Physical disabilities at diagnosis of leprosy in a hyperendemic area of Brazil: trends and associated factors

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. We analyzed data from the Notifiable Diseases Information System (S...

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Veröffentlicht in:Leprosy review 2015-09, Vol.86 (3), p.240-250
Hauptverfasser: Monteiro, Lorena Dias, Martins-Melo, Francisco Rogerlândio, Brito, Aline Lima, Alencar, Carlos Henrique, Heukelbach, Jorg
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container_end_page 250
container_issue 3
container_start_page 240
container_title Leprosy review
container_volume 86
creator Monteiro, Lorena Dias
Martins-Melo, Francisco Rogerlândio
Brito, Aline Lima
Alencar, Carlos Henrique
Heukelbach, Jorg
description 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. We analyzed data from the Notifiable Diseases Information System (SINAN). We included new leprosy cases resident in Tocantins, diagnosed between 2001 and 2012. 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 ≥ 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 ≥ 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). 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.
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We analyzed trends and identified factors associated with the occurrence of disability at diagnosis. We analyzed data from the Notifiable Diseases Information System (SINAN). We included new leprosy cases resident in Tocantins, diagnosed between 2001 and 2012. 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 ≥ 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 ≥ 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). The leprosy control programme should focus on socio-economically disadvantaged and difficult-to-reach population groups. 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Grade 2 disabilities at diagnosis were also more common in the presence of ≥ 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). The leprosy control programme should focus on socio-economically disadvantaged and difficult-to-reach population groups. 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subjects Adolescent
Adult
Brazil - epidemiology
Diagnosis
Disease Notification
Endemic Diseases - statistics & numerical data
Female
Health Status Indicators
Humans
Leprosy
Leprosy - complications
Leprosy - diagnosis
Leprosy - epidemiology
Male
Middle Aged
Physiological aspects
Time Factors
Young Adult
title Physical disabilities at diagnosis of leprosy in a hyperendemic area of Brazil: trends and associated factors
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