Factors associated with the development of physical disabilities in Hansen's disease.

Hansen's disease is probably the human disease that causes more damage. The aim of this study was to investigate the association between the occurrence of the association of grade 1 and 2 physical disabilities in Hansen's disease, as well as implications of joint analysis and strength of association with independent demographic and clinical variables. This is a quantitative, descriptive, retrospective, population-based and documentary study developed from 2009 to 2014 in a Hansen's disease reference center in Joao Pessoa, PB. It involved 414 medical records, the diagnosis and discharge data on socio-demographic, clinical and simplified neurological evaluation variables. Data were analyzed using descriptive (absolute frequency and percentage) and inferential (Chi-Square and Prevalence Ratio (PR) statistics techniques. Both in the diagnosis and discharge, low education level, multibacillary classification and presence of affected nerves were statistically associated to the development of disabilities (p <0.05). The gender showed association only at discharge (p <0.05). Male gender, low education level, multibacillary classification and presence of affected nerves were identified as factors associated with the development of disabilities, and the individuals were more likely to develop disabilities at discharge. There is a need for development of surveillance actions for the population group identified for the detection and early treatment of the disease. Higher chances of developing disabilities in the discharge period makes the promotion of guidelines that standardize the care of these individuals imperative.

Deficiências e incapacidades na hanseníase: do diagnóstico à alta por cura / Deficiencies and disabilities in leprosy: from the diagnosis to discharge by cure

Objetivou-se comparar o grau de incapacidade física, os sítios corporais afetados, as deficiências e incapacidades presentes e os nervos acometidos no diagnóstico e na alta em pacientes com hanseníase. Trata-se de um estudo desenvolvido entre 2009 e 2014 em centro de referência para hanseníase na Paraíba. Envolveu 414 prontuários, utilizando formulário estruturado. Os dados foram analisados através de técnicas de estatística descritiva (frequência absoluta e percentagem) e inferencial (Teste de Wilcoxon e Mcnemar). Nota-se decréscimo do acometimento dos sítios corporais (nariz p=0,000), das deficiências (ressecamento p=0,002 e ferida p=0,000 no nariz e úlcera p=0,004 nos pés) e da quantidade de nervos afetados (p=0,000) entre o diagnóstico e a alta por cura. Na análise dos anos 2009-2014 observa-se redução da quantidade de pacientes apresentando grau de incapacidade física 2. Conclui-se, portanto, que mesmo após a alta os pacientes estão propícios a desenvolver ou agravar incapacidades físicas, necessitando de acompanhamento periódico.

The aim was to compare the level of physical disability of the affected body sites, the deficiencies and disabilities present in affected nerves in the diagnosis and discharge of leprosy patients. This is a study developed between 2009 and 2014 in a reference center for leprosy in Paraíba. It involved 414 medical records, using a structured form. The data were analyzed using descriptive (absolute frequency and percentage) and inferential (Wilcoxon's and Mcnemar's tests) statistical techniques. There was a decrease of impairment in body sites (nose p=0.000), in disabilities (dryness p=0.002 and wound p=0.000 on the nose and ulcer p=0.004 in the feet) and, of the number of affected nerves (p=0.000) between the diagnosis and discharge by cure. In the analysis of the years 2009-2014, a reduction of patients presenting level 2 of physical disability was noted. Therefore, in conclusion, even after the discharge, the patients are favorable to develop or to aggravate physical disabilities, needing periodical accompaniment.

[Epidemiological analysis of leprosy in an endemic state of northeastern Brazil]. / Análise epidemiológica da hanseníase em um estado endêmico do nordeste brasileiro.

OBJECTIVE: To characterise the trend of leprosy according to epidemiological and operational indicators in the state of Paraíba in the period of 2001-2011 with projections for the years 2012-2014. METHODS: An epidemiological, retrospective, documentary study of a temporal sequence conducted with 10,476 reported cases of leprosy diagnosed in adults between 2001 and 2011 in 223 municipalities in the state of Paraiba, Brazil. The results were composed and analysed using two epidemiological indicators, an operational indicator and statistical software. RESULTS: The annual detection rate of new cases showed an upward slope between 2001 and 2005 and a declining trend from 2006. Disability showed a cyclic variation with a downward tendency and a medium level of efficiency. CONCLUSION: The results show that the disease continues to be a problem in the state and reveal the need for shorter assessments that focus on health programmes and strategies that are used to fight leprosy.

Análise epidemiológica da hanseníase em um estado endêmico do nordeste brasileiro / Análisis epidemiológica de la lepra en estado endémico del nordeste brasileño / Epidemiological analysis of leprosy in an endemic state of northeastern Brazil

RESUMO Objetivo Caracterizar a tendência, segundo indicadores epidemiológicos e operacionais, de endemia da hanseníase no Estado da Paraíba no período de 2001-2011, com projeções para os anos de 2012-2014. Métodos Estudo epidemiológico de série temporal, retrospectivo e documental, realizado com 10.476 casos notificados de hanseníase, diagnosticados entre 2001-2011, nos 223 municípios do Estado paraibano. Utilizou-se para composição e análise dos resultados dois indicadores epidemiológicos e um indicador operacional além de software estatístico. Resultados Para o coeficiente de detecção anual de casos novos, verificou-se inclinação ascendente entre os anos de 2001 a 2005, com tendência de queda a partir de 2006. Quanto à incapacidade física, visualizou-se variação cíclica, com tendência à inclinação descendente, com classificação considerada de média efetividade. Conclusão Os resultados apontaram continuidade da endemia no Estado, existindo a necessidade de avaliações mais curtas voltadas aos programas e estratégias em saúde utilizadas no combate à hanseníase.

RESUMEN Objetivo Caracterizar la tendencia, según los indicadores epidemiológicos y operacionales, la enfermedad de la lepra en el estado de Paraíba, en el período 2001-2011, con proyecciones para los años 2012-2014. Métodos Estudio epidemiológico de series temporales retrospectivas y documentales, que se realizó con 10.476 casos notificados de lepra diagnosticados entre 2001 a 2011 en 223 municipios del Estado de Paraiba. Se utilizó para la composición y el análisis de los resultados de los indicadores epidemiológicos y un indicador de funcionamiento, así como el software estadístico. Resultados Para la tasa de detección anual de nuevos casos, hubo pendiente ascendente entre los años 2001-2005, con una tendencia a la baja a partir de 2006. En cuanto a la discapacidad, visualizado si una variación cíclica, con una tendencia a inclinar abajo la clasificación considerada eficacia media. Conclusión Los resultados muestran la continuidad de la enfermedad en el Estado, hay una necesidad de revisiones más cortas enfocadas en programas y estrategias de salud utilizadas para combatir la lepra.

ABSTRACT Objective To characterise the trend of leprosy according to epidemiological and operational indicators in the state of Paraíba in the period of 2001-2011 with projections for the years 2012-2014. Methods An epidemiological, retrospective, documentary study of a temporal sequence conducted with 10,476 reported cases of leprosy diagnosed in adults between 2001 and 2011 in 223 municipalities in the state of Paraiba, Brazil. The results were composed and analysed using two epidemiological indicators, an operational indicator and statistical software. Results The annual detection rate of new cases showed an upward slope between 2001 and 2005 and a declining trend from 2006. Disability showed a cyclic variation with a downward tendency and a medium level of efficiency. Conclusion The results show that the disease continues to be a problem in the state and reveal the need for shorter assessments that focus on health programmes and strategies that are used to fight leprosy.