Clinical variables associated with leprosy reactions and persistence of physical impairment

Abstract

Introduction: Leprosy is a chronic disease that affects skin and peripheral nerves. Disease complications include reactional episodes and physical impairment. One World Health Organization (WHO) goal of leprosy programs is to decrease the number of grade 2 impairment diagnoses by 2015. This study aims to evaluate clinical factors associated with the occurrence of leprosy reactions and physical impairment in leprosy patients. Methods: We conducted a retrospective study of data from medical records of patients followed in two important centers for the treatment of leprosy in Aracaju, Sergipe, Brazil, from 2005 to 2011. We used the chi-square test to analyze associations between the following categorical variables: gender, age, operational classifi cation, clinical forms, leprosy reactions, corticosteroid treatment, and physical impairment at the diagnosis and after cure. Clinical variables associated with multibacillary leprosy and/or reactional episodes and the presence of any grade of physical impairment after cure were evaluated using the logistic regression model. Results: We found that men were more affected by multibacillary forms, reactional episodes, and grade 2 physical impairment at diagnosis. Leprosy reactions were detected in a total of 40% of patients and all were treated with corticosteroids. However, physical impairment was observed in 29.8% of the patients analyzed at the end of the treatment and our multivariate analysis associated a low dose and short period of corticosteroid treatment with persistence of physical impairments. Conclusions: Physical impairment should receive an increased attention before and after treatment, and adequate treatment should be emphasized.

IL-10 and NOS2 Modulate Antigen-Specific Reactivity and Nerve Infiltration by T Cells in Experimental Leprosy

“…While ∼15% of reactions are identified at the time of leprosy diagnosis, reactions and neuropathy continue to occur during the first year of treatment (Scollard et al, submitted for publication) and even years after successful multidrug therapy (MDT) [66]–[68]. It has been hypothesized that antimicrobial therapy which kills the bacilli may cause release of increased or different antigens thereby heightening the risk for subsequent immunological complications in some patients.…”

sCD163 levels as a biomarker of disease severity in leprosy and visceral leishmaniasis

“…They were classified according to the Madrid (1953) criteria of clinical forms: Indeterminate Leprosy (IL, n = 9), Tuberculoid Leprosy (TT, n = 14), Borderline Leprosy (BL, n = 14) and Lepromatous Leprosy (LL, n = 10) [23]. The inclusion criteria were a diagnosis of leprosy confirmed by clinical aspects of the lesions and either positive bacilloscopy or histopathological confirmation in skin biopsies.…”

Incapacidades físicas em pessoas que concluíram a poliquimioterapia para hanseníase em Vitória da Conquista, Bahia, Brasil

“…25,30,31 O predomínio de homens com incapacidades físicas, pode advir de aspectos socioculturais relacionados à maior procura por atendimento médico por parte das mulheres, assim como aspectos relativos ao autocuidado. 23,32,33 Apesar de não ter sido verificada significância estatística neste estudo em relação à cronicidade da doença e o número de casos com deficiência ter sido encontrados acima dos de 50 anos, a literatura evidencia que há uma relação entre o avançar da idade e o agravamento das incapacidades físicas. 16,25,34,35,36 As condições crônicas ocasionadas por determinadas doenças, quando associadas às decorrentes do processo de envelhecimento, tendem a se manifestar de forma mais expressiva nos indivíduos, podendo gerar um processo incapacitante, afetando a funcionalidade e a qualidade de vida dessa parcela populacional.…”