Características epidemiológicas e clínicas das reações hansênicas em indivíduos paucibacilares e multibacilares, atendidos em dois centros de referência para hanseníase, na Cidade de Recife, Estado de Pernambuco
Abstract:RESUMOIntrodução: As reações são frequentes e importantes no contexto da hanseníase, representando uma significativa parcela de pacientes com incapacidades e submetidos ao retratamento da hanseníase. A caracterização clínico-epidemiológica dos padrões reacionais é primordial para o manejo dos pacientes. O objetivo desse trabalho é descrever as características epidemiológicas e clínicas das reações hansênicas em indivíduos paucibacilares e multibacilares. Métodos: Estudo transversal onde foram avaliados 201 pac… Show more
“…It is known that the closer to the lepromatous pole, the greater the likelihood of developing disabilities 19 . The development of leprosy reaction type 1 or reverse reaction was observed in a majority of patients in this study, similar to results reported by Teixeira et al 17 . Reactional states are the leading cause of nerve damage and physical disability caused by leprosy; therefore, monitoring and treating leprosy reactions is essential 20 .…”
Section: Discussionsupporting
confidence: 92%
“…Similar results were found in Teixeira et al 17 . The predominance of multibacillary forms is due, among many factors, to delayed diagnosis, which affects maintenance of the epidemiological chain and can serve as a source of increased transmission 14,17 . The borderline clinical form was the most prevalent form of leprosy in this study, corroborating the results of Alves et al 18 .…”
Introduction: Leprosy often results in sensory and physical limitations. This study aimed to evaluate these limitations using a quantitative approach in leprosy patients in Belém (Pará, Brazil). Methods: This epidemiological, cross-sectional study measured the sensory impairment of smell and taste through the use of a questionnaire and evaluated activity limitations of daily life imposed by leprosy through the Screening of Activity Limitation and Safety Awareness (SALSA) Scale. Data were collected from 84 patients and associations between the degree of disability and clinical and epidemiological characteristics were assessed. Results: The majority of patients were men (64.3%), married (52.4%), age 31-40 years old (26.2%), had primary education (50%), and were independent laborers (36.9%). The multibacillary operational classification (81%), borderline clinical form (57.1%), and 0 degrees of physical disability (41.7%) were predominant. SALSA scores ranged from 17 to 59 points, and being without limitations was predominant (53.6%). The risk awareness score ranged from 0 to 8, with a score of 0 (no awareness of risk) being the most common (56%). Evaluation of smell and taste sensory sensitivities revealed that 70.2% did not experience these sensory changes. Patients with leprosy reactions were 7 times more likely to develop activity limitations, and those who had physical disabilities were approximately four times more likely to develop a clinical picture of activity limitations. Conclusions: Most patients showed no sensory changes, but patients with leprosy reactions were significantly more likely to develop activity limitations. Finally, further studies should be performed, assessing a higher number of patients to confirm the present results.
“…It is known that the closer to the lepromatous pole, the greater the likelihood of developing disabilities 19 . The development of leprosy reaction type 1 or reverse reaction was observed in a majority of patients in this study, similar to results reported by Teixeira et al 17 . Reactional states are the leading cause of nerve damage and physical disability caused by leprosy; therefore, monitoring and treating leprosy reactions is essential 20 .…”
Section: Discussionsupporting
confidence: 92%
“…Similar results were found in Teixeira et al 17 . The predominance of multibacillary forms is due, among many factors, to delayed diagnosis, which affects maintenance of the epidemiological chain and can serve as a source of increased transmission 14,17 . The borderline clinical form was the most prevalent form of leprosy in this study, corroborating the results of Alves et al 18 .…”
Introduction: Leprosy often results in sensory and physical limitations. This study aimed to evaluate these limitations using a quantitative approach in leprosy patients in Belém (Pará, Brazil). Methods: This epidemiological, cross-sectional study measured the sensory impairment of smell and taste through the use of a questionnaire and evaluated activity limitations of daily life imposed by leprosy through the Screening of Activity Limitation and Safety Awareness (SALSA) Scale. Data were collected from 84 patients and associations between the degree of disability and clinical and epidemiological characteristics were assessed. Results: The majority of patients were men (64.3%), married (52.4%), age 31-40 years old (26.2%), had primary education (50%), and were independent laborers (36.9%). The multibacillary operational classification (81%), borderline clinical form (57.1%), and 0 degrees of physical disability (41.7%) were predominant. SALSA scores ranged from 17 to 59 points, and being without limitations was predominant (53.6%). The risk awareness score ranged from 0 to 8, with a score of 0 (no awareness of risk) being the most common (56%). Evaluation of smell and taste sensory sensitivities revealed that 70.2% did not experience these sensory changes. Patients with leprosy reactions were 7 times more likely to develop activity limitations, and those who had physical disabilities were approximately four times more likely to develop a clinical picture of activity limitations. Conclusions: Most patients showed no sensory changes, but patients with leprosy reactions were significantly more likely to develop activity limitations. Finally, further studies should be performed, assessing a higher number of patients to confirm the present results.
“…Research studies have indicated the males predominate in new cases and in relapsed cases of leprosy; men are between 0.21 and 0.81 times more likely to have a relapse when compared to women. This may be related to the persistent behavior of low search for health services in the case of men [12,13,14,15,16].…”
Leprosy is a chronic infectious disease influenced by unfavorable housing and sanitation conditions and number of cohabitants, especially in cases of relapses. Methods: This is a cross-sectional study conducted in Teresina, a high leprosy endemic city. Association tests (chi-square or Fisher's exact test) were used to analyze data.Results: Three hundred and six cases were reported; 42.5% were registered in Basic Health Units (BHUs) and 57.5%, in Reference Units (RUs). There was predominance of multibacillary forms of leprosy. The typo of health unit reporting the case was associated with the clinical form of the disease (p < 0.01) and the number of affected nerves (p < 0.05). Records without specification of the clinical form were more frequent in BHUs than in RUs, and the dimorphic form was more frequently reported in RUs.
Conclusions:The present data has similarities with other studies, but it is believed that underreporting of cases takes place in the studied city. Thus, greater attention is necessary to the diagnostic confirmation of relapses. Training health professionals on epidemiological surveillance is fundamental, as well as the appropriate management of relapsed cases of leprosy in the context of public health.
“…1 Os poucos estudos sobre mortalidade por hanseníase realizados em São Paulo mostram a mesma predominância de óbitos em pessoas do sexo masculino. [14][15][16] Sabe-se que os homens são mais frequentemente acometidos 8,17,18 e mais propensos ao desenvolvimento de formas mais graves da doença. 8 Em relação aos aspectos sociais dos indivíduos que morreram por hanseníase como causa básica, cerca de 60% possuíam baixo nível de escolaridade, achado semelhante ao de um estudo dos óbitos por hanseníase ocorridos no Brasil no mesmo período.…”
Section: Discussionunclassified
“…6 Porém, indivíduos curados pela poliquimioterapia para hanseníase (PQT) e, portanto, curados segundo o Sinan, podem apresentar condições clínicas que incluem estados reacionais, incapacidades físicas e sequelas decorrentes da doença. 7,8 Tais condições não são registradas na Declaração de Óbito (DO).…”
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