Factors influencing inadequate diagnosis and follow-up of leprosy reactions in Rondônia state, Brazil

Authors

  • Carmelita Ribeiro de Oliveira Especialista em Gestão de Sistemas e Serviços de Saúde. Coordenação do Programa de Controle de Hanseníase - Agência de Vigilância em Saúde - Secretaria Estadual de Saúde de Rondônia.
  • Maria de Jesus Freitas de Alencar Mestranda em Saúde Pública pela Universidade Federal do Ceará. Agência de Vigilância em Saúde Secretaria Estadual de Saúde de Rondônia.
  • Sônia Carvalho de Santana Enfermeira. Técnica da Secretaria Municipal de Saúde de Ariquemes – Rondônia.
  • Sebastião Alves de Sena Neto Assessor de Sistemas de Informação da Gerência de Vigilância Epidemiológica e Ambiental da Secretaria Estadual de Saúde de Rondônia.
  • Alberto Novaes Ramos Jr Doutorando em Ciências Médicas pela Universidade Federal do Ceará. Professor do Departamento de Saúde Comunitária da Universidade Federal do Ceará.

DOI:

https://doi.org/10.47878/hi.2007.v32.36304

Keywords:

leprosy, complication, epidemiology, prevention of disabilities, leprosy reactions

Abstract

Leprosy reactions continue being one of the great challenges for National Leprosy Control Programs in endemic countries. The clinical aspects of reactions are well known, but data on the epidemiology are scanty. This hinders the elaboration of effective control strategies. In this study, factors were characterized which influenced inadequate diagnosis and follow-up of patients with leprosy reactions, as well as the impact of reactions on the development of physical disabilities. The descriptive operational study was done in Rondônia State in 1997, based on newly diagnosed cases and those that received discharge for cure. Data on leprosy reactions were obtained from medical records. Patients with reactions after discharge and progression of disability during treatment were interviewed, and a clinical evaluation was done. In addition, we described the structure of the Leprosy Control Programs in selected municipalities. Our data show that in Rondônia, despite progress in case detection, better availability of multidrug therapy, and reduction of disability grade at diagnosis and discharge from treatment, there continue to be difficulties in the management of leprosy reactions. Thus, it is necessary to define priorities focussing on the management of reactions, as a strategy to improve integrated patient care.

Downloads

Download data is not yet available.

References

1. Willcox ML. The impact of multidrug therapy on leprosy disabilities. Lepr Rev 1997; 68(1): 350-66.
2. Ministério da Saúde (BR). Secretaria de Políticas de Saúde. Departamento de Atenção Básica. Área Técnica de Dermatologia Sanitária. Legislação sobre o controle da Hanseníase no Brasil. Brasília: Ministério da Saúde; 2000.
3. Smith WCS. Review of current research in the prevention of nerve damage in leprosy. Lepr Rev 2000; (71): S138-S45.
4. Ministério da Saúde (BR). Secretaria de Políticas de Saúde. Departamento de Atenção Básica. Área Técnica de Dermatologia Sanitária. Hanseníase: Atividades de Controle e Manuais de Procedimentos. Brasília: Ministério da Saúde; 2001.
5. Ministério da Saúde (BR). Secretaria de Políticas de Saúde. Departamento de Atenção Básica. Área Técnica de Dermatologia Sanitária. Guia para o Controle da Hanseníase. Série Cadernos de Atenção Básica. Brasília: Ministério da Saúde; 2002.
6. World Health Organization. Expert Committee on Leprosy. (WHO Technical Report Series, 874). Geneva: World Health Organization; 1998.
7. Richardus JH, Meima A, Croft RP, Habbema JDF. Case detection, gender and disability in leprosy in Bangladesh: a trendanalysis. Lepr Rev 1999; 70(2): 160-73.
8. Van Brakel W.H. Periferal neuropathy in leprosy and its consequence. Lepr Rev 2000; (71): S146-S53.
9. Saunderson, P. The epidemiology of reactions and nerve demage. Lepr Rev 2000; (71): S106-S10.
10. Organização Mundial da Saúde. Manual para o controle de lepra. 2 ed. Washington: OMS; 1989.
11. Tropical: Hanseníase. 3 ed. Manaus; 1997. 165 p.
12. Van Brakel WH, Reed NK, Reed DS. Grading impairment in leprosy. Lepr Rev 1999; 70(2): 180-88.
13. Governo do Estado de Rondônia. Indicadores Municipais 1998/1999. Porto Velho: Seplan; 1999.
14. Meima A, Saunderson PR, Gebre S, Khabbema JDF. Dynamics of impairment during and after treatment: the AMFES cohort. Lepr Rev 2001; 72(2): 158-70.
15. Meima A, Saunderson PR, Gebre S, Desta K, Van Oortmars sen GJ, Habbema JDF. Factors associated with impairments in new leprosy patients: the AMFES cohort. Lepr Rev 1999; 70(2): 189-203.
16. Croft IRP, Niicholls PG, Richardus JH, Smith WCS. Incidence rates of acute nerve function impairment in leprosy: a prospective cohort analysis after 24 months (Bangladesh Acute Nerve Damage Study). Lep Rev 2000; 71(1): 18-33.
17. Nery JAC, Vieira LMM, Matos HJ, Gallo MEN, Sarno EN. Reactional states in multibacillary hansen disease patients during multidrug therapy. Rev Inst Med Trop S Paulo 1998; 40(6): 363-70.
18. Martelli CMT, Andrade ALSS, Grossi MAF, Leboeuf MAA, Lombardi C, Zicker F. Change in leprosy clinical pattern after multidrug therapy implementation. Int J Lepr 1995; 63(1): 95-7.
19. Croft IRP, Niicholls PG, Richardus JH, Smith WCS. Nerve function impairment in leprosy: design, methodology and intake status of a prospective cohort study of 2664 new leprosy cases in Bangladesh. The Bangladesh Nerve Damage Study. Lepr Rev 1999; 70(2): 140-59.
20. Nery JAC, Garcia CC, Wanzeller SHO, Sales AM, Gallo MEN, Vieira LMM. Características clínico-histopatológicas dos estados reacionais na Hanseníase em pacientes submetidos à poliquimioterapia (PQT). An Bras Dermatologia 1999; 74(1): 27-33.
21. Feliciano KVO, Kovacs MH, Sevilla E, Alzate A. Percepción de la lepra y las discapacidades antes del diagnóstico en Recife, Brasil. Rev Panam Salud Publica 1998; 3(5): 293-302.
22. Bechelli LM. Alguns aspectos psicológicos, sociais e econômicos relacionados com a lepra. J Bras Psiq 1987; 36(6): 321-4.
23. Amilarian MLT, Pinto EB, Ghirardi MIG, Lichtig I, Masini EFS, Pasqualin L. Conceituando deficiência. Rev Saúde Pública 2000; 34(1): 97-103.
24. Centers for Disease Control and Prevention (CDC - Atlanta - USA), Aplicativo Epi-Info versão 6.04d [CD ROM].
Statistical Package for Social Sciences (SPSS) em sua versão 25 9.0 [CD ROM].

Published

2007-11-30

How to Cite

1.
Oliveira CR de, Alencar M de JF de, Santana SC de, Neto SA de S, Ramos Jr AN. Factors influencing inadequate diagnosis and follow-up of leprosy reactions in Rondônia state, Brazil. Hansen. Int. [Internet]. 2007 Nov. 30 [cited 2024 Jul. 3];32(2):185-96. Available from: https://periodicos.saude.sp.gov.br/hansenologia/article/view/36304

Issue

Section

Original articles

Most read articles by the same author(s)