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

Monteiro, Lorena Dias, Martins-melo, Francisco Rogerlândio, Brito, Aline Lima, Alencar, Carlos Henrique, and Heukelbach, Jorg (2015) Physical disabilities at diagnosis of leprosy in a hyperendemic area of Brazil: trends and associated factors. Leprosy Review, 86 (3). pp. 240-250.

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Abstract

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 = 224; 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 = 278; CI: 231 - 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.

Item ID: 41743
Item Type: Article (Research - C1)
ISSN: 2162-8807
Keywords: leprosy, time series studies, person health with disabilities, neglected tropical diseases
Funders: Conselho Nacional de Desenvolvimento Cientı´fico e Tecnolo´ gico (CNPq), CAPES Foundation, Brazilian Ministry of Education
Date Deposited: 08 Dec 2015 18:35
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110309 Infectious Diseases @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920109 Infectious Diseases @ 100%
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