Physical disability and social participation in patients affected by leprosy after discontinuation of multidrug therapy

Castro, Luiz Eduardo de; Cunha, Antônio José Lêdo Alves da; Fontana, Ana Paula; Halfoun, Vera Lucia Rabello de Castro; Gomes, Maria Kátia

doi:10.47276/lr.85.3.208

Cited by 19 publications

(19 citation statements)

References 15 publications

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“…13 Note that about 30% of the individuals after discharge from MDT are subject to immunological reactions that can determine additional damage to the peripheral nerve. 14 Among these individuals, those of the dimorphic clinical form (DL) stand out who, because of their immunological instability, are more predisposed to reaction states and the consequent prolonged use of corticosteroid therapy and its adverse effects.…”

Section: Discussionmentioning

confidence: 99%

Progression of peripheral nerve injury in leprosy: Evaluation of the effect of nerve decompression surgery in an endemic region of Brazil

Kenedi

Cabral

Narahashi

et al. 2021

LEPROSY

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To evaluate the progression of nerve injury in leprosy patients undergoing peripheral nerve decompression surgery. Methodology: Observational study of retrospective, descriptive-analytical cohort. In the convenience sample, individuals with leprosy who underwent peripheral nerve decompression surgery at the Casa de Saúde Santa Marcelina, Porto Velho/RO, between 2000 and 2019 were evaluated nerve by nerve, before and after surgery. Results: Note that 574 individuals underwent 2549 surgeries of the ulnar, median, tibial and/or fibular nerves. Most individuals were male (51.6%), of brown race (80.3%), multibacillary (90.9%), aged between 31 and 60 years (73.2%) and originating from other municipalities in the state of Rondônia, Northern Region of Brazil (67.4%). Most individuals maintained or improved the GD (WHO Grade of Disability), the sensory or the motor nerve function in the limbs operated.

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Section: Discussionmentioning

confidence: 99%

Progression of peripheral nerve injury in leprosy: Evaluation of the effect of nerve decompression surgery in an endemic region of Brazil

Kenedi

Cabral

Narahashi

et al. 2021

LEPROSY

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“…O dano neurológico e consequente agravamento da deficiência após a conclusão da PQT para hanseníase relaciona-se ao diagnóstico tardio, à extensão e à gravidade da doença e à presença de neurite (17) . As reações hansênicas também interferem no grau de incapacidade, por comprometerem a função neural, e podem ocorrer antes, durante ou após o tratamento (19) .…”

Section: Caracterização De Usuários No Pós-alta Em Hanseníaseunclassified

“…. No contexto da hanseníase, a restrição à participação social está associada às incapacidades físicas e ao estigma que elas carregam, o que torna importante o acompanhamento dos pacientes no pós-alta (19) . Ressalta-se que, a fim de minimizar a solidão, a rejeição e a depressão, deve ser incentivado maior cuidado e apoio para os pacientes que receberam alta (21) .…”

Section: Repercussão Social Da Hanseníaseunclassified

“…As deficiências adquiridas em decorrência da hanseníase e suas consequentes limitações físicas constituem-se empecilho no desenvolvimento de certas atividades que requerem habilidade motora. Sobre essa questão e no tocante às condições de empregabilidade, sugerem-se ocupações que não exigem força intensa e movimentos repetitivos, a fim de evitar o agravamento da patologia (19) .…”

Section: Repercussão Social Da Hanseníaseunclassified

“…Entende-se ser recomendável o desenvolvimento de programas de reabilitação, desenvolvidos com base em intervenções apoiadas nas visitas domiciliares, estímulo para o desenvolvimento das atividades diárias, incentivo para a reintegração social, reabilitação socioeconômica, bem como o desenvolvimento de grupos de autocuidado (19) . Todos os egressos do tratamento para hanseníase necessitam de acompanhamento regular, a fim de prevenir incapacidades físicas e diagnosticar precocemente casos de reações hansênicas e recidiva (15) .…”

Section: Possibilidades Terapêuticas E Acompanhamento Pós-altaunclassified

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Limitações E Incapacidades Físicas No Pós-Alta Em Hanseníase: Uma Revisão Integrativa

et al. 2016

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Objetivo: sintetizar informações produzidas sobre limitações e incapacidades físicas no pós-alta em hanseníase. Método: revisão integrativa realizada nos meses de maio e junho de 2015, nas bases de dados CINAHL, LILACS, PubMed e Scopus, utilizando os descritores indexados Hanseníase, Alta do Paciente e Pessoas com Deficiência, e seus correspondentes em inglês e espanhol, associado ao operador boleano and. Resultados: selecionaram-se 15 estudos, dos quais 26,6% estão voltados para avaliação da limitação de atividades e participação social do indivíduo no pós-alta em hanseníase, e outros 26,6%, para a avaliação das incapacidades físicas. Na análise temática, foram identificadas três categorias: caracterização de usuários no pós-alta em hanseníase; repercussão social; e possibilidades terapêuticas e acompanhamento pós-alta. Conclusão: estudos mostraram predominância de casos multibacilares com incapacidades físicas, limitações de atividades e de participação social entre os usuários no pós--alta em hanseníase, sugerindo a necessida de continuidade da assistência após a alta medicamentosa. Descritores: Hanseníase; Alta do Paciente; Pessoas com Deficiência; Saúde.Objective: to summarize the information produced about limitations and disabilities in post-treatment for leprosy. Method: integrative review conducted in May and June 2015 in CINAHL, LILACS, PubMed and Scopus databases, using the indexed descriptors: Leprosy, Patient Discharge and People with Disabilities and their counterparts in English and Spanish, together with the Boolean and operator. Results: we selected 15 studies, of which 26.6% are focused on evaluating the limitation of activities and social participation of the individual in post-treatment for leprosy and another 26.6% for the assessment of physical disabilities. Three categories were identified through thematic analysis: Profile of users in post-treatment for leprosy; Social impact; and post-treatment therapeutic possibilities and followup. Conclusion: studies have shown predominance of multibacillary cases with physical disabilities, limitations in activities and of social participation among users in post-treatment for leprosy, suggesting the need for the continuity of care after release from medication.

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Risk Factors for Physical Disability in Patients With Leprosy

et al. 2019

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(WHO) 2016-2020 Global Leprosy Strategy aims to reinvigorate efforts to control leprosy and avert leprosy disability to less than 1 per million population. OBJECTIVE To systematically identify clinical factors associated with physical disability in patients with leprosy. DATA SOURCE Searches were conducted in Scopus, PubMed, and Web of Science databases to identify studies published from January 23, 1988, to May 23, 2018, using the keywords leprosy and physical disability and related terms. STUDY SELECTION Studies that evaluated patients using the WHO leprosy disability grading system and reported the number of patients with and without disability by clinical characteristics were included. DATA EXTRACTION AND SYNTHESIS The odds ratio (OR) was used as a measure of association between the clinical features and physical disability. Summary estimates were calculated using random-effects models. MAIN OUTCOMES AND MEASURES The primary outcome was physical disability according to the WHO disability classification. The association between clinical features and physical disability was evaluated. RESULTS The search identified 2447 reports. After screening titles and abstracts, 177 full-text articles were assessed for eligibility, and 32 studies were included in the systematic review; 24 of the 32 studies included sex information (39 571 patients), of whom 24 218 (61.2%) were male. Male patients with leprosy were more likely to have physical disability than female patients with leprosy (pooled OR, 1.66; 95% CI, 1.43-1.93; I 2 , 81.3%; P < .001). Persons with multibacillary leprosy were 4-fold more likely to have physical disability than those with paucibacillary leprosy (pooled OR, 4.32; 95% CI, 3.37-5.53; I 2 , 88.9%, P < .001). Patients having leprosy reactions were more likely to have disability (pooled OR, 2.43; 95% CI, 1.35-4.36; I 2 , 92.1%; P < .001). Patients with lepromatous leprosy experienced 5-to 12-fold higher odds of disability. CONCLUSIONS AND RELEVANCE This systematic review and meta-analysis confirms the association between the presence of physical disabilities and male sex, multibacillary leprosy, leprosy reactions, and lepromatous presentation. These findings can guide the development of targeted interventions for early identification of individuals at greater risk of developing physical disabilities and education campaigns to promote early consultation to institute treatment for leprosy reactions and prevent physical disability.

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Physical disability and social participation in patients affected by leprosy after discontinuation of multidrug therapy

Cited by 19 publications

References 15 publications

Progression of peripheral nerve injury in leprosy: Evaluation of the effect of nerve decompression surgery in an endemic region of Brazil

Progression of peripheral nerve injury in leprosy: Evaluation of the effect of nerve decompression surgery in an endemic region of Brazil

Limitações E Incapacidades Físicas No Pós-Alta Em Hanseníase: Uma Revisão Integrativa

Risk Factors for Physical Disability in Patients With Leprosy

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