Enfrentamento da hanseníase em tempos de COVID-19: uma experiência exitosa de implantação de um sistema de rastreamento em área endêmica do Nordeste / Coping with leprosy in times of COVID-19: a successful experience of implementing a tracking system in an endemic area in the Northeast / Enfrentando la lepra en tiempos de COVID-19: una experiencia exitosa de implementación de un sistema de rastreo en un área endémica del Nordeste

Introdução: A COVID-19 (coronavirus disease 2019) trouxe inúmeros desafios e sobrecarga ao Sistema Único de Saúde (SUS), gerando dificuldades no enfrentamento das outras enfermidades endêmicas e negligenciadas no território brasileiro, entre elas a hanseníase. Objetivo: Relatar a experiência de enfrentamento da prevalência oculta de hanseníase por uma equipe de atenção primária à saúde do interior do estado de Sergipe durante a pandemia de COVID-19. Métodos: O projeto foi desenvolvido entre os meses de setembro de 2020 e janeiro de 2021 e caracterizou-se pela oferta de exame dermatológico aos indivíduos que buscaram atendimento na unidade de saúde do bairro Cidade Nova, em Estância, Sergipe. Confirmado o diagnóstico de hanseníase, foi introduzido o tratamento com esquema de poliquimioterapia da Organização Mundial da Saúde (PQT-OMS) e os contatos foram examinados, respeitando-se as medidas sanitárias de prevenção à contaminação pela COVID-19. Resultados: No período analisado, foram avaliados 235 indivíduos, sendo feitos seis diagnósticos clínicos de hanseníase (2,5%), entre os quais um em menor de 15 anos de idade. No município, durante todo o ano de 2020, registrou-se o total de nove casos novos de hanseníase. Sem o projeto, o coeficiente de detecção de casos novos de hanseníase no município seria de 4,3/100 mil habitantes e, com o projeto, esse coeficiente foi três vezes superior (12,9/100 mil habitantes). Conclusão: A oferta de exame dermatoneurológico durante consultas médicas de rotina em áreas vulneráveis permitiu evidenciar a prevalência oculta de hanseníase no bairro Cidade Nova, Estância. Além disso, ações dessa natureza permitem o diagnóstico precoce, evitando-se a evolução para incapacidades físicas.

Introduction: COVID-19 (coronavirus disease 2019) has brought numerous challenges and burdens on the Unified Health System (SUS, acronym in Portuguese), creating difficulties for the facing of other endemic diseases in the Brazilian territory, such as leprosy. Objective: To report an experience of coping with the hidden prevalence of leprosy by a primary health care team in the countryside of the state of Sergipe during the COVID-19 pandemic. Methods: The project was developed from September 2020 to January 2021 and was characterized for offering a dermatological examination to individuals seeking care at the health unit in the Cidade Nova neighborhood, Estância, Sergipe. For confirmed cases, treatment was instituted and household contacts were examined, respecting the measures to prevent contamination by COVID-19. Results: In the analyzed period, 235 individuals were evaluated, with six diagnoses of leprosy (2.5%), one under the age of 15. In 2020, the municipality registered nine total cases. Without the project, the detection rate of new leprosy cases in the municipality would have been 4.3/100,000 inhabitants and, with the project, this coefficient was three times higher (12.9/100,000 inhabitants). Conclusion: The offer of dermato-neurological exams during routine medical appointments made it possible to show the hidden prevalence of leprosy in the neighborhood of Cidade Nova, Estância. In addition, actions of this nature allow early diagnosis, preventing the occurrence of physical disabilities.

Introducción: La COVID-19 (enfermedad por coronavirus 2019) trajo numerosos desafíos y cargas al Sistema Único de Salud (SUS), creando dificultades para enfrentar otras enfermedades endémicas en el territorio brasileño, como la lepra. Objetivo: Informar una experiencia de afrontamiento de la prevalencia oculta de lepra por parte de un equipo de atención primaria en el interior del estado de Sergipe durante la pandemia de COVID-19. Métodos: El proyecto se desarrolló desde septiembre de 2020 hasta enero de 2021 y se caracterizó por ofrecer un examen dermatológico a las personas que buscaban atención en la unidad de salud del barrio Cidade Nova, en Estância, Sergipe. En caso de confirmarse los casos, se instituyó el tratamiento y se examinaron los contactos domiciliarios, respetando las medidas para prevenir la contaminación por COVID-19. Resultados: En el período analizado se evaluaron 235 individuos, con 06 diagnósticos de lepra (2,5%), uno menor de 15 años. En 2020, el municipio registró nueve casos en total. Sin el proyecto, la tasa de detección de nuevos casos de lepra en el municipio sería de 4,3/100 mil habitantes y, con el proyecto, este coeficiente era tres veces mayor (12,9/100 mil habitantes). Conclusión: La oferta de exámenes dermatoneurológicos durante las consultas médicas de rutina permitió mostrar la prevalencia oculta de la lepra en el barrio Cidade Nova, Estância. Además, acciones de esta naturaleza permiten un diagnóstico precoz, evitando la aparición de discapacidades físicas.

Epidemiological aspects of leprosy in Juazeiro-BA, from 2002 to 2012

Abstract: BACKGROUND: Leprosy is an infectious disease caused by Mycobacterium leprae, able to infect large numbers of people. This work is relevant to Juazeiro-BA, a hyper-endemic area for leprosy, since unravel the behavior of the disease in the area, may suggest the decision making for sectors of surveillance, establishing strategies, organizing and evaluating programs and services. OBJECTIVES: To analyze the epidemiology of leprosy in Juazeiro-BA, from 2002 to 2012. METHODS: A descriptive, cross-sectional study was conducted based in data of the Diseases Notification System, assigned by the service of Epidemiology from Juazeiro-BA, between 2002 and 2012. RESULTS: 1,916 new cases of leprosy were detected between 2002 and 2012, of which 921 (48.07%) represented male sex, 995 (51.93%) female, and there was a reduction in the incidence rate of leprosy per 100,000 inhabitants. Most carriers were brown individuals, with low levels of education, living in the urban area, being more prevalent in the economically active age group. Through statistical analysis we found that there are more chances of developing sequelae among men, and multibacillary individuals older than 45 years. CONCLUSIONS: The work serves to direct efforts to control this disease, and highlights the importance of active search for new cases to achieve an early diagnosis, reducing the number of sequels and allowing breaking the chain of disease transmission.

Epidemiological aspects of leprosy in Juazeiro-BA, from 2002 to 2012.

BACKGROUND: Leprosy is an infectious disease caused by Mycobacterium leprae, able to infect large numbers of people. This work is relevant to Juazeiro-BA, a hyper-endemic area for leprosy, since unravel the behavior of the disease in the area, may suggest the decision making for sectors of surveillance, establishing strategies, organizing and evaluating programs and services. OBJECTIVES: To analyze the epidemiology of leprosy in Juazeiro-BA, from 2002 to 2012. METHODS: A descriptive, cross-sectional study was conducted based in data of the Diseases Notification System, assigned by the service of Epidemiology from Juazeiro-BA, between 2002 and 2012. RESULTS: 1,916 new cases of leprosy were detected between 2002 and 2012, of which 921 (48.07%) represented male sex, 995 (51.93%) female, and there was a reduction in the incidence rate of leprosy per 100,000 inhabitants. Most carriers were brown individuals, with low levels of education, living in the urban area, being more prevalent in the economically active age group. Through statistical analysis we found that there are more chances of developing sequelae among men, and multibacillary individuals older than 45 years. CONCLUSIONS: The work serves to direct efforts to control this disease, and highlights the importance of active search for new cases to achieve an early diagnosis, reducing the number of sequels and allowing breaking the chain of disease transmission.