Fatores preditivos de incapacidades em pacientes com hanseníase

Gonçalves, Soraya Diniz; Sampaio, Rosana Ferreira; Antunes, Carlos Maurício de Figueiredo

doi:10.1590/s0034-89102009000200007

Cited by 67 publications

(75 citation statements)

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“…Physical disability affects approximately 23.0% of leprosy patients after discharge 9 . The evaluation and monitoring of the state of the patients are essential to the preservation of the structure and function of the peripheral nerve, contributing to the early identification of neural complications and disabilities 6 .…”

Section: Palavrasmentioning

confidence: 99%

Neural complications and physical disabilities in leprosy in a capital of northeastern Brazil with high endemicity

Araujo

Aquino

Goulart

et al. 2014

Rev. bras. epidemiol.

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Introduction:Leprosy is an infectious disease whose etiologic agent is Mycobacterium leprae, manifested by dermatological and neurological signs and symptoms. Objective: To investigate neural changes and the degree of physical disability in the eyes, hands and feet before and after treatment, as well as sociodemographic and clinical profile of patients affected by leprosy. Method: A longitudinal epidemiological study comprising 155 patients with leprosy, from a spontaneous demand, diagnosed between March 2010 and February 2011, and treated with multidrug therapy (MDT) between March 2010 and July 2012 in a program for leprosy eradication in São Luis (MA), Brazil. Results: Before treatment, 46.5% of patients were considered as borderline, 51.6% had some alteration in the eyes and 52.3% in the feet, and the radial nerve (18.7%) was the most affected. There was a statistically significant difference between the changes in the radial nerve at the beginning of and after treatment. Conclusions: The analysis points to late diagnosis, as some patients have had abnormal neural and physical disabilities before treatment.

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Section: Palavrasmentioning

confidence: 99%

Neural complications and physical disabilities in leprosy in a capital of northeastern Brazil with high endemicity

Araujo

Aquino

Goulart

et al. 2014

Rev. bras. epidemiol.

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“…15 Patients and professionals equate fi nishing the treatment with a discharge from the Prevention and Rehabilitation of Disability due to Leprosy service (PRD), which is mistaken. 8 Croft et al 3 showed that in multibacillary cases, which treatment begins with nerve function already altered, there is a risk of up to 65% of presenting new damage during treatment; in paucibacillary leprosy, the risk is 16%.…”

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confidence: 99%

Deficiências após a alta medicamentosa da hanseníase: prevalência e distribuição espacial

et al. 2012

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OBJECTIVE:To estimate the frequency of people with leprosy-related physical disabilities after release from multidrug treatment and to analyze their spatial distribution. METHODS:Descriptive cross-sectional study with 232 leprosy patients treated between 1998 and 2006. Physical disabilities were assessed using the World Health Organization disability grading and the eye-hand-foot (EHF) sum score. The residential address of patients and rehabilitation centers were geocoded. It was estimated the overall frequency of physical disability and frequency by disability grade (grade 0, grade 1, and grade 2) according to the WHO disability grading taking into consideration clinical and sociodemographic variables in the descriptive analysis. Student's t-test, chi-square test (χ2), and Fisher's test were used as appropriate at a 5% signifi cance level. RESULTS:Of the patients studied, 51.6% were female, mean age 54 years old (SD 15.7), 30.5% had less than 2 years of formal education, 43.5% were employed, and 26.9% were retired. Borderline leprosy was the most prevalent form of leprosy (39.9%). A total of 32% of these patients had disabilities according to the WHO disability grading and the EHF score. Disabilities increased with age (p = 0.029), they were more common in patients with multibacillary leprosy (p = 0.005) and poor self-rated physical health (p < 0.001). Those who required prevention/rehabilitation care traveled on average 5.5 km to the rehabilitation center. People with physical disabilities lived scattered across the city but they were mostly concentrated in the most densely populated and socioeconomically deprived area. CONCLUSIONS:There is a high frequency of people with leprosy-related disabilities after release from multidrug therapy. Prevention and rehabilitation actions should target uneducated and older patients, those who had multibacillary forms of leprosy and poor self-rated physical health. The travel distance to rehabilitation centers calls for reorganization of local care networks.

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“…No Brasil, aproximadamente 23% dos pacientes hansenianos apresentam algum tipo de incapacidade após a alta 5,6 . Mesmo assim, o Ministério da Saúde preconiza que, após a conclusão do tratamento adequado, ou seja poliquimioterapia por seis a doze meses, o paciente pode ser considerado como curado e retirado das estatísticas oficiais.…”

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Incapacidade pós-tratamento em pacientes hansenianos em Várzea Grande, Estado de Mato Grosso

Ramos

Souto

2010

Rev. Soc. Bras. Med. Trop.

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RESUMOIntrodução: A hanseníase é um importante problema de saúde pública. O Brasil responde por mais de 90% dos casos do continente americano. Aproximadamente, 23% dos pacientes hansenianos apresentam algum tipo de incapacidade após a alta. Métodos: Neste estudo, estimou-se a prevalência das incapacidades em 169 pacientes (94 homens e 75 mulheres) com qualquer das formas clínicas de hanseníase no município de Várzea Grande, MT, que já haviam concluído tratamento nos anos anteriores. Foi realizada entrevista e exame clínico da sensibilidade em mãos e pés mediante os filamentos de Semmes-Weinstein. Resultados: A prevalência de incapacidades na amostra analisada foi de 42,6% sendo 10,1% de grau dois. Encontrou-se relação estatisticamente significante entre maior prevalência de incapacidades e formas multibacilares de hanseníase. Desde o término do tratamento, 84 (50,2%) pacientes apresentaram piora evolutiva da sensibilidade, sendo esta piora associada à presença de lesão neural no momento do diagnóstico. Conclusões: Estes resultados enfatizam a importância de monitorar a função neural dos pacientes, muito além do momento de finalizar a poliquimioterapia, com o intuito de prevenir a aparição de incapacidades em pacientes que já receberam alta. Palavras-chaves:Hanseníase. Incapacidades. Prevalência. ABSTRACTIntroduction: Leprosy is a major public health concern. Brazil accounts for more than 90% of the cases in the Americas. Around 23% of leprosy patients present some kind of disability after discharge. Methods: In the present study, the prevalence of disabilities among 169 patients (94 men and 75 women) with any of the clinical forms of leprosy, in the municipality of Várzea Grande, Mato Grosso, was estimated. They had already completed treatment over previous years. Interviews were conducted and clinical examinations of hand and foot sensitivity using Semmes-Weinstein filaments were carried out. Results: The prevalence of disabilities among the study sample was 42.6%, among which 10.1% was grade 2. A statistically significant relationship was found between disabilities and multibacillary forms of leprosy. Since the end of the treatment, sensitivity had worsened in 84 patients (50.2%), and this was associated with presence of neural injury at the time of diagnosis. Conclusions: These results emphasize the importance of monitoring patients' neural functioning well beyond the time of concluding polychemotherapy, with the aim of preventing the appearance of disabilities among patients who have already been discharged.

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Fatores preditivos de incapacidades em pacientes com hanseníase

Cited by 67 publications

References 12 publications

Neural complications and physical disabilities in leprosy in a capital of northeastern Brazil with high endemicity

Neural complications and physical disabilities in leprosy in a capital of northeastern Brazil with high endemicity

Deficiências após a alta medicamentosa da hanseníase: prevalência e distribuição espacial

Incapacidade pós-tratamento em pacientes hansenianos em Várzea Grande, Estado de Mato Grosso

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