Physical disability and Hansen’s disease in Brazil in the 21st century: Brief analysis

Souza, Carlos Dornels Freire de

doi:10.1590/abd1806-4841.20198082

Cited by 6 publications

(4 citation statements)

References 2 publications

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“…This profile is similar to that found in Minas Gerais, Maranhão, and, internationally, in Dhaka and Bangladesh 33 , 34 , 35 . Physical disabilities have been a challenge in the fight against leprosy in Brazil, often leading to temporary or permanent sick leave from work, which may result in consequences for social security in the long-term 36 , 37 , 38 , 39 .…”

Section: Discussionmentioning

confidence: 99%

Epidemiological, temporal and spatial dynamics of leprosy in a municipality in northeastern Brazil (2008-2017): an ecological study

Albuquerque

Silva

Barreto

et al. 2020

Rev. Soc. Bras. Med. Trop.

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Introduction: Leprosy is a chronic infectious disease caused by Mycobacterium leprae.This study aimed to analyze the epidemiological, temporal, and spatial dynamics ofleprosy in a municipality in northeastern Brazil. Methods: This is an ecological study on new leprosy cases in the population of Arapiraca (Alagoas, Northeast Region, Brazil), from 2008 to 2017. Data extracted from a national database were analyzed forepidemiological indicators, factors associated with physical disabilities, and spatialanalysis in the neighborhoods of Arapiraca. Results: A total of 292 new cases of leprosy were recorded, particularly occurring among the following groups: women, the age group of 46-59 years, brown-skinned individuals, people with less than eight years of schooling, and urban residents; the new cases were also predominantly the tuberculoid form and were of the paucibacillary classification of the disease. Almost 1/3 of the people had some degree of physical disability, which was mainly associated with the group 60 years of age and older, black ethnicity, and the multibacillary clinical form of leprosy. The joinpoint regression showed a stationary temporal behavior of indicators. There was a heterogeneous spatial distribution with active transmission areas, especially in the neighborhoods Primavera, Baixão, Ouro Preto, and downtown. Conclusions: The epidemiological indicators revealed complexity in the process of leprosy development. These spatial and temporal studies are relevant to help in the planning, monitoring, and guidance of interventions in the municipality. The spatial analysis showed heterogeneous distribution in the analyzed neighborhoods.

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Section: Discussionmentioning

confidence: 99%

Epidemiological, temporal and spatial dynamics of leprosy in a municipality in northeastern Brazil (2008-2017): an ecological study

Albuquerque

Silva

Barreto

et al. 2020

Rev. Soc. Bras. Med. Trop.

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“…Leprosy is an infectious disease caused by Mycobacterium leprae, an acid-resistant bacillus with an affinity for the cutaneous and peripheral nerves 1 . The high disabling potential of leprosy can result in social, economic, and psychological damage to patients, expanding the context of social vulnerability [2][3][4] .…”

Section: Introductionmentioning

confidence: 99%

Pure neural leprosy or amyloid neuropathy? Systematic review and clinical case report

Santos

Fernandes

Barbosa

et al. 2021

Rev. Assoc. Med. Bras.

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OBJECTIVE:To review the literature and to report a clinical case with initial suspicion of pure neural leprosy and final diagnosis of amyloid neuropathy. METHODS:The study was conducted in two stages. In stage one, a systematic literature review was carried out, with searches performed in the PubMed, Medline, and Lilacs databases, as well as in the leprosy sectoral library of the Virtual Health Library, using the following descriptors: neuritic leprosy, pure neural leprosy, primary neural leprosy, pure neuritic leprosy, amyloid polyneuropathy, amyloid neuropathies, and amyloid polyneuropathy. The search was carried out on May 28, 2020. Clinical trials, cohort studies, crosssectional studies, clinical cases, and case studies published in Portuguese, English or Spanish between 2010 and 2020 were included.Stage two reports a case with initial suspicion of pure neural leprosy. Laboratory tests, electroneuromyography, ultrasound, and biopsy of the sural nerve were requested.RESULTS: Twenty-three scientific texts were included. No publications were found that contained both topics together. The challenging diagnosis of pure neural leprosy and the possibility of using auxiliary resources in diagnosis were the most emphasized themes in the studies. In the clinical case, the patient's electroneuromyography showed sensitive and motor polyneuropathy of the lower limbs, which was predominantly sensory and axonal, symmetrical, of moderate intensity, and the mixed type (axonal-demyelinating). Ultrasonography of the sural nerve revealed changes in the contour of the deep fibular nerves; biopsy of the sural nerve showed an accumulation of amorphous eosinophilic material in the nerve path, and Congo red stain showed apple-green birefringence of the deposit under polarized light. The final diagnosis was amyloid neuropathy. CONCLUSIONS:The final clinical diagnosis was amyloid neuropathy. The diagnosis of pure neural leprosy in endemic areas in Brasil is still a challenge for the health system.

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“…In 2019, 10813 leprosy cases with Grade 2 disabilities at diagnosis (G2D) were reported globally, and the proportion of G2D cases was 5.3% among new cases, corresponding to 1.2 per million population [ 2 ]. However, disability is unevenly distributed, with a relatively high rate of G2D continuously reported in recent years in India [ 3 ], Brazil [ 4 , 5 ], and China [ 6 ]. In India, 5245 leprosy cases with G2D were identified in 2016, corresponding to 2.9 per million population [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…In India, 5245 leprosy cases with G2D were identified in 2016, corresponding to 2.9 per million population [ 3 ]. In Brazil, the proportion of new leprosy cases with G2D was 7.9%, and the rate was 8.42 per 1 million population in 2016 [ 4 ]. From 2012 to 2016, the mean rate of leprosy new case detection with G2D in Brazil was 10.5 per 1 million inhabitants [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for physical disability in patients with leprosy disease in Yunnan, China: Evidence from a retrospective observational study

et al. 2021

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Background Leprosy is potentially debilitating. The risk factors related to physical disabilities associated with leprosy disease in Yunnan, China was not clear. Methodology/Principal findings We studied 10644 newly detected leprosy patients from Yunnan, China, from 1990 to 2019. Factors associated with Grade 1 (G1D) and Grade 2 (G2D) physical disabilities or overall physical disabilities (combined G1D and G2D) associated with leprosy were analyzed using multinomial and ordinal logistic regression analyses. The following factors were associated with the development of physical disability in these patients with leprosy: delayed diagnosis [odds ratio (OR): 5.652, 4.399, and 2.275; 95% confidence intervals (CIs): 4.516–7.073, 3.714–5.212, and 2.063–2.509; for ≥ 10, 5–10 y, and 2–5 years, respectively], nerve damage (OR: 3.474 and 2.428; 95% CI: 2.843–4.244, and 1.959–3.008; for 2 and 1 damaged nerves, respectively), WHO classification of PB (OR: 1.759; 95% CI: 1.341–2.307), Ridley-Jopling classification (OR: 1.479, 1.438, 1.522 and 1.239; 95% CI: 1.052–2.079, 1.075–1.923, 1.261–1.838, and 1.072–1.431; for TT, BT, BB, and BL when compared with LL, respectively), advanced age (OR: 1.472 and 2.053; 95% CI: 1.106–1.960 and 1.498–2.814; for 15–59 and over 60 years old, respectively), zero skin lesions (OR: 1.916; 95% CI: 1.522–2.413), leprosy reaction (OR: 1.528; 95% CI: 1.195–1.952), rural occupation (OR: 1.364; 95% CI: 1.128–1.650), Han ethnicity (OR: 1.268; 95% CI: 1.159–1.386), and male sex (OR: 1.128; 95% CI: 1.024–1.243). Conclusions Delayed diagnosis, nerve damage, no skin lesions, WHO and Ridley-Jopling classifications, leprosy reactions, advanced age, rural occupation, Han ethnicity, and male sex were associated with disability in leprosy patients. Identifying risk factors could help to prevent physical disability.

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Physical disability and Hansen’s disease in Brazil in the 21st century: Brief analysis

Cited by 6 publications

References 2 publications

Epidemiological, temporal and spatial dynamics of leprosy in a municipality in northeastern Brazil (2008-2017): an ecological study

Epidemiological, temporal and spatial dynamics of leprosy in a municipality in northeastern Brazil (2008-2017): an ecological study

Pure neural leprosy or amyloid neuropathy? Systematic review and clinical case report

Risk factors for physical disability in patients with leprosy disease in Yunnan, China: Evidence from a retrospective observational study

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