RESUMO
OBJECTIVES: To analyse factors associated with the worsening of physical disabilities during the treatment of leprosy in Brazil in cases that were newly diagnosed in 2009. METHODS: This epidemiological study performed as a retrospective cohort investigated the factors associated with the worsening of the physical disability grade during the treatment of paucibacillary and multibacillary leprosy cases. Logistic regression with a confidence interval of 95% was used to analyse the variables associated with the worsening of disability grade. RESULTS: The cases with the greatest odds for worsening physical disability grade were patients from the south (odds ratio [OR] = 2.60) and southeast regions (OR = 1.74); with multibacillary disease (OR = 3.48); who were illiterate (OR = 2.26); and with reactive episodes (OR = 2.42). CONCLUSIONS: The factors associated with higher odds of worsening physical disability during treatment demonstrate failure to apply appropriate remedial measures to prevent disabilities, and greater attention should be given to patients with the most severe disease.
Assuntos
Avaliação da Deficiência , Pessoas com Deficiência , Hanseníase/patologia , Hanseníase/terapia , Brasil/epidemiologia , Progressão da Doença , Humanos , Hansenostáticos , Hanseníase/epidemiologia , Doenças do Sistema Nervoso/complicações , Doenças do Sistema Nervoso/etiologia , Estudos Retrospectivos , Fatores de RiscoRESUMO
Thalidomide is the best known human teratogen. Although withdrawn from the market in 1961, thalidomide was remarketed after 1965 in several countries, for the treatment of erythema nodosum leprosum. Thalidomide has a potent immunomodulatory property and has now a number of approved and off-label uses in dermatologic, oncologic, infectious and gastrointestinal conditions. In the U.S., FDA approved the use of thalidomide in 1998, but no cases of thalidomide embriophaty were registered after that. Since 1996 no new cases were reported in Latin America. However, the Teratogen Information Service (TIS) Porto Alegre, recorded three new cases of thalidomide embriophaty born in Brazil since 2005. Considering that these three cases were not registered through a systematic surveillance system, but that came to our attention through a series of coincidental random events, it can be assumed that the actual occurrence of affected babies by thalidomide continues being as frequent as denounced ten years ago.