Risk factors for physical disability due to leprosy: a case-control study

Abstract

Background The main consequence of leprosy is physical disability. Objective To identify risk factors of physical disabilities due to leprosy. Method Case-control study carried out at the Notifiable Diseases Information System – Leprosy in the 9th Regional Health District of the state of Paraíba, Brazil, between 2001 and 2014. Cases were individuals who presented degree of physical disability 1 or 2 at diagnosis or discharge; and controls included individuals with degree of physical disability 0 also at diagnosis and discharge. A 1:1 (case:control) proportion was used. Data were analyzed using the Epi Info and BioEstat software packages. Results The following cases and controls (428 each) at risk for physical disability were analyzed: aged ≥15 years (96.5%, OR=0.33, p<0.01), males (59.3%, OR=1.82, p<0.01), low education level (70.4%, OR=2.66, p<0.01), multibacillary classification (72.9%, OR=9.29; p< 0.01), number of lesions ≥5 (34.3%, OR=0.18, p<0.01), and number of nerves affected ≥1 (12.6%, OR=0.05; p<0.01). Late diagnosis, missing/inadequately filled data, absence/non-registration of dermato-neurological evaluation, and low control of contacts were observed. Conclusion The need for active surveillance and early detection of leprosy cases and contacts is highlighted.

Caracterização de casos e indicadores epidemiológicos e operacionais da hanseníase: análise de séries temporais e distribuição espacial, Piauí, 2007-2021

“…Consequentemente, há aumento dos gastos públicos com a assistência médica e os serviços sociais para esses indivíduos. 19 Para a proporção de casos paucibacilares, a tendência decrescente poderia indicar atenuação da exposição da população ao bacilo, sinalizando, desse modo, maior controle da endemia e menor transmissão ativa da doença. 20…”

Characterization of cases and epidemiological and operational indicators of leprosy: analysis of time series and spatial distribution, Piauí state, Brazil, 2007-2021

“…Consequently, there is an increase in public spending on medical care and social services for these people. 19 …”

“…Consequently, there is an increase in public spending on medical care and social services for these people. 19 Regarding the proportion of paucibacillary cases, the falling trend could indicate attenuation of the population's exposure to the bacillus, thus signaling greater control of the endemic and less active transmission of the disease. 20 However, the rising trend in the proportion of new multibacillary cases becomes more relevant, as this form of the disease is responsible for transmission and these individuals have large quantities of bacilli in the dermis and mucous membranes, being prone to spreading them in the environment.…”

“…1 According to the Brazilian Ministry of Health, the country reported 18,143 new leprosy cases in 2021, with a detection rate of 8.51 cases per 100,000 inhabitants. The state of Piauí, located in the Northeast region of Brazil, accounted for 652 cases in the same year, with a detection rate of 19.82 cases per 100,000 inhabitants, the fifth highest rate among the Brazilian Federative Units. 2 The COVID -19 pandemic posed new challenges emerged for healthcare systems, compromising access to public healthcare services and the priority given to emergency cases.…”

Características sociodemográficas e epidemiológicas relacionadas ao grau de incapacidade física em hanseníase no estado da Paraíba, Brasil

“…Estudos realizados na Índia 20 e no Brasil [21][22][23] associam o desenvolvimento da incapacidade física na hanseníase ao menor número de anos de estudo formal, como detectado também nesta investigação. Evidências desta natureza possibilitam sugerir que pessoas com menor grau de instrução formal podem apresentar conhecimento insuficiente e/ou condições financeiras precárias que prejudicam a busca pelos serviços de saúde para a realização do diagnóstico precoce e seu devido acompanhamento.…”