Factors associated with the worsening of the disability grade during leprosy treatment in Brazil

Costa, Letícia Gomes; Cortela, Denise da Costa Boamorte; Soares, Rosa Castalia França Ribeiro; Ignotti, Eliane

doi:10.47276/lr.86.3.265

Cited by 15 publications

(15 citation statements)

References 14 publications

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“…Any worsening of the PD of leprosy patients post-release from treatment is worrying, and a lack of comprehensive and systematic follow-up health care can leave cured leprosy patients neglected and vulnerable [3]. Many patients are released from treatment with leprosy reactions and neural impairment [5,6] but are then excluded from active review of their disease status and adequate management of their conditions [7]. In Brazil, newly diagnosed leprosy patients are systematically recorded and monitored during multidrug therapy (MDT) and are considered cured at the end of treatment according to the paucibacillary (PB) or multibacillary (MB) treatment protocol, depending on the initial diagnosis [7].…”

Section: Introductionmentioning

confidence: 99%

“…The relevance of PD among leprosy patients is widely acknowledged. It is also well known that it can occur post-release from treatment either due to late detection [2,8], late onset of leprosy reactions [3,5,9] or in the absence of qualified and timely assistance [10]. The lack of adherence to recommended self-care for prevention of PD as another contributing factor during treatment [11] and post-discharge has also been documented [12].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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Background Leprosy can be cured, but physical disability (PD) as a result of the infection can progress in the post-release from treatment phase. This study evaluated the likelihood of, and factors associated with, the progression of the PD grade post-release from treatment among leprosy patients treated in Cáceres-MT, Brazil in the period 2000 to 2017. Methods A retrospective cohort study and survival analysis were performed in the hyperendemic municipality of Cáceres in the state of Mato Grosso. The study population consisted of newly diagnosed leprosy patients released from treatment between January 1, 2000 and December 31, 2017. The main outcome was the progression of the PD grade with regard to probability and time; and the evaluated covariates included clinical, operational and demographic variables. The Cox proportional risk model was used to estimate the risk ratio (Hazard Ratios) of the covariates. Both an univariate and a multivariate analysis were implemented, with 95% confidence intervals. Results The mean time for progression of the PD grade was 162 months for PB and 151 months for MB leprosy patients. The survival curve showed that 15 years after the release from treatment, the probability of PD grade progression was 35%, with no difference between PB and MB or age groups. Leprosy reactions and registered medical complaints of any kind during treatment were identified as risk factors with Hazard Ratios of 1.6 and 1.8 respectively. Conclusions People released from treatment as cured of leprosy are susceptible to worsening of the PD, especially those who have had complications during multi-drug therapy treatment. This indicates that leprosy patients should be periodically monitored, even after the successful completion of multidrug therapy.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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“…4 OTA and OTC are crucial for leprosy patients due to disability and relapse, which are associated with irregular treatment. 3,21 This study has revealed that the adherence to on-time collection of MDT blister packs is low for 3rd, 8th, and 11th months. A study conducted elsewhere had reported association between late collections of MDT in second and third months with the late completion of treatment.…”

Section: Discussionmentioning

confidence: 95%

“…Low adherence is considered to be the main challenge because of the long treatment duration, which may lead to residual sources of infection, incomplete cure, persisting infections, irreversible complications, and transmission to new susceptible, multidrug resistance, and developing disability or deformity. 3,4 An integrated and innovative approach is, therefore, needed to improve patients’ adherence to MDT regimens and leprosy elimination programs. 5…”

Section: Introductionmentioning

confidence: 99%

Encouraging On-Time Completion of Leprosy Patients Treatment: Implementing E-Leprosy Framework to Primary Health Care in Indonesia

Rachmani

Hsu

Chang

et al. 2019

Asia Pac J Public Health

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Low adherence to leprosy treatment is the main challenge in Indonesia. This is a quasi-experimental observational study in a real setting of a leprosy control program in Indonesia. The study is aimed at evaluating an e-leprosy framework in increasing the rate of on-time attendance at primary health care and on-time completion of treatment of leprosy patients. This study has implemented an e-leprosy framework for primary health care at Pekalongan District. The intervention was conducted for 19 months to observe a 1-episode long-term treatment of leprosy patients. The study collected data of 391 registered patients from June 2012 to March 2016. Based on the inclusion and exclusion criteria, this study selected 188 patients. The SMS (short message service) reminders proved to be effective in increasing on-time completion and on-time attendance rates by 21% and 14.6%, respectively. There is a trend for late collections of the drugs at the 3rd, 8th, and 11th multidrug therapy drug collections.

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“…Estudo aponta a baixa percepção do risco hansênico que reflete a deficiência no autocuidado (22) . Tal resultado torna-se uma ameaça para a integridade física e psicológica e para a imagem pessoal, ainda mais considerando que as incapacidades podem aparecer em qualquer fase da doença, necessitando da realização do autocuidado o quanto antes (23)(24) . Ressalta-se, em complementariedade às informações acima, que a caracterização clínica dos indivíduos representa majoritariamente classificação multibacilares e dimorfa na amostra.…”

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Autocuidado Em Indivíduos Com Hanseníase: Avaliação De Práticas Na Rede De Atenção Secundária À Saúde

et al. 2020

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Objetivo: avaliar as práticas de autocuidado com face, mãos e pés de indivíduos com hanseníaseatendidos na rede de atenção secundária à saúde.Método: estudo quantitativo, descritivo-exploratório, transversal, realizado em hospital dereferência. População de 127 pessoas e amostra com 74. Coleta de dados realizada por meio dedois instrumentos estruturados e analisados pelos testes de Spearman e qui-quadrado.Resultados: as práticas de autocuidado para os pés se mostraram melhor executadas em comparaçãoàs demais dimensões. Houve correlação significante nas práticas para mãos/pés e face/mãos. Asassociações foram significantes para classificação operacional/práticas para pés, comprometimentofacial/práticas para face e comprometimento de membros inferiores/práticas para pés.Conclusão: o estudo atente ao objetivo proposto e conclui que as práticas de autocuidado precisamser melhor conhecidas e aplicadas, uma vez que tem sua eficácia reconhecida no meio científico,tratando-se de uma estratégia baseada em evidências.

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Factors associated with the worsening of the disability grade during leprosy treatment in Brazil

Cited by 15 publications

References 14 publications

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

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

Encouraging On-Time Completion of Leprosy Patients Treatment: Implementing E-Leprosy Framework to Primary Health Care in Indonesia

Autocuidado Em Indivíduos Com Hanseníase: Avaliação De Práticas Na Rede De Atenção Secundária À Saúde

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