]></surname>
<given-names><![CDATA[Alberto Novaes]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidade Federal do Ceará Faculdade de Medicina ]]></institution>
<addr-line><![CDATA[Fortaleza CE]]></addr-line>
<country>Brasil</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidade Federal da Bahia Instituto Multidisciplinar em Saúde ]]></institution>
<addr-line><![CDATA[Vitória da Conquista BA]]></addr-line>
<country>Brasil</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Secretaria Municipal de Saúde de Cacoal  ]]></institution>
<addr-line><![CDATA[Cacoal RO]]></addr-line>
<country>Brasil</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Secretaria Municipal de Saúde de Picos  ]]></institution>
<addr-line><![CDATA[Picos PI]]></addr-line>
<country>Brasil</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Universidade Federal do Rio de Janeiro Hospital Universitário Clementino Fraga Filho ]]></institution>
<addr-line><![CDATA[Rio de Janeiro RJ]]></addr-line>
<country>Brasil</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Hospital Giselda Trigueiro Secretaria de Estado da Saúde Pública ]]></institution>
<addr-line><![CDATA[Natal RN]]></addr-line>
<country>Brasil</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2020</year>
</pub-date>
<volume>29</volume>
<numero>4</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iec.gov.br/scielo.php?script=sci_arttext&amp;pid=S1679-49742020000400011&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iec.gov.br/scielo.php?script=sci_abstract&amp;pid=S1679-49742020000400011&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iec.gov.br/scielo.php?script=sci_pdf&amp;pid=S1679-49742020000400011&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo Objetivo. Analisar a vulnerabilidade institucional/programática de serviços de saúde no desenvolvimento das ações de atenção a pessoas acometidas pela hanseníase e de vigilância de contatos. Métodos. Estudo transversal, conduzido em 2017, sobre dados primários de amostra de casos de hanseníase notificados no período 2001-2014, com sobreposição de casos em redes de convívio domiciliar (RCD), em municípios dos estados da Bahia, Piauí e Rondônia, Brasil. Resultados. Dos 233 casos de hanseníase analisados, 154 (66,1%) pertenciam a RCD com 3 ou mais casos de hanseníase. Em 53,2% dos casos, houve acometimento de duas ou mais gerações, um desfecho significativamente associado a não realização do exame dermato-neurológico (razão de prevalências [RP] 1,32; intervalo de confiança [IC95%1,10;1,59]; p-valor=0,004). Conclusão. Falhas operacionais na vigilância de contatos de hanseníase em áreas de alta endemicidade reforçam o caráter de vulnerabilidade institucional/programática em contextos de RCD com mais de um caso de hanseníase, nos três estados analisados.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Objetivo. Analizar la vulnerabilidad institucional/programática de los servicios de salud para el desarrollo de acciones de atención a personas afectadas por lepra y de vigilancia de sus contactos. Métodos. Estudio transversal realizado en 2017 basado en datos primarios de una muestra de casos de lepra notificados entre 2001-2014 con casos superpuestos en redes de convivencia domiciliar (RCD) en Municipios de los Estados de Bahía, Piauí y Rondônia, Brasil. Resultados. Del total de 233 casos de lepra analizados, 154 (66,1%) pertenecían a RCD con 3 o más casos de lepra. En el 53.2% de los casos hubo 2 o más generaciones afectadas, resultado significativamente asociado con la no realización del dermato-neurológico (razón de prevalencias [RP] 1,32; intervalo de confianza [IC95%1,10;1,59]; valor-p=0.004). Conclusión. Las fallas operativas en la vigilancia de los contactos de lepra en áreas de alta endemicidad refuerzan el carácter de vulnerabilidad institucional/programática en los contextos de redes de convivencia domiciliar (RCD) con más de un caso de lepra en los tres estados analizados.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Objective. To analyze institutional/programmatic vulnerability of health services in the development of health care actions for people affected by leprosy and contact surveillance. Methods. This was a cross-sectional study conducted in 2017 based on primary data from a sample of leprosy cases notified between 2001-2014 with overlapping cases in household social networks (HSN) in municipalities in the states of Bahia, Piauí and Rondônia, Brazil. Results. A total of 233 leprosy cases were analyzed, 154 (66.1%) belonged to HSN with 3 or more leprosy cases. In 53.2% of cases, 2 or more generations were affected, this being an outcome associated with absence of dermato-neurological examination (prevalence ratio 1.32; confidence interval [95%CI 1.10;1.59]; p-value=0.004). Conclusion. Operational failures in the surveillance of leprosy contacts in areas of high endemicity reinforce the character of institutional/programmatic vulnerability in HSN contexts with more than one case of leprosy in the three states analyzed.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Hanseníase]]></kwd>
<kwd lng="pt"><![CDATA[Epidemiologia]]></kwd>
<kwd lng="pt"><![CDATA[Busca de Comunicante]]></kwd>
<kwd lng="pt"><![CDATA[Vigilância]]></kwd>
<kwd lng="pt"><![CDATA[Estudos Transversais]]></kwd>
<kwd lng="es"><![CDATA[Lepra]]></kwd>
<kwd lng="es"><![CDATA[Epidemiología]]></kwd>
<kwd lng="es"><![CDATA[Trazado de Contacto]]></kwd>
<kwd lng="es"><![CDATA[Vigilancia]]></kwd>
<kwd lng="es"><![CDATA[Estudios Transversales]]></kwd>
<kwd lng="en"><![CDATA[Leprosy]]></kwd>
<kwd lng="en"><![CDATA[Epidemiology]]></kwd>
<kwd lng="en"><![CDATA[Contact Tracing]]></kwd>
<kwd lng="en"><![CDATA[Surveillance]]></kwd>
<kwd lng="en"><![CDATA[Cross-Sectional Studies]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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