Leprosy: clinical and epidemiological study in patients above 60 years in Espírito Santo State - Brazil

Abstract: Background: Leprosy is a chronic infectious disease that is endemic in Brazil and little studied in patients over 60 years old. Objective: The aim of this study was the epidemiological and clinical description of cases of leprosy in individuals older than 60 years, notified in the State of Espírito Santo - Brazil. Methods: It was an observational, descriptive and retrospective study of leprosy patients notified between 2001 and 2011. Results: Out of 16,025 notifications, 2,510 (15.6%) were of patients over 60 years of age; the distribution among the period was egalitarian except in the last 2 years, when there was a mild reduction of cases; the average was 70 years of age (±7 years); 46% were women, being 62% of those paucibacillary cases; 1,145 (50.5%) were dark-skined people in particular among paucibacillary cases; 1,638 (72.9%) were illiterates or poorly instructed n particular among multibacillary cases (P=0.022); 59.9% patients were clinically multibacillary cases and 37.4% had positive bacilloscopy; 37.9% patients had clinical alterations on peripheral nerves, 36.7% of all the multibacillary cases were classified as grade I and 15.3% as grade in assessment of disability. Study limitations: This was a retrospective study, which used secondary data generated by physicians and notified by other professionals, whar could have enabled possible errors on original data. Conclusions: Leprosy in this age group suggests a long incubation period with reactivation of latent focus or late infection. Men were more affected, as well as the afro descendent race was statistically significant in the paucibacillary cases (P=0.000) and illiterate/poor education in multibacillary cases (P=0.022). Nearly 40% of patients had positive bacilloscopy and grade I/II disability, demonstrating a late diagnosis.

Leprosy: clinical and epidemiological study in patients above 60 years in Espírito Santo State - Brazil.

BACKGROUND: Leprosy is a chronic infectious disease that is endemic in Brazil and little studied in patients over 60 years old. OBJECTIVE: The aim of this study was the epidemiological and clinical description of cases of leprosy in individuals older than 60 years, notified in the State of Espírito Santo - Brazil. METHODS: It was an observational, descriptive and retrospective study of leprosy patients notified between 2001 and 2011. RESULTS: Out of 16,025 notifications, 2,510 (15.6%) were of patients over 60 years of age; the distribution among the period was egalitarian except in the last 2 years, when there was a mild reduction of cases; the average was 70 years of age (±7 years); 46% were women, being 62% of those paucibacillary cases; 1,145 (50.5%) were dark-skined people in particular among paucibacillary cases; 1,638 (72.9%) were illiterates or poorly instructed n particular among multibacillary cases (P=0.022); 59.9% patients were clinically multibacillary cases and 37.4% had positive bacilloscopy; 37.9% patients had clinical alterations on peripheral nerves, 36.7% of all the multibacillary cases were classified as grade I and 15.3% as grade in assessment of disability. STUDY LIMITATIONS: This was a retrospective study, which used secondary data generated by physicians and notified by other professionals, whar could have enabled possible errors on original data. CONCLUSIONS: Leprosy in this age group suggests a long incubation period with reactivation of latent focus or late infection. Men were more affected, as well as the afro descendent race was statistically significant in the paucibacillary cases (P=0.000) and illiterate/poor education in multibacillary cases (P=0.022). Nearly 40% of patients had positive bacilloscopy and grade I/II disability, demonstrating a late diagnosis.

Eco-epidemiologic study of emerging fungi related to the work of babaçu coconut breakers in the State of Maranhão, Brazil.

INTRODUCTION: There are more than 300,000 extractors using the babaçu coconut as a source of income in the States of Maranhão, Pará, Tocantins and Piauí, and this activity is associated with fungal infections. The objective of this study was to examine the occurrence of emergent fungi in the conjunctiva, nails and surface and subcutaneous injuries of female coconut breakers in Esperantinópolis, Maranhão. Additionally, soil samples and palm structures were collected. METHODS: The obtained samples were cultured in Petri dishes containing potato-dextrose-agar and chloramphenicol. The etiological agent was confirmed by a direct mycological exam and growth in culture. RESULTS: In total, 150 domiciles were visited, and samples were collected from 80 patients. From the ground, the most frequently isolated fungus was Aspergillus niger (53. 8%). the most frequently detected fungus in babaçu coconut was Aspergillus niger (66.7%). Conjunctival fungal growth occurred in 76.3% of the women. The ocular fungal microbiota consisted of filamentous fungi (80.6%), and yeasts were present in 19.4% of cases. Onychomycosis was diagnosed in 44% (11/25) of the women. CONCLUSIONS: The identification of the genera Neosartorya, Rhizopus and Curvularia in onychomycoses shows that emergent filamentous fungi can be isolated. Aspergillus sp., Penicillium sp. and Scedosporium sp. were the predominant genera found in the babaçu coconut. From ocular conjunctiva, Candida spp. were the most prevalent species isolated, and Fusarium sp. was present only in one woman. The nearly permanent exposure of coconut breakers to the external environment and to the soil is most likely the reason for the existence of a mycotic flora and fungal infections, varying according to the individual's practices and occupation.

Eco-epidemiologic study of emerging fungi related to the work of babacu coconut breakers in the State of Maranhao, Brazil

Introduction: There are more than 300,000 extractors using the babaçu coconut as a source of income in the States of Maranhão, Pará, Tocantins and Piauí, and this activity is associated with fungal infections. The objective of this study was to examine the occurrence of emergent fungi in the conjunctiva, nails and surface and subcutaneous injuries of female coconut breakers in Esperantinópolis, Maranhão. Additionally, soil samples and palm structures were collected. Methods: The obtained samples were cultured in Petri dishes containing potato-dextrose-agar and chloramphenicol. The etiological agent was confirmed by a direct mycological exam and growth in culture. Results: In total, 150 domiciles were visited, and samples were collected from 80 patients. From the ground, the most frequently isolated fungus was Aspergillus niger (53. 8%). the most frequently detected fungus in babaçu coconut was Aspergillus niger (66.7%). Conjunctival fungal growth occurred in 76.3% of the women. The ocular fungal microbiota consisted of filamentous fungi (80.6%), and yeasts were present in 19.4% of cases. Onychomycosis was diagnosed in 44% (11/25) of the women. Conclusions: The identification of the genera Neosartorya, Rhizopus and Curvularia in onychomycoses shows that emergent filamentous fungi can be isolated. Aspergillus sp., Penicillium sp. and Scedosporium sp. were the predominant genera found in the babaçu coconut. From ocular conjunctiva, Candida spp. were the most prevalent species isolated, and Fusarium sp. was present only in one woman. The nearly permanent exposure of coconut breakers to the external environment and to the soil is most likely the reason for the existence of a mycotic flora and fungal infections, varying according to the individual's practices and occupation. .