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Mendes AFM, Gomes CM, Kurizky PS, Ianhez M. Case Report: A Case Series of Immunobiological Therapy (Anti-TNF-α) for Patients With Erythema Nodosum Leprosum. Front Med (Lausanne) 2022; 9:879527. [PMID: 35814767 PMCID: PMC9263440 DOI: 10.3389/fmed.2022.879527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 06/06/2022] [Indexed: 11/30/2022] Open
Abstract
Patients with leprosy may experience a chronic and severe type II leprosy reaction (ENL) erythema nodosum leprosum that may not respond to thalidomide and systemic immunosuppressants or may even cause serious adverse events. We here present four patients in whom anti-TNF-α therapy was used with successful results and compare our findings with other published cases. Four patients with chronic and severe ENL who did not respond to, at least, thalidomide and steroids (high doses) were followed up at two reference centers in Brazil. A thorough laboratory investigation was performed to exclude tuberculosis and other diseases before the start of immunobiological medication. Three patients were started on etanercept, and one patient was started on adalimumab. Of all patients, three developed severe adverse events resulting from the use of classical immunosuppressants for ENL (cataracts, deep vein thrombosis, diabetes, and osteoporosis). In all cases, a reduction in the number of ENL and, at least half of the immunosuppressant dose between 6 months and 2 years, were observed. Long-term follow-up of one patient revealed a dramatic reduction in hospital admissions due to ENL, from 12 instances in 1 year (before biologic therapy) to none (after biologic therapy), along with an improvement in condyloma acuminatum. In addition, no direct adverse events were observed with biologics. Treatment with anti-TNF-α therapy may be used as an alternative in patients with chronic and severe ENL who do not respond to traditional treatment (e.g., thalidomide, steroids, and other immunosuppressants). This treatment can help reduce the frequency of ENL, the immunosuppressive burden, and the number of hospital admissions.
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Affiliation(s)
| | - Ciro Martins Gomes
- Departamento de Dermatologia, Universidade de Brasília (UnB), Brasília, Brazil
| | | | - Mayra Ianhez
- Dermatologia, Hospital de Doenças Tropicais, Goiânia, Brazil
- Dermatologia, Universidade Federal de Goiás (UFG), Goiânia, Brazil
- *Correspondence: Mayra Ianhez
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Khanna D, de Wildt G, de Souza Duarte Filho LAM, Bajaj M, Lai JF, Gardiner E, de Araújo Fonseca AMF, Lindenmeyer A, Rosa PS. Improving treatment outcomes for leprosy in Pernambuco, Brazil: a qualitative study exploring the experiences and perceptions of retreatment patients and their carers. BMC Infect Dis 2021; 21:282. [PMID: 33740912 PMCID: PMC7980336 DOI: 10.1186/s12879-021-05980-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 03/10/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Brazil has a high leprosy burden and poor treatment outcomes (TOs), manifesting in high relapse rates. Pernambuco, an impoverished Brazilian state suffering notable geographical health inequalities, has 'hyperendemic' leprosy. Although current literature identifies barriers and facilitators influencing leprosy treatment compliance, inadequate investigation exists on other factors influencing TOs, including carers' roles and psycho-dermatological impact. This qualitative study explores experiences and perceptions of leprosy patients and their carers in Pernambuco, Brazil; to identify location-specific factors influencing TOs, and consequently inform future management. METHODS 27, semi-structured, in-depth interviews were conducted with 14 patients and 13 carers. Participants were recruited using maximum variation and snowball sampling from three clinics in Petrolina, Pernambuco. Transcripts and field notes from both participant groups were separately analysed using conventional thematic and deviant case analysis. The University of Birmingham Internal Research Ethics Committee and Instituto Lauro de Souza Lima provided ethical approval. RESULTS Two homologous sets of four, primary, interdependent themes influencing leprosy TOs emerged: 'personal factors'; 'external factors'; 'clinical factors'; and 'the healthcare professional (HCP)-patient-carer relationship'. Poor participant knowledge and lack of symptomatic relief caused patients to distrust treatment. However, because participants thought HCP-led interventions were vital for optimal TOs, patients were effectively persuaded to adhere to pharmaceutical treatments. High standard patient and population education facilitated treatment engagement by encouraging evidence-based medicine belief, and dispelling health myths and stigma. Healthcare, on occasions, was perceived as disorganised, particularly in resource-scarce rural areas, and for those with mental health needs. Participants additionally experienced incorrect/delayed diagnoses and poor contact tracing. Leprosy's negative socio-economic impact on employment - together with stigma, dependency and changing relationships - caused altered senses of identity, negatively impacting TOs. Better dialogue between patients, HCPs and carers facilitated individualised patient support. CONCLUSION This study highlights the importance of: effective evidence-based leprosy education; communication between HCPs, patients and carers; state-funded support; and healthcare resource distribution. These findings, if prioritised on governmental scales, provide the valuable insight needed to inform location-specific management strategies, and consequently improve TOs. Future research should evaluate the effectiveness of these implementations. Failure to address these findings will hinder regional elimination efforts.
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Affiliation(s)
- Divya Khanna
- Medical School, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Gilles de Wildt
- Institute of Clinical Sciences College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | | | - Mitali Bajaj
- Medical School, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Jo Freda Lai
- Medical School, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Esme Gardiner
- Medical School, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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Fonseca ABDL, Simon MDV, Cazzaniga RA, de Moura TR, de Almeida RP, Duthie MS, Reed SG, de Jesus AR. The influence of innate and adaptative immune responses on the differential clinical outcomes of leprosy. Infect Dis Poverty 2017; 6:5. [PMID: 28162092 PMCID: PMC5292790 DOI: 10.1186/s40249-016-0229-3] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 12/20/2016] [Indexed: 12/22/2022] Open
Abstract
Leprosy is a chronic infectious disease caused by Mycobacterium leprae. According to official reports from 121 countries across five WHO regions, there were 213 899 newly diagnosed cases in 2014. Although leprosy affects the skin and peripheral nerves, it can present across a spectrum of clinical and histopathological forms that are strongly influenced by the immune response of the infected individuals. These forms comprise the extremes of tuberculoid leprosy (TT), with a M. leprae-specific Th1, but also a Th17, response that limits M. leprae multiplication, through to lepromatous leprosy (LL), with M. leprae-specific Th2 and T regulatory responses that do not control M. leprae replication but rather allow bacterial dissemination. The interpolar borderline clinical forms present with similar, but less extreme, immune biases. Acute inflammatory episodes, known as leprosy reactions, are complications that may occur before, during or after treatment, and cause further neurological damages that can cause irreversible chronic disabilities. This review discusses the innate and adaptive immune responses, and their interactions, that are known to affect pathogenesis and influence the clinical outcome of leprosy.
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Affiliation(s)
- Adriana Barbosa de Lima Fonseca
- Department of Medicine, Molecular Biology Laboratory, University Hospital, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brazil
| | - Marise do Vale Simon
- Department of Medicine, Molecular Biology Laboratory, University Hospital, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brazil
| | - Rodrigo Anselmo Cazzaniga
- Department of Medicine, Molecular Biology Laboratory, University Hospital, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brazil
| | - Tatiana Rodrigues de Moura
- Department of Medicine, Molecular Biology Laboratory, University Hospital, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brazil
| | - Roque Pacheco de Almeida
- Department of Medicine, Molecular Biology Laboratory, University Hospital, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brazil.,Instituto de Investigação em Imunologia, Institutos Nacionais de Ciência e Tecnologia, CNPq, São Paulo, SP, Brazil
| | | | | | - Amelia Ribeiro de Jesus
- Department of Medicine, Molecular Biology Laboratory, University Hospital, Universidade Federal de Sergipe, São Cristóvão, Sergipe, Brazil. .,Instituto de Investigação em Imunologia, Institutos Nacionais de Ciência e Tecnologia, CNPq, São Paulo, SP, Brazil.
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Lima ASD, Pizzol VID, Fritsch S, Fonseca GP, Mulinari-Brenner FA, Muller CDS, Ottoboni VCD. Nailfold capillaroscopy in leprosy. An Bras Dermatol 2016; 91:686-687. [PMID: 27828654 PMCID: PMC5087239 DOI: 10.1590/abd1806-4841.20164814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 10/10/2015] [Indexed: 11/26/2022] Open
Abstract
Due to mounting evidences of interaction between Hansen's bacilli with
endothelial cells and the paucity of studies addressing the presence of nailfold
capillaroscopic alterations in patients with Hansen's disease, a study was
carried out in order to verify the presence of capillaroscopic alterations in
patients with leprosy in its various forms and its correlation with clinical
parameters. Ten patients were evaluated at a specialized university service.
Sixty percent of those had some capillaroscopic change, such as
micro-hemorrhages, ectatic, bushy and corkscrew capillaries. Such changes were
unspecific, which suggests there is not a specific pattern for this disease.
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Affiliation(s)
| | | | - Scheila Fritsch
- Universidade Federal do Paraná (UFPR) - Curitiba (PR), Brazil
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Lima ASD, Pinto KC, Bona MPS, Mattos SMLD, Hoffmann MP, Mulinari-Brenner FA, Ottoboni VCD. Leprosy in a University Hospital in Southern Brazil. An Bras Dermatol 2016; 90:654-9. [PMID: 26560210 PMCID: PMC4631230 DOI: 10.1590/abd1806-4841.20153959] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 10/14/2014] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Leprosy is an infectious disease that may lead to irreversible nerve damage,
compromising patient's quality of life and leading to loss of working years. OBJECTIVES To evaluate the epidemiological profile of patients followed at a University
Hospital. MATERIALS AND METHODS This is a retrospective observational study, based on a review of medical records.
We studied the clinical and epidemiological features of patients with leprosy
monitored at the Hospital de Clínicas of the Federal University of
Paraná between January 2005 and January 2010. RESULTS The mean age was 47.51, while 35.94% of patients were aged 41-60. The male:female
rate was 1.8:1. The most prevalent occupations were: retired, students or rural
workers. Patients came mainly from Curitiba or nearby areas, but there were also
patients from the countryside. The mean diagnostic delay was 24.57 months.
Multibacillary forms prevailed, with the lepromatous variety being the most
common, closely followed by the borderline type. Neural enlargement was found in
more than 50% of the patients and 48.44% of them developed reactional states.
Hemolysis was the most commonly detected drug side effect. Initial functional
evaluation was possible in 70% of patients, 55% of whom had disabilities upon
diagnosis. The most prevalent associated disease was hypertension. CONCLUSIONS This study showed an important diagnostic delay and a high rate of sequelae in
this specific population. Brazil is one of the few remaining countries that has
not yet eradicated leprosy and it is important to improve health policies in order
to prevent sequelae and achieve eradication.
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Leprosy Reaction in Thai Population: A 20-Year Retrospective Study. Dermatol Res Pract 2015; 2015:253154. [PMID: 26508912 PMCID: PMC4609858 DOI: 10.1155/2015/253154] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 09/15/2015] [Indexed: 11/21/2022] Open
Abstract
Background. Leprosy is a chronic infectious disease that presents with varying dermatological and neurological symptoms. The leprosy reactions occur over the chronic course of the disease and lead to extensive disability and morbidity. Objective. To analyze and identify the risk factors which contribute to leprosy reactions. Methods. In a retrospective study, we reviewed the medical records of leprosy patients registered at the leprosy clinic, Ramathibodi Hospital, Thailand, between March 1995 and April 2015. One hundred and eight patients were included; descriptive analysis was used for baseline characteristics and a binary logistic regression model was applied for identifying risk factors correlated with leprosy reactions. Results. Of the 108 cases analyzed, 51 were male and 57 were female. The mean age of presentation was 45 years. The borderline tuberculoid type was the most common clinical form. Leprosy reactions were documented in 61 cases (56.5%). The average time to reaction was 8.9 months. From multivariate analysis, risk factors for leprosy reactions were being female, positive bacillary index status, and MB treatment regimen. Conclusions. Leprosy reactions are common complications in leprosy patients. Being female, positive bacillary index status, and multibacillary treatment regimen are significantly associated with the reactions. Early detection in cases with risk factors followed by appropriate treatment could prevent the morbidity of leprosy patients.
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Mowla MR, Ara S, Tripura S. Leprosy profiles in post-elimination stage: a tertiary care hospital experience. Int J Dermatol 2015; 54:1407-13. [PMID: 26227884 DOI: 10.1111/ijd.12975] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 11/26/2014] [Accepted: 01/14/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Most countries that were previously highly endemic for leprosy have achieved elimination at the national level. OBJECTIVES To find out the pattern, prevalence, and trends of leprosy in the post-elimination stage. METHODS A descriptive retrospective cross-sectional study was carried out using the registered records of patients attending the leprosy clinic in Chittagong Medical College Hospital between the periods 2001 and 2011. RESULTS The new case detection rate was declining. The prevalence rate was 0.75 at the end of 2011. Of a total of 789 patients, males (74%) outnumbered the females (26%). The age of the patients in the study group ranged from 6 years to 87 years with mean age 35.58 years ± 0.05 SEM. Paucibacillary (PB) and multibacillary (MB) cases were 314 (39.80%) and 475 (60.20%), respectively. MB percentage was increasing more among new cases in the study period, and 119 (15.08%) patients presented with grade 2 deformities. Smear positive cases were 141 (17.87%). Leprosy reaction comprised of 193 (24.46%) type 1, 68 (8.62%) type 2, and 97 (12.29%) neuritis cases. LIMITATIONS This is a retrospective study from a single tertiary health center. CONCLUSION MB cases with grade 2 deformities are in an upward trend, and rates of children are declining. Developing reinforced new therapies to curb reactions, deformities are very important and contact tracing, especially of children, is essential. Domiciliary treatment needs to be made available to ensure early diagnosis.
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Affiliation(s)
- Mohammad Rafiqul Mowla
- Department of Dermatology & Venereology, Chittagong Medical College, Chittagong, Bangladesh
| | - Shamim Ara
- National Hospital Chittagong, Chittagong, Bangladesh
| | - Sanai Tripura
- Chittagong Leprosy Control Project, Chittagong, Bangladesh
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Moreira SC, Batos CJDC, Tawil L. Epidemiological situation of leprosy in Salvador from 2001 to 2009. An Bras Dermatol 2014; 89:107-17. [PMID: 24626655 PMCID: PMC3938361 DOI: 10.1590/abd1806-4841.20142175] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 03/22/2013] [Indexed: 11/22/2022] Open
Abstract
Mycobacterium leprae was first described as the bacillus that causes leprosy, a chronic granulomatous infectious disease, in 1873 by Amauer Hansen. Leprosy is part of a group of 10 neglected diseases and Bahia has endemic levels of this illness, varying between high and very high. The detection of 52 new cases of leprosy in children under 15 years old in Salvador in 2006 is alarming, and suggests an early contact with the disease. The aim of this review is to analyze the epidemiological situation, the detection rate and evaluate the clinical and epidemiological profile of leprosy in Salvador, in the period 2001-2009. A retrospective cross-sectional study was performed using secondary data collected at Notifiable Diseases Information System Database (SINAN) through the notification of patients with leprosy. Over these nine years 3,226 patients were reported, with a predominance of: females (51.5%), and clinical multibacillary forms in the general population (51.7%), but when we analyze those under 15 years old, paucibacillary forms (tuberculoid + indeterminate) prevailed. The tuberculoid form was the most diagnosed type of presentation. The annual detection rate in Salvador remained at a very high level of endemicity during the studied period and for those under 15 years old it ranged between high and very high. Grade 2 disabilities both at the time of diagnosis and at discharge after cure, varied between low and medium. Based on these data we conclude that the high levels of leprosy detection rates in the general population, plus the variation between high and very high levels in those under 15 years old, associated with the medium level of grade 2 disabilities at the time of diagnosis and discharge, demonstrate the need for improvement on the existing services, investment in active case finding and training of the healthcare professionals in Salvador.
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Affiliation(s)
- Shirlei Cristina Moreira
- Ministry of Health, SalvadorBA, Brazil, MD, Dermatologist - Physician at the Ministry of Health and at Santa Izabel Hospital - Salvador (BA), Brazil
| | - Claudilson José de Carvalho Batos
- Diseases at Couto Maia Hospital, SalvadorBA, Brazil, MD, Specialist in infectious Diseases at Couto Maia Hospital - Professor at the Science and Technology College - Salvador (BA), Brazil
| | - Lara Tawil
- MD - Private practice - Salvador (BA), Brazil
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Voorend CGN, Post EB. A systematic review on the epidemiological data of erythema nodosum leprosum, a type 2 leprosy reaction. PLoS Negl Trop Dis 2013; 7:e2440. [PMID: 24098819 PMCID: PMC3789767 DOI: 10.1371/journal.pntd.0002440] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 08/11/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Erythema Nodosum Leprosum (ENL) is a humoral immunological response in leprosy that leads to inflammatory skin nodules which may result in nerve and organ damage, and may occur years after antibiotic treatment. Multiple episodes are frequent and suppression requires high doses of immunosuppressive drugs. Global occurrence is unknown. METHODOLOGY/PRINCIPAL FINDINGS Systematic review of evidence on ENL incidence resulted in 65 papers, predominantly from India (24) and Brazil (9), and inclusive of four reviews. Average incidences are based on cumulative incidence and size of study populations (n>100). In field-based studies 653/54,737 (1.2%) of all leprosy cases, 194/4,279 (4.5%) of MB cases, and 86/560 (15.4%) of LL cases develop ENL. Some studies found a range of 1-8 per 100 person-years-at-risk (PYAR) amongst MB cases. Hospital samples indicate that 2,393/17,513 (13.7%) of MB cases develop ENL. Regional differences could not be confirmed. Multiple ENL episodes occurred in 39 to 77% of ENL patients, with an average of 2.6. Some studies find a peak in ENL incidence in the first year of treatment, others during the second and third year after starting MDT. The main risk factor for ENL is a high bacteriological index. CONCLUSIONS/SIGNIFICANCE Few studies reported on ENL as a primary outcome, and definitions of ENL differed between studies. Although, in this review averages are presented, accurate data on global and regional ENL incidence is lacking. Large prospective studies or accurate surveillance data would be required to clarify this. Health staff needs to be aware of late reactions, as new ENL may develop as late as five years after MDT completion, and recurrences up to 8 years afterwards.
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Affiliation(s)
| | - Erik B. Post
- The Royal Tropical Institute (KIT Health), Amsterdam, The Netherlands
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Girão RJS, Soares NLR, Pinheiro JV, Oliveira GDP, de Carvalho SMF, de Abreu LC, Valenti VE, Fonseca FLA. Leprosy treatment dropout: a systematic review. Int Arch Med 2013; 6:34. [PMID: 24000954 PMCID: PMC3766109 DOI: 10.1186/1755-7682-6-34] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Accepted: 08/26/2013] [Indexed: 12/03/2022] Open
Abstract
Background Leprosy is a chronic infectious disease endemic in some undeveloped areas, and still represents a public health problem in Brazil. Therefore, the control of this endemic disease depends necessarily on the institution of correct treatment and containment of treatment dropout. This study aims to conduct a systematic review of published studies on treatment dropout of leprosy. Methods We conducted a systematic review of articles on treatment dropout of leprosy, published between january 2005 and april 2013, on MEDLINE and SciELO databases. The search was performed using the MeSH terms: “leprosy”; “patients dropouts” and the keywords: “leprosy, treatment” and “noncompliance, leprosy” in association, beside the equivalents in Portuguese. Results There were originally 196 references. After analyzing the titles and abstracts of articles, 20 articles were obtained and included in the final sample. Discussion Leprosy is a notifiable disease known as its disfiguring capability and the high rate of non-compliance to treatment. The low adhesion is responsible for the remaining potential sources of infection, irreversible complications, incomplete cure and, additionally, may lead to resistance to multiple drugs. Many factors are responsible for the interruption or dropout treatment: socioeconomic factors, education level, knowledge about the disease, lack of efficiency of health services, demographics, side effects of drugs, alcoholism, among others. Conclusion The recent scientific literature about the subject diverge regarding the factors that most affect the dropout problem in treating leprosy patients. However, better integration between professionals and users, and greater commitment of the patient, are common points among the authors of the studies.
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Melão S, Blanco LFDO, Mounzer N, Veronezi CCD, Simões PWTDA. [Epidemiological profile of leprosy patients in the extreme south of Santa Catarina between 2001 and 2007]. Rev Soc Bras Med Trop 2011; 44:79-84. [PMID: 21340414 DOI: 10.1590/s0037-86822011000100018] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Accepted: 09/16/2010] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Leprosy is one of the oldest diseases of humanity and persists as a serious public health problem. Brazil has the highest incidence and second highest prevalence. In the Americas, it accounts for 93% of the cases, according to World Health Organization data from 2008. The objective of this study was to ascertain the profile of leprosy patients in the municipalities of the Association of Municipalities of the Carboniferous Region (AMREC), over the period from January 1, 2001, to December 31, 2007. METHODS This was a retrospective cross-sectional study carried out in the AMREC region in Santa Catarina, Brazil. The sample was of census type, in which all the patients notified were analyzed. RESULTS 54 patients were analyzed, among whom 57% were female and 42.6% were male. The most prevalent age group was from 30 to 39 years old (31.5%) and 79.6% had white skin color. The occupation was unknown in 51 cases, as was bacilloscopy in 98%. The tuberculoid and Virchowian forms each presented a frequency of 27.8%. The coefficient of detection observed in the municipalities ranged from low to very high. CONCLUSIONS Neither multibacillary nor paucibacillary forms predominated in the analysis, nor any specific clinical form. Nevertheless, it is known that cases are being diagnosed late because of the low percentage of indeterminate cases, with predominance among females. Added to this, the information on the notification forms is sparse, which makes it impossible to show the realities of the study population.
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Affiliation(s)
- Suelen Melão
- Faculdade de Medicina, Universidade do Extremo Sul Catarinense, Criciúma, SC.
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Simon M, Scherlock J, Duthie MS, Ribeiro de Jesus A. Clinical, immunological, and genetic aspects in leprosy. Drug Dev Res 2011. [DOI: 10.1002/ddr.20457] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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