Múltiplas dimensões da gestão do cuidado à hanseníase e os desafios para a eliminação

Cavalcante, Marília Daniella Machado Araújo; Larocca, Liliana Müller; Chaves, Maria Marta Nolasco

doi:10.1590/s1980-220x2019010703649

Cited by 18 publications

(14 citation statements)

References 18 publications

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“…Studies had been conducted in various settings: community (n = 10), hospital (9), clinic (4), mixed hospital and clinic (1), mixed community and clinic (1), mixed clinic and a region aggregate data (1) and a nation-wide data assessment (1). As well as assessing the experiences of leprosy patients, studies had also involved health-care professionals [ 36 – 38 ], pastors [ 38 ] and parents of leprosy patients [ 32 ]. Detailed information on the selected studies is given in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

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Individual and community factors determining delayed leprosy case detection: A systematic review

et al. 2021

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Background The number of new leprosy cases is declining globally, but the disability caused by leprosy remains an important disease burden. The chance of disability is increased by delayed case detection. This review focusses on the individual and community determinants of delayed leprosy case detection. Methods This study was conducted according to the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). The study protocol is registered in PROSPERO (code: CRD42020189274). To identify determinants of delayed detection, data was collected from five electronic databases: Embase.com, Medline All Ovid, Web of Science, Cochrane CENTRAL, and the WHO Global Health Library. Results We included 27 papers from 4315 records assessed. They originated in twelve countries, had been published between January 1, 2000, and January 31, 2021, and described the factors related to delayed leprosy case detection, the duration of the delayed case, and the percentage of Grade 2 Disability (G2D). The median delay in detection ranged from 12 to 36 months, the mean delay ranged from 11.5 to 64.1 months, and the percentage of G2D ranged from 5.6 to 43.2%. Health-service-seeking behavior was the most common factor associated with delayed detection. The most common individual factors were older age, being male, having a lower disease-symptom perception, having multibacillary leprosy, and lack of knowledge. The most common socioeconomic factors were living in a rural area, performing agricultural labor, and being unemployed. Stigma was the most common social and community factor. Conclusions Delayed leprosy case detection is clearly correlated with increased disability and should therefore be a priority of leprosy programs. Interventions should focus on determinants of delayed case detection such as health-service-seeking behavior, and should consider relevant individual, socioeconomic, and community factors, including stigmatization. Further study is required of the health service-related factors contributing to delay.

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Section: Resultsmentioning

confidence: 99%

“…Six studies investigated the role of stigma [ 27 , 32 , 33 , 36 – 38 ]. One of these, a quantitative study [ 27 ], reported a significant association between delay and the fear of isolation (OR = 10.37; 95% CI = 2.2–49.5).…”

Section: Resultsmentioning

confidence: 99%

Individual and community factors determining delayed leprosy case detection: A systematic review

et al. 2021

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“…Nos estudos 13 e 14 foram avaliados fatores que predispõe o agravamento da hanseníase e evidenciado que a falta do diagnóstico precoce é um fator determinante, sendo proveniente o acometimento agressivo da enfermidade e consequentemente diversos graus de incapacidades físicas, atingindo principalmente populações menos favorecidas e áreas historicamente endêmicas (Cavalcante et al, 2020).…”

Section: Resultsunclassified

“…Algumas estratégias de saúde precisam ser continuadas no que diz respeito ao diagnóstico e tratamento precoce da hanseníase, este estudo evidenciou que a vigilância de contatos intradomiciliares é uma estratégia excelente e por isso, deve ser vastamente utilizada nos serviços de saúde, que por vezes negligencia esse problema de saúde pública. Ademais, estratégias de prevenção devem ser as de primeira escolha, enfatizando o estigma, que na maioria das vezes é perpetuado pelos próprios portadores da doença e é um dos principais causadores de não adesão e/ou abandono do tratamento (Cavalcante et al, 2020).…”

Section: Discussionunclassified

“…A Atenção Básica tem potencial grandioso no diagnóstico precoce e combate à hanseníase, no entanto, algumas deficiências são identificadas como na descentralização da assistência à hanseníase, precisam ser sanadas para que seus recursos possam ser utilizados em sua máxima potência. O que pode ser utilizado como subsídio para estimular o uso dos serviços públicos de saúde, são programas sociais que estimulam o aumento a frequência escolar e busca meios de promover o sustento às famílias de extrema pobreza e outras, refletindo tais ações nos indicadores de saúde das pessoas mais suscetíveis (Cavalcante et al, 2020).…”

Section: Discussionunclassified

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Análise dos impactos biopsicossociais da hanseníase em adultos

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Barreto

Silva

et al. 2021

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Objetivo: Descrever o impacto da hanseníase na qualidade de vida dos portadores. Métodos: Trata-se de uma revisão bibliográfica integrativa realizada nas bases de dados Scientific Electronic Library Online (SciELO) e Banco de Dados em Enfermagem (BDENF). Como critérios de inclusão: artigos que abordem a temática, nos últimos dez anos. Como critérios de exclusão: artigos que não contemplavam o tema. Foram encontrados 85 estudos nas bases selecionadas e após aplicar os critérios de inclusão e exclusão, foram selecionados 11 estudos para compor a revisão. Resultados: A hanseníase é uma doença transmissível, que afeta os nervos periféricos e a pele, podendo causar sérios prejuízos sensoriais, motores e autônomos. É decorrente da suscetibilidade dos indivíduos, predisposição genética ou contato prolongado com portadores da hanseníase sem tratamento. Sabe-se que a hanseníase atualmente tem cura e seu tratamento é ofertado através do Sistema Único de Saúde (SUS), no entanto fatores como o estigma, preconceito e a falta de informação retardam o processo de cura da doença e traz consequências desafiadoras no âmbito da saúde pública. Considerações Finais: Portanto, torna-se pertinente à discussão do problema, com intuito de identificar estratégias que melhor minimizem o impacto da hanseníase na vida de portadores e os efeitos colaterais para coletividade.

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Delayed detection of leprosy cases: A systematic review of healthcare-related factors

et al. 2022

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Background In new leprosy cases, grade 2 disability (G2D) is still a public health burden worldwide. It is often associated with the delayed leprosy diagnoses that healthcare systems should play a crucial role in preventing. The aim of this systematic review was to identify healthcare factors related to delays in case detection in leprosy. Methods PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) was used as a guideline in this research. The study protocol was registered in the PROSPERO (International Prospective Register of Systematic Reviews) with reference code CRD42020189274. Data was collected from five electronic databases: Embase.com, Medline All Ovid, Web of Science, Cochrane CENTRAL, and the WHO Global Health Library. Results After applying the selection criteria for original empirical studies, and after removing duplicates, we included 20 papers from 4313 records. They had been conducted in ten countries and published between January 1, 2000, and January 31, 2021. We identified three categories of healthcare factors related to delayed case. 1) Structural factors, such as i) financial and logistic issues, and geographical circumstances (which we classified as barriers); ii) Health service organization and management including the level of decentralization (classified as facilitators). 2) Health service factors, such as problems or shortages involving referral centers, healthcare personnel, and case-detection methods. 3) Intermediate factors, such as misdiagnosis, higher numbers of consultations before diagnosis, and inappropriate healthcare services visited by people with leprosy. Conclusions Delays in leprosy case detection are due mainly to misdiagnosis. It is crucial to improve the training and capacity of healthcare staff. To avoid misdiagnosis and reduce detection delays, national leprosy control programs should ensure the sustainability of leprosy control within integrated health services.

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Múltiplas dimensões da gestão do cuidado à hanseníase e os desafios para a eliminação

Cited by 18 publications

References 18 publications

Individual and community factors determining delayed leprosy case detection: A systematic review

Individual and community factors determining delayed leprosy case detection: A systematic review

Análise dos impactos biopsicossociais da hanseníase em adultos

Delayed detection of leprosy cases: A systematic review of healthcare-related factors

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