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Journal of Tropical Medicine
Volume 2013, Article ID 495076, 10 pages
Research Article

Factors Associated with Migration in Individuals Affected by Leprosy, Maranhão, Brazil: An Exploratory Cross-Sectional Study

1Swiss Tropical and Public Health Institute, University of Basel, 4002 Basel, Switzerland
2Hamovitch Center for Science in the Human Services, School of Social Work, University of Southern California, 1150 S. Olive Street, Los Angeles, CA 90015, USA
3Department of Community Health, School of Medicine, Federal University of Ceará, 60430-140 Fortaleza, CE, Brazil
4School of Medicine, University of Cologne, Cologne, Germany
5Leprosy Control Program, State Health Secretariat of Maranhão, 65076 Sao Luis, MA, Brazil
6Anton Breinl Centre for Public Health and Tropical Medicine, School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, QLD 4811, Australia

Received 9 May 2013; Accepted 9 August 2013

Academic Editor: Aditya Prasad Dash

Copyright © 2013 C. Murto et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


In Brazil, leprosy is endemic and concentrated in high-risk clusters. Internal migration is common in the country and may influence leprosy transmission and hamper control efforts. We performed a cross-sectional study with two separate analyses evaluating factors associated with migration in Brazil’s Northeast: one among individuals newly diagnosed with leprosy and the other among a clinically unapparent population with no symptoms of leprosy for comparison. We included 394 individuals newly diagnosed with leprosy and 391 from the clinically unapparent population. Of those with leprosy, 258 (65.5%) were birth migrants, 105 (26.6%) were past five-year migrants, and 43 (10.9%) were circular migrants. In multivariate logistic regression, three independent factors were found to be significantly associated with migration among those with leprosy: (1) alcohol consumption, (2) separation from family/friends, and (3) difficulty reaching the healthcare facility. Separation from family/friends was also associated with migration in the clinically unapparent population. The health sector may consider adapting services to meet the needs of migrating populations. Future research is needed to explore risks associated with leprosy susceptibility from life stressors, such as separation from family and friends, access to healthcare facilities, and alcohol consumption to establish causal relationships.