Factors associated with the delay of diagnosis of leprosy in north‐eastern Colombia: a quantitative analysis

Gomez, L.J. Posso; Rivera, Alberto; Vidal, Yesenia; Bilbao, Jorge; Kasang, Christa; Parisi, Sandra; Schwienhorst-Stich, Eva‐Maria; Puchner, Karl Philipp

doi:10.1111/tmi.13023

Cited by 47 publications

(53 citation statements)

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“…Ignorance of illness or waiting for the disappearance of the symptom by itself was the major reason for not seeking help in the majority of the cases. A study at Columbia also reported that 90% of the study participants not sought any HCP after noticing the first symptom [24]. Henry and colleagues reported that participants who thought their symptoms were not serious had a threefold greater chance of waiting longer before consulting than those who did.…”

Section: Discussionmentioning

confidence: 99%

Risk of disability among adult leprosy cases and determinants of delay in diagnosis in five states of India: A case-control study

Govindarajulu

Muthuvel²,

Lal³

et al. 2019

PLoS Negl Trop Dis

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Introduction A high proportion of grade 2 disability (visible deformity) is indicative of delay in detection of leprosy and leprosy is one of the major causes of preventable disability. We conducted this study to determine the risk factors associated with disability (G2D and G1D) among adult new leprosy cases and to measure their strength of association. Methods A multi-centric case-control study was undertaken in five states of India i.e. Andhra Pradesh, Delhi, Gujarat, Maharashtra and West Bengal). Among new adult patients, cases were defined as those with disability (G2D and G1D) at the time of diagnosis and controls were defined as those without any disability (G0D). Delays were quantified based on patient recall across a timeline. Patient delay defined as the time period between first noticed symptom by the patient and the first visit to any health care provider (HCP); HCP delay defined as the time period between patient’s first visit to any HCP and the confirmation of diagnosis of leprosy; and total delay defined as the sum of both patient and HCP delays. Results A total of 1400 new leprosy patients (700 G2D/G1D and 700 G0D) across five states were interviewed. Among G2D/G1D, the median patient delay was 8 months compared with 4 months among G0D. The median HCP delay was 2 months for G2D/G1D and 1 month for G0D. The median total delay was 14 months for G2D/G1D and 6.2 months for G0D; observed median difference between groups was statistically significant (p<0.001). When patient delay was more than 3 months, odds of G2D/G1D at diagnosis were 1.6 times higher compared to when patient delay was less than 3 months. When the HCP delay was more than one month, the odds of G2D/G1D were 1.4 times higher compared to when the HCP delay was less than one month. When the patient had multi-bacillary type leprosy the odds of G2D/G1D at the time of diagnosis was nine times higher compared to pauci-bacillary type leprosy. Conclusion Patient delay is the major reason for risk of disability (G2D/G1D) among adult leprosy patients. A patient delay of more than 3 months from the notice of first symptom is a significant indicator for the disabilities among adult leprosy patients. Early case detection campaigns like active surveys in endemic spots should be done periodically as this can reduce delays and promote early diagnosis. Additionally, the program should lay greater emphasis on raising community awareness regarding the disease. Also, health care provider delay of more than 1 month have been significant risk factors for disability among adult leprosy cases. Hence, periodical capacitation of all HCPs including private practitioners would significantly contribute to reduce diagnostic delay and promote timely referral and early detection.

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Section: Discussionmentioning

confidence: 99%

Risk of disability among adult leprosy cases and determinants of delay in diagnosis in five states of India: A case-control study

Govindarajulu

Muthuvel²,

Lal³

et al. 2019

PLoS Negl Trop Dis

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“…Early detection and timely treatment of leprosy are key for interrupting transmission and preventing physical and social complications and thus reducing disease burden [ 5 ]. However, as a relatively rare skin disease, early identification and diagnosis of leprosy patients remains a challenge, especially in low-endemic areas.…”

Section: Introductionmentioning

confidence: 99%

The role of an active surveillance strategy of targeting household and neighborhood contacts related to leprosy cases released from treatment in a low-endemic area of China

Wang

Chu

et al. 2020

PLoS Negl Trop Dis

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Objective Early diagnosis remains the primary goal for leprosy management programs. This study aims to determine whether active surveillance of patients with leprosy and their contact individuals increased identification of latent leprosy cases in the low-endemic areas. Methods This cross-sectional survey was carried out between October 2014 and August 2016 in 21 counties throughout Shandong Province. The survey was conducted among patients with leprosy released from treatment (RFT) and their contacts from both household and neighbors. Results A total of 2,210 RFT patients and 9,742 contacts comprising 7877 household contacts (HHCs), including 5,844 genetic related family members (GRFMs) and 2033 non-genetic related family members and 1,865 contacts living in neighboring houses (neighbor contacts, NCs), were recruited. Among identified individuals, one relapsed and 13 were newly diagnosed, giving a detection rate of 0.12%, corresponding to 120 times the passive case detection rate. Detection rates were similar for HHCs and NCs (0.114% vs. 0.214%, P = 0.287). Analysis of the family history of leprosy patients revealed clustering of newly diagnosed PLOS NEGLECTED TROPICAL DISEASES

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“…Estudo realizado no nordeste da Colômbia, sobre fatores associados ao atraso no diagnóstico da hanseníase, constatou que os homens eram mais diagnosticados com hanseníase, com atraso médio no diagnóstico da doença de 33,5 meses, na forma multibacilar e com grau 2 de incapacidade física no momento do diagnóstico 17 .…”

Section: Discussionunclassified

Mortalidade relacionada à hanseníase no Estado do Piauí, Brasil: tendências temporais e padrões espaciais, 2000-2015

et al. 2020

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O estudo teve por objetivo analisar padrões espaciais e tendências temporais da mortalidade relacionada à hanseníase no Estado do Piauí, Brasil, de 2000 a 2015. Trata-se de estudo ecológico misto, com abordagem espacial e temporal, de base estadual, a partir de dados do Sistema de Informaçãos sobre Mortalidade. A análise inclui características epidemiológicas, tendências de mortalidade por regressão Joinpoint e análise espacial, usando os 224 municípios como unidade geográfica. Dos 245.413 óbitos identificados, a hanseníase foi identificada em 324 declarações, 135 (41,7%) como causa básica de óbito e 189 (58,3%) como associada. Os maiores coeficientes de mortalidade relacionados à hanseníase foram observados entre homens (risco relativo - RR = 2,38; IC95%: 1,87; 3,03), idosos (RR = 10,52; IC95%: 7,16; 15,46), cor parda (RR = 2,22; IC95%: 1,47; 3,35) e residentes do interior do estado (RR = 5,72; IC95%: 4,54; 7,21). O coeficiente bruto de mortalidade relacionado à hanseníase apresentou incremento significativo entre idosos (70 anos), raça/cor parda, em cidades com menos de 20 mil habitantes e região Meio-norte, mas não significativo para o Estado do Piauí. A distribuição espacial pelos coeficientes de mortalidade ajustada por idade foi heterogênea nos municípios, concentrando altos coeficientes de mortalidade no norte do estado, próximo ao litoral. Verificou-se padrão de aumento dos coeficientes de mortalidade suavizados no decorrer dos quadriênios do estudo, concentrando altos coeficientes nas regiões Meio-norte e Semiárido. A mortalidade por hanseníase é espacialmente heterogênea e crescente ao longo dos anos. Ressalta-se a importância de potencializar ações integradas de vigilância e atenção à saúde.

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Factors associated with the delay of diagnosis of leprosy in north‐eastern Colombia: a quantitative analysis

Cited by 47 publications

References 10 publications

Risk of disability among adult leprosy cases and determinants of delay in diagnosis in five states of India: A case-control study

Risk of disability among adult leprosy cases and determinants of delay in diagnosis in five states of India: A case-control study

The role of an active surveillance strategy of targeting household and neighborhood contacts related to leprosy cases released from treatment in a low-endemic area of China

Mortalidade relacionada à hanseníase no Estado do Piauí, Brasil: tendências temporais e padrões espaciais, 2000-2015

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