Epidemiological, clinical, and operational aspects of leprosy patients assisted at a referral service in the state of Maranhão, Brazil

Corrêa, Rita da Graça Carvalhal Frazão; Aquino, Dorlene Maria Cardoso de; Caldas, Arlene de Jesus Mendes; Amaral, Dayse Karen Carneiro Rêgo; França, Fábio Silva; Mesquita, Emygdia Rosa Rêgo Barros Pires-Leal

doi:10.1590/s0037-86822012000100017

Cited by 40 publications

(56 citation statements)

References 17 publications

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“…A civil status of married was common in our study population, corroborating the findings of Correa et al 14 . This finding indicates the potential need for family assistance since leprosy, and associated disability, may affect family relationships 15 .…”

Section: Discussionsupporting

confidence: 93%

“…Similar results were found in Teixeira et al 17 . The predominance of multibacillary forms is due, among many factors, to delayed diagnosis, which affects maintenance of the epidemiological chain and can serve as a source of increased transmission 14,17 . The borderline clinical form was the most prevalent form of leprosy in this study, corroborating the results of Alves et al 18 .…”

Section: Discussionmentioning

confidence: 99%

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Assessment of the sensory and physical limitations imposed by leprosy in a Brazilian Amazon Population

Aben-Athar

Lima

Ishak

et al. 2017

Rev. Soc. Bras. Med. Trop.

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Introduction: Leprosy often results in sensory and physical limitations. This study aimed to evaluate these limitations using a quantitative approach in leprosy patients in Belém (Pará, Brazil). Methods: This epidemiological, cross-sectional study measured the sensory impairment of smell and taste through the use of a questionnaire and evaluated activity limitations of daily life imposed by leprosy through the Screening of Activity Limitation and Safety Awareness (SALSA) Scale. Data were collected from 84 patients and associations between the degree of disability and clinical and epidemiological characteristics were assessed. Results: The majority of patients were men (64.3%), married (52.4%), age 31-40 years old (26.2%), had primary education (50%), and were independent laborers (36.9%). The multibacillary operational classification (81%), borderline clinical form (57.1%), and 0 degrees of physical disability (41.7%) were predominant. SALSA scores ranged from 17 to 59 points, and being without limitations was predominant (53.6%). The risk awareness score ranged from 0 to 8, with a score of 0 (no awareness of risk) being the most common (56%). Evaluation of smell and taste sensory sensitivities revealed that 70.2% did not experience these sensory changes. Patients with leprosy reactions were 7 times more likely to develop activity limitations, and those who had physical disabilities were approximately four times more likely to develop a clinical picture of activity limitations. Conclusions: Most patients showed no sensory changes, but patients with leprosy reactions were significantly more likely to develop activity limitations. Finally, further studies should be performed, assessing a higher number of patients to confirm the present results.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Assessment of the sensory and physical limitations imposed by leprosy in a Brazilian Amazon Population

Aben-Athar

Lima

Ishak

et al. 2017

Rev. Soc. Bras. Med. Trop.

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“…The study by Lima et al 21 also found a higher frequency of clinical borderline, followed by tuberculoid, indeterminate and lepromatous forms. Similar results were observed in the study by Corrêa et al 22 , also conducted at the leprosy elimination program of Hospital Universitário Presidente Dutra (MA) between 2008 and 2009, in which 42.3% of patients presented the clinical lepromatous form, which demonstrates that the diagnosis of leprosy was performed later, with a higher likelihood of disease transmission, and the development of neural complications and disability in the patient.…”

Section: Discussionsupporting

confidence: 87%

Neural complications and physical disabilities in leprosy in a capital of northeastern Brazil with high endemicity

Araujo

Aquino

Goulart

et al. 2014

Rev. bras. epidemiol.

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Introduction:Leprosy is an infectious disease whose etiologic agent is Mycobacterium leprae, manifested by dermatological and neurological signs and symptoms. Objective: To investigate neural changes and the degree of physical disability in the eyes, hands and feet before and after treatment, as well as sociodemographic and clinical profile of patients affected by leprosy. Method: A longitudinal epidemiological study comprising 155 patients with leprosy, from a spontaneous demand, diagnosed between March 2010 and February 2011, and treated with multidrug therapy (MDT) between March 2010 and July 2012 in a program for leprosy eradication in São Luis (MA), Brazil. Results: Before treatment, 46.5% of patients were considered as borderline, 51.6% had some alteration in the eyes and 52.3% in the feet, and the radial nerve (18.7%) was the most affected. There was a statistically significant difference between the changes in the radial nerve at the beginning of and after treatment. Conclusions: The analysis points to late diagnosis, as some patients have had abnormal neural and physical disabilities before treatment.

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“…Esse achado corrobora com a literatura, segundo a qual grande parte das doenças transmissíveis predomina nesse sexo (6) . Além disso, encontra-se também que a hanseníase em adultos é mais frequente no sexo masculino, e o risco de exposição é determinante dessa diferença (15) . Com relação à faixa etária, a média nesta atual pesquisa foi de 46,4 anos.…”

Section: Discussionunclassified

“…Em outros estudos, observa-se aumento expressivo e inesperado a partir dos 40 anos de idade (16,17) . Uma das possíveis explicações seria a possibilidade de uma inadequação do diagnóstico de hanseníase nessa faixa etária, uma vez que doenças poderiam levar a avaliações falso-positivas, como a diabetes mellitus ou insuficiências arteriais e venosas, principalmente na ausência de lesões clássicas da hanseníase (15,16) .…”

Section: Discussionunclassified

Avaliação neurofuncional em pacientes com hanseníase

Mesquita¹,

Melo²,

Vasconcelos³

et al. 2014

RBPS

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Evaluación neurofuncional de pacientes con hanseniasis RESUMOObjetivo: Investigar as alterações neurofuncionais apresentadas pelos pacientes com hanseníase, buscando também identificar seu perfil socioeconômico e clínico. Métodos: Estudo transversal com 51 pacientes adultos diagnosticados com hanseníase, independentemente do sexo, realizado em centro de referência, em 2010, no qual se aplicou a ficha de "avaliação neurológica simplificada" e um questionário (dados socioeconômicos e clínicos). Achados apresentados de forma descritiva. Resultados: Encontrou-se média de idade de 46,4 ± 14,9 anos, 32 (62,7%) pacientes do sexo masculino, 32 (62,7%) com ensino fundamental incompleto e 37 (72,5%) com renda familiar de 1 a 3 salários mínimos. O tempo médio em tratamento era de 14,4 ± 15,63 meses. Dominou a hanseníase do tipo multibacilar (n=18/35,3%) e a forma tuberculoide (n=11/21,6%). Articulações interfalangeanas em membros superiores e inferiores comprometidas em 5 (9,8%) e 6 (11,7%) pacientes, respectivamente. Nervos mais acometidos: tibial posterior em 19 (37,3%), ulnar em 17 (33,3%) e fibular comum em 13 (25,5%) pacientes. Músculos com déficits: extensor do hálux (n=8/15,7%), extensor dos artelhos (n=6/11,8%) e abdutor do 5º dedo (n=6;11,8%). Observou-se que 35 (68,6%) pacientes tinham alterações sensitivas em membros inferiores e 14 (27,5%) apresentavam incapacidade funcional grau 1. Conclusão: O estudo evidenciou o perfil socioeconômico dos pacientes com hanseníase como sendo homens, de baixa escolaridade e renda, com classificação operacional multibacilar apresentando a forma clínica tuberculoide. Na avaliação neurofuncional, houve maior ocorrência de alterações sensitivas sobre as motoras, como também discreta presença de deformidades e elevado grau de incapacidade funcional. Descritores

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Epidemiological, clinical, and operational aspects of leprosy patients assisted at a referral service in the state of Maranhão, Brazil

Abstract: The frequency of multibacillary forms found in this study and the cases in family members point out delayed diagnoses. Thus, early diagnosis and appropriate treatment are important in decreasing the outcome of disabilities.

Cited by 40 publications

References 17 publications

Assessment of the sensory and physical limitations imposed by leprosy in a Brazilian Amazon Population

Assessment of the sensory and physical limitations imposed by leprosy in a Brazilian Amazon Population

Neural complications and physical disabilities in leprosy in a capital of northeastern Brazil with high endemicity

Avaliação neurofuncional em pacientes com hanseníase

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