Neuropatia por hanseníase: atraso no diagnóstico ou um diagnóstico difícil?

Carneiro, Marcelo; Possuelo, Lia Gonçalves; Valim, Andréia Rosane Moura

doi:10.1590/s0102-311x2011001000020

Cited by 4 publications

(4 citation statements)

References 3 publications

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“…The predominance of multibacillary (MB) cases with neural disabilities indicates late diagnosis, reinforcing the ineffective epidemiological control in many countries [ 2 ]. In addition, new cases not only with high functional impairment, but also in children, reflect failure of early leprosy detection and indicate ongoing transmission [ 3 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Molecular, immunological and neurophysiological evaluations for early diagnosis of neural impairment in seropositive leprosy household contacts

et al. 2018

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BackgroundHousehold contacts constitute the highest risk group for leprosy development, and despite significant progress in the disease control, early diagnosis remains the primary goals for leprosy management programs.MethodsWe have recruited 175 seropositive and 35 seronegative household contacts from 2014 to 2016, who were subjected to an extensive protocol that included clinical, molecular (peripheral blood qPCR, slit-skin smear qPCR, skin biopsy qPCR) and electroneuromyographic evaluations.Results/Principal findingsThe positivity of peripheral blood qPCR of seropositive contacts was 40.6% (71/175) whereas only 8.6% (3/35) were qPCR positive in seronegative contacts (p = 0.0003). For the slit-skin smear, only 4% (7/175) of seropositive contacts presented positive bacilloscopy, whereas the qPCR detected 47.4% (83/175) positivity in this group compared with only 17.1% (6/35) in seronegative contacts (p = 0.0009). In the ENMG evaluation of contacts, 31.4% (55/175) of seropositives presented some neural impairment, and 13.3% (4/35) in seronegatives (p = 0.0163). The presence of neural thickening conferred a 2.94-fold higher chance of ENMG abnormality (p = 0.0031). Seropositive contacts presented a 4.04-fold higher chance of neural impairment (p = 0.0206). The peripheral blood qPCR positivity presented odds 2.08-fold higher towards neural impairment (OR, 2.08; p = 0.028). Contrarily, the presence of at least one BCG vaccine scar demonstrated 2.44-fold greater protection against neural impairment (OR = 0.41; p = 0.044).Conclusions/SignificanceELISA anti-PGL-I is the most important test in determining the increased chance of neural impairment in asymptomatic leprosy household contacts. The combination of the two assays (ELISA anti-PGL-I and peripheral blood qPCR) and the presence of BCG scar may identify individuals with higher chances of developing leprosy neuropathy, corroborating with the early diagnosis and treatment.

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Section: Introductionmentioning

confidence: 99%

Molecular, immunological and neurophysiological evaluations for early diagnosis of neural impairment in seropositive leprosy household contacts

et al. 2018

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“…O presente estudo encontrou que, no estado do Rio Grande do Sul, há evidências de subdiagnóstico e atraso no diagnóstico de hanseníase, assim como evidenciado em outros estudos similares. 4,14,15 Indicativo disso é o predomínio das formas multibacilares e com GIF em uma unidade federativa com baixa prevalência, em comparação com os níveis nacionais. 14,16 Tais indicadores possibilitam o entendimento de que a educação médica sobre o conhecimento da hanseníase, uma doença em que a avaliação clínica é determinante, é fundamental para o controle epidemiológico na região abordada, permitindo ponderar que na pandemia de Sars-CoV-2 o ensino foi negativamente afetado, com repercussões na formação médica e reflexos sobre as habilidades necessárias para manejo adequado frente a um quadro de suspeita.…”

Section: Discussionunclassified

As consequências da pandemia de Sars-CoV-2 sobre a educação médica no combate à hanseníase

Ziembowicz

Souza

Peruzzo

et al. 2022

Rev Epidemiol Control Infect

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Justificativa e objetivos: A hanseníase é uma doença infectocontagiosa na qual o diagnóstico precoce é fator decisivo para prevenir incapacidade e deficiências. O presente estudo buscou analisar o panorama da hanseníase entre os anos de 2016 e 2021 no estado do Rio Grande do Sul, desvelando a importância da educação médica no contexto das Doenças Tropicais Negligenciadas durante a pandemia da Sars-CoV-2. Métodos: Estudo transversal por meio da base de dados do Centro Estadual de Vigilância em Saúde do Rio Grande do Sul. Na coleta de dados, foram incluídos os dados de hanseníase em indivíduos residentes do estado do Rio Grande do Sul (RS), no período de 2016 a 2021. As variáveis analisadas foram os casos confirmados de hanseníase, os casos notificados, o número de casos quanto às classificações operacionais de hanseníase, o esquema terapêutico e o número de casos de acordo com os graus de incapacidade física. Resultados: No período analisado, foram confirmados 725 casos de hanseníase, sendo 70% nos anos de 2016, 2017 e 2018. Do número total de casos, 88% eram a forma multibacilar da doença, 50% apresentaram algum grau de incapacidade física no momento do diagnóstico e 80% realizaram o esquema terapêutico padrão. Conclusão: Existe atraso no diagnóstico de hanseníase e há subdiagnóstico da doença no estado do Rio Grande do Sul, o que evidencia a necessidade de reafirmação das práticas educacionais sobre a micobacteriose.

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“…This leads to the evolution of the disease to the most severe form and to the presence of physical disability. In addition, the occurrence of silent neuritis, which is not common in the age group studied, but which causes the appearance of physical disability, must also be considered 31 , 32 . The lack of perception of family members and health professionals regarding the early diagnosis of leprosy can also contribute to the significant result found in the studied sample.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological characteristics and trends of leprosy in children and adolescents under 15 years old in a low-endemic State in Southern Brazil

Moraes

Eidt

Koehler

et al. 2021

Rev. Inst. Med. trop. S. Paulo

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Leprosy is an infectious and contagious disease affecting skin and nerves. The number of cases in individuals under 15 years old is one of the parameters used in Brazil as an indicator of endemic permanence of the disease and its continuous transmission. Rio Grande do Sul State, in Southern Brazil, is low-endemic to leprosy. However, the disease remains a public health problem. This is a retrospective, observational and analytical study of a historical series of new cases of leprosy in children under 15 years old diagnosed in the period from 2000 to 2019, in all health units in Rio Grande do Sul State. Seventy-seven new cases were notified. The male gender was predominant in 53.2% of the cases (n=41). The average age was 10.4 years (standard deviation of 2.9), with predominance of the age group between 10 and 15 incomplete years old. The most frequent operational classification was multibacillary, in 62.3% of cases (n=48), and the most common clinical form was borderline, in 38.9% of cases (n=28). The predominant disability degree in the sample was grade zero, in 80.0% of the cases (n=60), but in 4.0% (n=3) the grade assessed was 2. In 54.0% of cases (n=27), bacilloscopy was performed, with positive results in 36.0% (n=9) of the exams. Multibacillary cases, with physical disability and/or positive bacilloscopy, draws attention that that the diagnosis is frequently not made in early stages.

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Neuropatia por hanseníase: atraso no diagnóstico ou um diagnóstico difícil?

Cited by 4 publications

References 3 publications

Molecular, immunological and neurophysiological evaluations for early diagnosis of neural impairment in seropositive leprosy household contacts

Molecular, immunological and neurophysiological evaluations for early diagnosis of neural impairment in seropositive leprosy household contacts

As consequências da pandemia de Sars-CoV-2 sobre a educação médica no combate à hanseníase

Epidemiological characteristics and trends of leprosy in children and adolescents under 15 years old in a low-endemic State in Southern Brazil

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