Profile of leprosy in children under 15 years of age monitored in a Brazilian referral center (2004-2012)

Pinto, Ana Cecília Versiani Duarte; Wachholz, Patrick Alexander; Silva, Gardênia Viana da; Masuda, Paula Yoshiko

doi:10.1590/abd1806-4841.20175676

Cited by 5 publications

(8 citation statements)

References 7 publications

(15 reference statements)

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“…Type I reactions were predominant in the children evaluated in this study, which is similar to reports in the literature 8,21,24,30. However, most patients (77.8%) developed two or more reactional episodes and this contradicts some studies conducted in all age groups, which reported type I reactions with single episodes or in only a minority of patients presenting with recurrence 8,34.…”

Section: Discussionsupporting

confidence: 78%

“…This study revealed a higher proportion (52.9%) of children with reactions and/or isolated neuritis than many previous reports, in which only 5–20% of children with leprosy had reactional episodes 8,9,11,19–23. However, a survey in India showed that 30% of patients in a study of 306 children had leprosy reactions,14 and in a series of 18 cases in children under 15 years old from a referral center in south eastern Brazil, 50% presented with type I reactions 24…”

Section: Discussionmentioning

confidence: 73%

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<p>Leprosy Reactions In Childhood: A Prospective Cohort Study In The Brazilian Amazon</p>

Bandeira¹,

Pires

Quaresma

2019

IDR

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Background and objectiveIn highly endemic areas, severe multibacillary forms of leprosy and reactional episodes are not rare in children. The objective of the present study was to describe the clinical and epidemiological aspects of leprosy reactions in children from the Brazilian Amazon.MethodsThis was a prospective cohort study of 34 leprosy patients aged under 15 years diagnosed at a health referral unit in northern Brazil between April 2014 and June 2015. Follow-up medical consultations were performed during multidrug therapy (MDT) and one year after the end of treatment. Participants underwent a simple neurologic examination and answered a structured questionnaire.ResultsOf the 34 recruited patients, 18 (52.9%) had leprosy reactions and/or neuritis. Among these, 10 (55.6%) had reactions at diagnosis, 13 (72.2%) had reactions after MDT, and 14 (77.8%) had two or more reactional episodes. Type I reactions occurred in 14 (77.8%) cases. Complications, such as disabilities, necrotizing erythema nodosum, or Cushing’s syndrome, occurred in six (33.3%) patients. The following variables showed significant associations (p ≤ 0.05) with leprosy reactions: age 8–14 years, number of doctors seen (≥3), multibacillary classification, number of skin lesions (≥10), or borderline and lepromatous clinical forms. The high frequency of type I reactions resulted in prolonged corticosteroid therapy, which may cause deficient bone maturation in childhood.ConclusionOlder age in children, consulting many physicians for diagnosis, severe clinical forms, and numerous skin lesions were positively associated with reaction development. Reactions after MDT highlight the need for continuity in healthcare of children with leprosy.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 73%

<p>Leprosy Reactions In Childhood: A Prospective Cohort Study In The Brazilian Amazon</p>

Bandeira¹,

Pires

Quaresma

2019

IDR

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“…As leprosy is a long-lasting disease, the presence of physical disability points to delayed diagnosis, hidden prevalence and failure of health services to identify cases. 1,22 In addition, the existence of clusters of the coefficient for new cases with grade II disability reinforces the existence of late diagnosis and hidden prevalence, indicating the most critical and highest priority areas for intervention. 1,23 The north, northeast and southern regions of Bahia require urgent measures to be taken.…”

Section: Discussionmentioning

confidence: 95%

Transmissão da hanseníase na Bahia, 2001-2015: modelagem a partir de regressão por pontos de inflexão e estatística de varredura espacial*

Souza¹,

Luna²,

Magalhães³

2019

Epidemiologia e Serviços de Saúde

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Objective: to describe the trend and the spatial distribution of leprosy in the state of Bahia, Brazil, 2001-2015. Methods: this was a mixed ecological study of epidemiological indicators of leprosy; Joinpoint regression was used for the temporal analysis, while spatial scan statistics were used to identify clusters of the disease; the trend was classified as stationary, increasing or decreasing; we calculated the annual percent change (APC) and average annual percent change (AAPC). Results: there was a reduction in prevalence (AAPC =-5.6; p<0,001), treatment dropout (AAPC =-13.7; p<0.001), and females with leprosy (AAPC =-0.6; p<0.001); the new grade II case coefficient (AAPC = 2.7; p<0.001) and the proportion of multibacillary cases (AAPC = 2,2; p<0.001) showed a growing trend; spatial distribution was heterogeneous and concentrated in three regions in particular (north, west and south of the state), with variation between the indicators. Conclusion: persisting leprosy transmission in the state, late diagnosis and high hidden prevalence is suggested.

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“…12 Although the majority of leprosy in children under 15 years of age in India were paucibacillary (PB), a study by Pinto et al found that MB cases were predominant. 14 The high number of children with MB leprosy may be related to the delay in reporting, 15 widespread nerve damage, and extensive nerve involvement. 13 In the current study, the majority of childhood leprosy patients had early symptoms of hypopigmented anesthetic macules on the skin (92.42%), while 10 patients (7.58%) had nodules as their early symptom.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Grade 2 Disability in Indonesian Children with Leprosy: A Five-Year Multicenter Retrospective Study

Gunawan

Kamilia

Menaldi

et al. 2021

CCID

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Background: One of the indicators of achieved leprosy control is lower new cases of leprosy with grade 2 disability (G2D), while zero new pediatric case with G2D is one of the targets of The Global Leprosy Strategy. This study aimed to describe the characteristics of leprosy in children with G2D from seven provincial hospitals in Indonesia, spanning a period of five years. Methods: This was a descriptive and retrospective study with cross-sectional design. Data were obtained from the medical records of leprosy-affected children in seven provincial hospitals in Indonesia between January 2014 and December 2019 using a total sampling method. Data obtained include characteristics of patients, clinical manifestations, and profile of leprosy in children with G2D. Results: From the 132 data of childhood leprosy retrieved, male (58.33%), age group of 13-14 years (47.73%), and borderline tuberculoid leprosy (34.09%) comprised the majority of patients. Most of the patients had anesthetic macules as the initial manifestation. The results showed 20 (15.15%) children had G2D. Hands were the most common site affected (50.00%), manifested as claw hands, contractures, atrophy of thenar and hypothenar muscles, and pseudomutilation. Foot drop was seen in five (62.50%) children, and lagophthalmos was seen in one child with leprosy. Conclusion:This study shows that G2D is observed in 15.15% Indonesian children with leprosy at the time of diagnosis, which mostly occurs on the hands in the form of claw hands. Foot disabilities were also observed, most commonly as foot drop, while lagophthalmos was present with disabilities in the eyes. Disability due to leprosy in children really exists. The commitment of all health care services and related institutions is needed in order to reduce the incidence of disability due to leprosy in children.

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Profile of leprosy in children under 15 years of age monitored in a Brazilian referral center (2004-2012)

Cited by 5 publications

References 7 publications

<p>Leprosy Reactions In Childhood: A Prospective Cohort Study In The Brazilian Amazon</p>

<p>Leprosy Reactions In Childhood: A Prospective Cohort Study In The Brazilian Amazon</p>

Transmissão da hanseníase na Bahia, 2001-2015: modelagem a partir de regressão por pontos de inflexão e estatística de varredura espacial*

Characteristics of Grade 2 Disability in Indonesian Children with Leprosy: A Five-Year Multicenter Retrospective Study

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