Interruption and Defaulting of Multidrug Therapy against Leprosy: Population-Based Study in Brazil's Savannah Region

Heukelbach, Jörg; Chichava, Olga André; Oliveira, Alexcian Rodrigues de; Häfner, Kathrin; Walther, Friederike; Alencar, Carlos Henrique; Ramos, Alberto Novaes; Ferreira, Adriana Cavalcante; Ariza, Liana

doi:10.1371/journal.pntd.0001031

Cited by 42 publications

(42 citation statements)

References 15 publications

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“…These actions are essential, but not sufficient for the control of the disease in a territory marked by misery and poverty 10,16,18 . On the other hand, the 139 municipalities had average coverage of the FHS above 60.0% during the 12 years of the study.…”

Section: Discussionmentioning

confidence: 99%

Social determinants of leprosy in a hyperendemic State in North Brazil

et al. 2017

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OBJECTIVE To identify the socioeconomic, demographic, operational, and health service-related factors associated with the occurrence of leprosy in a hyperendemic State in North Brazil.METHODS This is an ecological study based on secondary data from the Sistema de Informações de Agravos de Notificação in municipalities of the State of Tocantins from 2001 to 2012. Units of analysis were the 139 municipalities of the State. Negative binomial log linear regression models were used to estimate incidence rate ratios.RESULTS In bivariate analysis, the incidence rate ratios were significantly higher for municipalities with higher income ratio of the poorest 20.0% (1.47; 95%CI 1.19–1.81) and better Municipal Human Development Index (1.53; 95%CI 1.14–2.06). In multivariate analysis, the incidence rate ratios were significantly higher in municipalities with higher proportion of immigrants (1.31; 95%CI 1.11–1.55) and higher proportion of households with waste collection (1.37; 95%CI 1.11–1.69). There was a significant reduction in the incidence rate ratio with increased coverage of the Bolsa Família Program (0.98; 95%CI 0.96–0.99).CONCLUSIONS Control programs need to focus on activities in municipalities of greater social vulnerability with intersectoral investment for the improvement of the living conditions of the population.

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Section: Discussionmentioning

confidence: 99%

Social determinants of leprosy in a hyperendemic State in North Brazil

et al. 2017

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“…Em relação às características dos indivíduos que participaram do estudo, estas foram, de uma forma geral, semelhantes às da maioria da população brasileira no que se refere ao grau de escolaridade das pessoas com hanseníase [7][8][9][10][11]25 . Outros estudos conduzidos nos dois municípios estudados reforçam tal achado 26,27 .…”

Section: Discussionunclassified

Atenção pós-alta em hanseníase no Sistema Único de Saúde: aspectos relativos ao acesso na região Nordeste

et al. 2014

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Cad. Saúde Colet., 2014, Rio de Janeiro, 22 (4): 351-8Resumo O acesso universal aos serviços de saúde representa um processo complexo de inter-relações. Em um sentido mais amplo, incorpora dimensões que passam por aspectos econômicos, técnicos, políticos e simbólicos. Para doenças negligenciadas, como a hanseníase, por exemplo, reverte-se em maiores desafios. Este estudo objetivou caracterizar o acesso aos serviços de saúde por pessoas atingidas pela hanseníase em pós-alta de poliquimioterapia (PQT) nos municípios de Fortaleza e Sobral. Estudo transversal descritivo que incluiu 10% da população que recebeu alta entre 2003 e 2005 (304 pessoas), com caracterização sociodemográfica e clínica, bem como exploração de modalidades e contextos relativos ao acesso no pós-alta. A população era em sua maioria masculina (58%), com alta proporção de incapacidades físicas (34%) e estados reacionais (37%). A abordagem biomédica dos estados reacionais contemplou, em grande parte, a busca e a oferta de atenção nesse período. O acesso à atenção pós-alta foi frágil principalmente em intervenções como cirurgias reabilitadoras e atenção psicológica. Foram identificadas importantes lacunas em termos da operacionalização da atenção às pessoas atingidas no momento do pós-alta em ambos os municípios, o que traduz a relativa negligência em relação à hanseníase como condição crônica e o consequente distanciamento para a abordagem integral a essas pessoas no Sistema Único de Saúde (SUS).Palavras-chave: hanseníase; acesso aos serviços de saúde; atenção à saúde. AbstractUniversal access to health services represents a complex process of inter-relationships between users and health services. In a broader sense it includes economic, technical, political and symbolic aspects. For neglected diseases such as leprosy, this is a major challenge. This cross-sectional study aims to characterize access to health care services for people affected by leprosy after release from treatment in the cities of Sobral and Fortaleza. The study included a representative sample 10% of those concluding treatment from 2003 to 2005 (304 cases). Participants were characterized regarding socio demographic and clinical variables and access to health services after release from treatment. The study population was mostly male (58%), physical disabilities (34%) and with leprosy reactions (37%). The biomedical approach of leprosy reactions contemplated in large part to search for and supply of care in this period. The access to care after discharge was particularly weak in rehabilitative interventions such as surgery and psychological attention. We identified important gaps in the operationalization of attention to people affected after release from treatment in both cities. The date also shows the negligence of leprosy as a chronic condition and the resulting difficulties regarding on integrated distance to the comprehensive approach to people with leprosy after release from treatment in the Unified Health System (SUS).

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“…Mas houve maior percentual dos casos paucibacilares, acompanhando o padrão clínico epidemiológico nacional e estadual 6,24,29,30 .…”

Section: Resultsunclassified

Body fat percentage and body mass index in a probability sample of an adult urban population in Brazil

Anjos¹,

Teixeira²,

Wahrlich³

et al. 2013

Cad. Saúde Pública

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Interruption and Defaulting of Multidrug Therapy against Leprosy: Population-Based Study in Brazil's Savannah Region

Cited by 42 publications

References 15 publications

Social determinants of leprosy in a hyperendemic State in North Brazil

Social determinants of leprosy in a hyperendemic State in North Brazil

Atenção pós-alta em hanseníase no Sistema Único de Saúde: aspectos relativos ao acesso na região Nordeste

Body fat percentage and body mass index in a probability sample of an adult urban population in Brazil

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