Risk factors for physical disability upon release from multidrug therapy in new cases of leprosy at a referral center in Brazil

Abstract

The present study sought to investigate the risk factors for physical disability upon release from multidrug therapy (MDT) in new cases of leprosy, registered at a referral center in Brazil. This is a longitudinal and retrospective study that evaluated 260 patients. Multivariate analyses, using both the ordinal logistic regression, as well as the classification and regression tree (CART) algorithm were performed to determine the factors associated with physical disability upon release from treatment. The prevalence of disability did not differ significantly between diagnosis and release from treatment. Number of affected nerves and sensory impairment upon diagnosis were risk factors for disability at the end of MDT. The analysis using the CART algorithm resulted in the development of a clinical score to predict the risk of disability upon release from MDT. The decision tree may have a direct applicability in clinical practice for professionals dealing with leprosy, as it allows them to identify patients with a higher risk of physical disability through the use of simple and widely available clinical tests. This study also shows that the disability grade upon admission is the main risk factor for disability upon release from MDT. This result draws attention to the importance of early diagnosis in disability prevention.

Multi - Bacillary Leprosy Under Chinese Leprosy Elimination Program

“…By adding Class I disability (96 cases, 31.48%) to Class II disability (122 cases, 40.0%), the number of patients with disabilities increased to 218 (71.48%), which represented a high percentage of the overall disability. In addition, the incidence rate of Class II disability in our sample is far higher than the global average of 6% reported by the World Health Organization in 2016, 32 which indicated that there is a delay in diagnosis or misdiagnosis in these patients.…”

Disability progression among leprosy patients released from treatment: a survival analysis

“…The emphasis of the WHO strategy is early detection to prevent cases with G2D at the time of diagnosis [15]. The relevance of early detection as an approach to reduce the risk of developing disabilities is undisputed [20]. Studies conducted in the post-release from treatment period showed that early diagnosis is associated with reduced risk of PD [2,8,21].…”

Spatial analysis of epidemiological and quality indicators of health services for leprosy in hyperendemic areas in Northeastern Brazil

“…In this study, cure was the most frequent treatment outcome. In 2019, Assis et al 32 reported nervous and sensory system impairment upon diagnosis as risk factors for disability at the end of the polychemotherapy. Authors of another study reported deficiencies during treatment 33 .…”