Analysis of the additional protocol of diagnostic investigation of cases of leprosy in children under 15 years in priority municipalities in the state of Rio de Janeiro in 2009 and 2010

Abstract

Introduction: The occurrence of leprosy in children and adolescents is of concern because its increase is considered an indicator of severity of leprosy. The Ministry of Health established in 2008 an Additional Protocol of Diagnostic Research in Children under 15 Years (PCID <15), to be fulfilled by professionals in the health units whenever a case of leprosy in patients in this age group is diagnosed. The present study aimed to critically analyze the information contained in the files of the PCID < 15, in priority municipalities of Rio de Janeiro State. Methods: We conducted a retrospective cross-sectional study using descriptive statistics, based on the evaluation of the information contained in the records of leprosy cases registered in PCID <15 years in 2009 and 2010 from the priority municipalities according to the criteria of the Sanitary Dermatology Department of the Rio de Janeiro State Health Secretariat. We analyzed the completeness of fields including the consistency of the information fields according to the operational classification and number of skin lesions, contained in the 172 records included in the study. Results: Excellent percentage of completion, according to the parameters of SINAN, occurred in most fields, with only 15.4% of fields with regular percentage of completion (“records”, “residence time”, “number of people in the family with skin diseases”, and “BCG vaccination scar”). The study revealed a strong concordance (Kappa coefficient k = 0.76, p <0.0001) between the fields number skin lesions and operational classification, with inconsistency in only 7% of cases. There was a slight predominance of females, 92.3% of cases between 5 and 14 years, 71.6% diagnosed with six months or more after the onset of signs and symptoms, 58.6% of patients had history of leprosy in the family, 85% of cases had up to 5 skin lesions and 83.6% had a BCG scar. Among 127 patients whose records had this field fulfilled, 88,1% had no disabilities or impairments related to the disease, and disabilities/impairments predominated in the age range 5 years or more. Conclusions: PCID < 15 reflects the epidemiological situation of patients younger than 15 years with leprosy, but taking into account the duplication of information in the Information System for Disease Notification (SINAN-leprosy) and PCID <15, if it is maintained by the Ministry of Health it is important to consider the improvement of observed weaknesses.