Neurological assessment and degree of disability of leprosy patients: observation at diagnosis and at discharge

Abstract

Background: Caring for leprosy patients requires neurological assessment for prevention of potential physical disabilities. This study focused on the neurological impairment and degree of physical incapacity (DI) at the time of the diagnosis and at discharge of leprosy patients from Dermatology Department of the University of the State of Pará.
 Methods and findings: It was a cross-sectional, observational study based on the medical records, neurological assessment and DI of 14 patients assisted at a referral service between 2012 and 2016, applying descriptive statistical analysis. At diagnosis were observed patients with decreased abduction forces of the 5th finger (14.28%), extension of hallux and foot dorsiflexion (10.72%); loss of protective sensitivity in the ulnar nerve area (3.57%) and tibial nerve area (25%); 7.15% of thickened ulnar nerve; DI 0 (64.28%) and DI 1 (35.72%). At discharge, 10.72% of the patients showed decreased abduction of the 5th finger, extension of hallux and foot dorsiflexion (14.28%); loss of protective sensitivity just in the tibial nerve area (17.87%); 4.28% of thickened ulnar nerve; DI 0 (78.57%) and DI 1 (21.43%).
 Conclusions: Therefore, most of the patients had normal neurological assessment and DI 0 at both moments, with reduction of alterations in discharge, except for the fibular nerve. Thus, it is highlighted the primary role of the health team, which constitutes one of the main agents promoters of health education, especially when it comes to preventing disabilities in leprosy.

Avaliação do grau de incapacidade neurofuncional dos pacientes com diagnóstico de Hanseníase/ Assessment of the degree of neurofunctional disability in patients diagnosed with leprosy

“…Dentre os motivos que levariam a esse dado, destacam-se a menor preocupação com a estética corporal e a falta de políticas específicas para esse grupo. Contudo, um estudo realizado no Ceará apresentou discordância em relação ao gênero, que mostrou um pequeno predomínio no sexo feminino 13,14,16,17,18,19,20,21 .…”

“…A literatura explica que isso ocorre devido a forma multibacilar sustentar a cadeia de transmissão, principalmente em regiões com difícil controle da doença. Segundo a Organização Mundial da Saúde, existe uma prevalência mundial de formas multibacilares, especialmente nos continentes africano e americano, que ainda enfrentam os problemas de extrema desigualdade social e pobreza 16,17,18,19,20,21,23 .…”