Hansen's disease in Portugal: multibacillary patients treated between 1988 and 2003

Medeiros, Sandra; Catorze, M Goreti; Vieira, Luis Carlos

doi:10.1111/j.1468-3083.2008.02941.x

Cited by 8 publications

(7 citation statements)

References 15 publications

(52 reference statements)

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“…These cases occurred mostly in citizens residing in Spain (particularly in southern Spain) [ 7 , 28 , 29 ], although some lived in other countries [ 7 ]. However, it is also important to note that leprosy was endemic in both Spain [ 3 ] and Portugal [ 30 ] until relatively recently.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Leprosy in Spain: The Role of the International Migration

2016

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BackgroundAlthough incidence of leprosy in Spain has declined steadily over the years, the fivefold increase in immigration since the turn of the century—much of it from countries where leprosy is still prevalent—has been linked to an uptick in registered cases.ObjectiveTo describe the epidemiologic trends of incident leprosy cases detected in Spain among Spanish- and foreign-born population groups.MethodsObservational, retrospective study of suspected leprosy cases in Spain, as reported through the System of Compulsory Notification of Diseases from 2003 to 2013, with results disaggregated by country of birth. We collected statistical data on leprosy burden for other countries from WHO to estimate the expected number of imported cases.ResultsOf the 168 leprosy cases registered during the study period, 40 (24.6%) were in Spanish patients, while 128 (76.2%) were detected in legally resident immigrants. We identified a significantly higher number of imported leprosy cases during the 2008–2010 and 2011–2013 trienniums compared to the reference biennium 2003–2004 (OR 5.38, 95% CI 1.83–14.88 and OR 4.80, 95% CI 1.41–16.33, respectively). Most imported cases were diagnosed in Latin American immigrants (71.9%), especially Brazilians, but also Paraguayans, Bolivians and other nationalities from South and Central America. However, registered incidence was lower than expected for each year. For example, in 2003, the expected new cases in immigrants was 47.12, compared to only four cases that were actually detected (a 91% difference). Likewise, we expected to find 49.6 incident cases among immigrants in 2009, but only 15 new cases were reported (60% fewer than expected).ConclusionImported cases of leprosy are responsible for most leprosy incidence in Spain, and we cannot rule out some under-diagnosis. Clinicians should be made more aware of the potential for leprosy incidence among patients from countries where the disease is endemic.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of Leprosy in Spain: The Role of the International Migration

2016

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“…Nineteen papers published between 2009 and 2018 were included in the review, accounting for 280 patients reported by five nationwide reports [ 7 , 8 , 9 , 22 , 23 ] ( Table 2 ), 14 case reports [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ], and three case series described by single centers [ 7 , 38 , 39 ] ( Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

“…Naturally, the chronology of the published cases is not the same as that of our case series, as many papers referred to cases observed years before the publication. The majority of the papers were from Italy [ 7 , 25 , 27 , 28 , 31 , 35 , 37 ], Spain [ 9 , 29 , 30 , 38 , 39 ], and the United Kingdom (UK) [ 26 , 32 , 33 ], whereas Portugal [ 22 ], France [ 24 ], Germany [ 34 ], Greece [ 23 ], and Denmark [ 8 ] contributed with one paper each. The continents of origin were South and Central America for 144 patients (51%), Africa (79 patients, 28%), and Asia (55 patients, 20%).…”

Section: Resultsmentioning

confidence: 99%

“…In contrast, our study population mainly originated from Africa (42%) and Asia (40%). The origin of the published European cases was not uniform across countries, however, while 56% of the cases observed in Portugal were from Africa [ 22 ], and 87% and 50% of the cases observed in Denmark and Greece, respectively, were from Asia [ 8 , 23 ]; while in Spain, Latin American patients predominated (72%) [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

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Leprosy in Refugees and Migrants in Italy and a Literature Review of Cases Reported in Europe between 2009 and 2018

et al. 2020

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Leprosy is a chronic neglected infectious disease that affects over 200,000 people each year and causes disabilities in more than four million people in Asia, Africa, and Latin America. The disease can appear with a wide spectrum of clinical forms, and therefore the clinical suspicion is often difficult. Refugees and migrants from endemic countries affected by leprosy can remain undiagnosed in Europe due to the unpreparedness of clinicians. We retrospectively describe the characteristics of 55 refugees/migrants with a diagnosis of leprosy established in Italy from 2009 to 2018. Continents of origin were Africa (42%), Asia (40%), and South and Central America (18%). The symptoms reported were skin lesions (91%), neuropathy (71%), edema (7%), eye involvement (6%), fever (6%), arthritis (4%), and lymphadenopathy (4%). Seven patients (13%) had irreversible complications. Overall, 35% were relapses and 66% multibacillary leprosy. Furthermore, we conducted a review of 17 case reports or case series and five nationwide reports, published in the same decade, describing 280 migrant patients with leprosy in Europe. In Europe, leprosy is a rare chronic infectious disease, but it has not completely disappeared. Diagnosis and treatment of leprosy in refugees and migrants from endemic countries are a challenge. European guidelines for this neglected disease in this high-risk population would be beneficial.

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“…De referir que pode ocorrer recorrência da doença após terapêutica multifarmacológica de curta duração 2 . As taxas de recorrência variam entre 1 e 20% 5 .…”

Section: História Natural Da Infecçãounclassified

Doença De Hansen E Gravidez

Lima¹,

Francisco²,

Mendes³

et al. 2011

SPDV

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A Doença de Hansen é uma doença infecciosa causada pelo microrganismo Mycobacterium leprae. No passado, a gravidade da apresentação desta doença e a inexistência de terapêutica adequada, levou à estigmatiza- ção destes doentes. Felizmente, a forma com se olha esta patologia melhorou nas últimas décadas graças à terapêu- tica múltipla que agora temos ao nosso dispor. Com o fenómeno da imigração de regiões do globo onde esta doença ainda tem uma prevalência significativa, assis- timos ao surgimento de novos casos de Lepra em Portugal, nomeadamente em mulheres em idade fértil. A doença de Hansen na gravidez coloca questões quer no que respeita às consequências da terapêutica (durante a gravidez e amamentação), quer no que se refere ao momento do parto. A gravidez causa uma diminuição relativa da imunidade celular, o que permite a proliferação do bacilo com possível agravamento da doença. A escolha dos fármacos adequados impede a lesão nervosa permanente. Relatam-se três casos seguidos na Maternidade Dr. Alfredo da Costa, em conjunto com o serviço de Dermatologia do Hospital Curry Cabral, que pretendem ilustrar a vigilância da gravidez nestas situações. Em todos eles as grávidas foram medicadas com rifampicina e clofazimina. Esta reflexão sobre Gravidez e Lepra visa desmistificar a patologia e sublinhar a importância do seguimento multidis- ciplinar destas gestações.PALAVRAS-CHAVE – Gravidez; Clofazimina; Rifampicina; Lepra.

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Hansen's disease in Portugal: multibacillary patients treated between 1988 and 2003

Abstract: Background There is an estimate low incidence of patients with Hansen's disease in Portugal. Following the 1982 World

Cited by 8 publications

References 15 publications

Epidemiology of Leprosy in Spain: The Role of the International Migration

Epidemiology of Leprosy in Spain: The Role of the International Migration

Leprosy in Refugees and Migrants in Italy and a Literature Review of Cases Reported in Europe between 2009 and 2018

Doença De Hansen E Gravidez

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