학술논문
Physical disabilities at diagnosis of leprosy in a hyperendemic area of Brazil: trends and associated factors
Document Type
Report
Author
Source
Leprosy Review. September 2015, Vol. 86 Issue 3, p240, 11 p.
Subject
Language
English
ISSN
0305-7518
Abstract
Introduction Leprosy can lead to peripheral sensory, motor and autonomic neuropathy, physical impairments and resulting permanent disabilities. Common impairments include loss of protective sensibility on eyes, hands and feet, presence [...]
Introduction: Tocantins State in north Brazil remains endemic for leprosy, with high detection rates and occurrence of disabilities at diagnosis. We analyzed trends and identified factors associated with the occurrence of disability at diagnosis. Methods: We analyzed data from the Notifiable Diseases Information System (SINAN). We included new leprosy cases resident in Tocantins, diagnosed between 2001 and 2012. Results: During the study period, there were 14,532 new leprosy cases residing in Tocantins. Of these, 12,328 (84.9%) were assessed for degree of disability at diagnosis: 9,166 (74.4%) with Grade 0; 2,498 (20.3%) with Grade 1; and 664 (5.4%) with Grade 2 disability. The proportion of disability Grade 2 remained stable over time. Factors associated with Grade 2 at diagnosis included: male gender (RR = 2.24; CI: 1.89-2.65), age [greater than or equal to] 45 years (RR = 5.31; CI: 3.21-8, 29), illiteracy (RR = 6.70; CI: 3.75-11.95), diagnosis made through mass campaigns (RR = 2.40; CI: 1.50-3.85), and residency in rural areas (RR = 1.28; CI: 1.06-1.5). Grade 2 disabilities at diagnosis were also more common in the presence of [greater than or equal to] 5 five skin lesions (RR = 4.42, CI: 3.74-5.21), leprosy reactions (RR = 2.78; CI: 2.31-3.33), multibacillary disease (RR = 7.43; CI: 6.11-9.04), and lepromatous clinical form (RR = 16.53, CI: 12.10-20.60). Conclusions: The leprosy control programme should focus on socio-economically disadvantaged and difficult-to-reach population groups. Leprosy mass campaigns and other collective examinations, to be integrated with other disease control programmes, may be an effective means to reduce disability degree at diagnosis. Keywords: Leprosy, Time Series Studies, Person Health with disabilities, Neglected Tropical Diseases
Introduction: Tocantins State in north Brazil remains endemic for leprosy, with high detection rates and occurrence of disabilities at diagnosis. We analyzed trends and identified factors associated with the occurrence of disability at diagnosis. Methods: We analyzed data from the Notifiable Diseases Information System (SINAN). We included new leprosy cases resident in Tocantins, diagnosed between 2001 and 2012. Results: During the study period, there were 14,532 new leprosy cases residing in Tocantins. Of these, 12,328 (84.9%) were assessed for degree of disability at diagnosis: 9,166 (74.4%) with Grade 0; 2,498 (20.3%) with Grade 1; and 664 (5.4%) with Grade 2 disability. The proportion of disability Grade 2 remained stable over time. Factors associated with Grade 2 at diagnosis included: male gender (RR = 2.24; CI: 1.89-2.65), age [greater than or equal to] 45 years (RR = 5.31; CI: 3.21-8, 29), illiteracy (RR = 6.70; CI: 3.75-11.95), diagnosis made through mass campaigns (RR = 2.40; CI: 1.50-3.85), and residency in rural areas (RR = 1.28; CI: 1.06-1.5). Grade 2 disabilities at diagnosis were also more common in the presence of [greater than or equal to] 5 five skin lesions (RR = 4.42, CI: 3.74-5.21), leprosy reactions (RR = 2.78; CI: 2.31-3.33), multibacillary disease (RR = 7.43; CI: 6.11-9.04), and lepromatous clinical form (RR = 16.53, CI: 12.10-20.60). Conclusions: The leprosy control programme should focus on socio-economically disadvantaged and difficult-to-reach population groups. Leprosy mass campaigns and other collective examinations, to be integrated with other disease control programmes, may be an effective means to reduce disability degree at diagnosis. Keywords: Leprosy, Time Series Studies, Person Health with disabilities, Neglected Tropical Diseases