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1.
Lepr Rev ; 71(2): 206-11, 2000 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10920615

RESUMO

New strategies for the countries that have already achieved the elimination goal, which includes the great majority of the endemic countries, are needed. There is current concern in these countries about the reduction in the political-technical commitment when the goal is achieved and the possibility of the re-emergence of the disease. A review of the literature on the leprosy post-elimination strategy is done. The proposal to estimate the true prevalence using hidden prevalence based on late diagnosis of the new cases is made. Suggestions are explored for strategies of the work after elimination at national level is attained such as the stratification at the first sub-national level, using estimated true prevalence. It is considered necessary to define strategies for the post-elimination phase with the aim of continuing to the long-term objective of the interruption of transmission and the consequent leprosy eradication.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Hanseníase/epidemiologia , Hanseníase/prevenção & controle , Regionalização da Saúde/organização & administração , Saúde Global , Humanos , Prevalência , Organização Mundial da Saúde
2.
Rev Panam Salud Publica ; 4(3): 149-55, 1998 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-9796386

RESUMO

Leprosy, a disease that used to be shrouded in darkness and fear, can now be cured thanks to a multidrug treatment schedule with rifampicin, clofazimine, and dapsone which has been in use since 1981. In 1991 the World Health Assembly, encouraged by the efficacy of this treatment regimen, established the goal of eliminating the disease as a public health problem globally and nationally by the year 2000. This goal, which calls for reducing disease prevalence to less than one case per 10,000 inhabitants, should not be confused with the goal of eradicating the disease, which implies a complete interruption of its transmission. Eliminating leprosy is an attainable goal which will depend on the forceful and massive use of the multidrug treatment regimen. This paper describes and discusses the various initiatives that have been launched in Latin America for the purpose of achieving this goal and the results obtained so far. It also explores the factors that impact on the feasibility of eradicating the disease.


Assuntos
Hanseníase/epidemiologia , Brasil/epidemiologia , Feminino , Humanos , América Latina/epidemiologia , Hanseníase/prevenção & controle , Masculino
3.
s.l; s.n; 1997. 1 p.
Não convencional em Português | LILACS, SES-SP, HANSEN, SESSP-ILSLACERVO, SES-SP | ID: biblio-1236202
4.
Bull Pan Am Health Organ ; 30(1): 24-30, 1996 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-8919722

RESUMO

The case-control study reported here evaluated the protective effect of BCG vaccine against leprosy in São Paulo, Brazil. Seventy-eight patients under age 16 who had been diagnosed as having leprosy (cases) and 385 healthy individuals (controls) were selected and matched by sex, age, place of residence, and type of exposure to leprosy (intradomiciliary or extradomiciliary). The cases were drawn from an active patient registry and from a group of new leprosy cases treated at 50 health centers in the cities of Bauru and Ribeirão Preto in the state of São Paulo. In order to estimate the protective effect of BCG, the prevalences of BCG scars in cases and controls were compared. The presence of one or more scars was associated with an estimated protective efficacy of 90% (95% confidence interval: 78% to 96%). Stratified analysis by age group, sex, socioeconomic level, and clinical form of the disease revealed no significant differences in the protection provided by the vaccine. However, it seems clear that more data will be needed in order to accurately assess the true relevance of BCG for leprosy control programs.


Assuntos
Vacina BCG , Hanseníase/prevenção & controle , Adolescente , Brasil , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Prevalência , Fatores de Risco , Saúde da População Urbana
5.
Bol Oficina Sanit Panam ; 119(5): 415-21, 1995 Nov.
Artigo em Espanhol | MEDLINE | ID: mdl-8540997

RESUMO

The protection against leprosy conferred by BCG vaccination was evaluated in a case-control study. Selected for the study were 97 patients under 16 years of age who had been diagnosed with leprosy (cases) and 385 healthy persons (controls), who were matched according to sex, age, place of residence, and type of contact (intra- or extradomicilliary). The cases were selected from a register of active cases as well as a series of new leprosy patients treated in 50 centers in the city of São Paulo, Brasil. To estimate the protective effect of BCG, the prevalences of BCG scars among cases and controls were compared. The presence of one or more scars was associated with a protective efficacy of 90% (95% confidence interval: 78%-96%). Stratified analysis by age group, sex, socioeconomic level, and clinical form of leprosy did not reveal any important differences in the protection conferred by the vaccine. The significance of these findings and the appropriateness of using BCG in leprosy control programs is discussed.


Assuntos
Vacina BCG/imunologia , Hanseníase/prevenção & controle , Adolescente , Brasil/epidemiologia , Estudos de Casos e Controles , Criança , Avaliação de Medicamentos , Feminino , Humanos , Hanseníase/epidemiologia , Masculino , Estatística como Assunto
7.
Braz J Med Biol Res ; 27(1): 43-54, 1994 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-8173529

RESUMO

1. We have studied some generic and specific aspects of the humoral immune response in 96 patients with leprosy (29 paucibacillary and 67 multibacillary individuals). We determined serum immunoglobulins (IgM, IgG and IgA), CH50, C1q, C3 and C4, circulating immune complexes (CIC), C-reactive protein (CRP), rheumatoid factor (RF) and antinuclear antibodies. No specific pattern of general humoral immune changes could be observed. 2. The specific immune response was studied by the detection of specific IgM anti-M. leprae antibodies. An immunoradiometric assay (IRMA) and an ELISA were compared for clinical effectiveness. IRMA showed greater sensitivity for the serodiagnosis of leprosy as compared to ELISA (88.1% vs 58.2% for multibacillary patients and 20.7% vs 10.3% for paucibacillary leprosy patients). Specificity was 96% for IRMA and 97% for ELISA. 3. Our results indicate that nonspecific changes in the humoral immune response are of little value in assessing leprosy patients and that immune assays for the detection of specific anti-M. leprae antibodies may be of value in the diagnosis, study and follow-up of these patients.


Assuntos
Anticorpos Antibacterianos/análise , Hanseníase/imunologia , Mycobacterium leprae/imunologia , Adolescente , Adulto , Idoso , Anticorpos Antinucleares , Proteína C-Reativa , Criança , Feminino , Interações Hospedeiro-Parasita , Humanos , Hanseníase/diagnóstico , Hanseníase Virchowiana/diagnóstico , Hanseníase Virchowiana/imunologia , Masculino , Pessoa de Meia-Idade , Fator Reumatoide/imunologia , Sensibilidade e Especificidade
8.
Acta Leprol ; 9(2): 83-8, 1994.
Artigo em Inglês | MEDLINE | ID: mdl-7863756

RESUMO

Histopathological slides from skin biopsies of fifty-seven self-reporting patients diagnosed as indeterminate leprosy by the Leprosy Control Programme in São Paulo, were sent to three independent histopathologists. Agreement between the reports were based on the following diagnosis: "indeterminate leprosy", "suggestive leprosy" or "no leprosy". A great variation was observed in the interpretation of the histopathological examination. The three pathologists reported "indeterminate leprosy" respectively in 7.0%, 54.4% and 84.2%, of the cases studied. A kappa index of agreement between any two pathologists ranged from 0.08 to 0.32, showing poor agreement between observers. Agreement improved by pooling together the reports "suggestive leprosy" and "indeterminate leprosy". The three pathologists agreed in the results of 24 biopsies of the 27 classified as leprosy by any one of the three observers. Eight cases were considered as "no leprosy" by all pathologists. Higher agreement indices were obtained for positive and negative proportionate concordance between any two examiners. The implications of the variation in the diagnosis of indeterminate leprosy and early leprosy are discussed in the context of public health and case-management.


Assuntos
Hanseníase/patologia , Brasil , Humanos , Hanseníase/classificação , Variações Dependentes do Observador , Patologia/estatística & dados numéricos
9.
Braz. j. med. biol. res ; 27(1): 43-54, jan. 1994. ilus
Artigo em Inglês | LILACS | ID: lil-136491

RESUMO

1. We have studied some generic and specific aspects of the humoral immune response in 96 patients with leprosy (29 paucibacillary and 67 multibacillary individuals). We determined serum immunoglobulins (IgM, IgG and IgA), CH50, C1q, C3 and C4, circulating immune complexes (CIC), C-reactive protein (CRP), rheumatoid factor (RF) and antinuclear antibodies. No specific pattern of general humoral immune changes could be observed. 2. The specific immune response was studied by the detection of specific IgM anti-M. leprae antibodies. An immunoradiometric assay (IRMA) and an ELISA were compared for clinical effectiveness. IRMA showed greater sensitivity for the serodiagnosis of leprosy as compared to ELISA (88.1 percent vs 58.2 percent for multibacillary patients and 20.7 percent vs 10.3 percent for paucibacillary leprosy patients). Specificity was 96 percent for IRMA and 97 percent for ELISA. 3. Our results indicate that nonspecific changes in the humoral immune response are of little value in assessing leprosy patients and that immune assays for the detection of specific anti-M. leprae antibodies may be of value in the diagnosis, study and follow-up of these patients


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Anticorpos Antibacterianos/análise , Ensaio de Imunoadsorção Enzimática , Hanseníase/imunologia , Ensaio Imunorradiométrico , Mycobacterium leprae/imunologia , Anticorpos Antinucleares , Proteína C-Reativa , Seguimentos , Hanseníase/diagnóstico , Hanseníase Virchowiana/diagnóstico , Hanseníase Virchowiana/imunologia , Interações Hospedeiro-Parasita , Sensibilidade e Especificidade
11.
Hansenol Int ; 14(1): 14-31, 1989 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-2490875

RESUMO

Socieconomic and sanitary characteristics of São Paulo State, where the Unified and Decentralized Health System (SUDS) is being developed, are described. SUDS basic strategy is the municipalization of primary health care. The Hanseniasis Control Program (GEPRO-hanseniasis), included in this context, is analysed under the point of view of administrative connections, objectives and performance. Special programs aiming at the absorption of new technology, such as multidrugtherapy and the early serological diagnosis of the disease, are also studied.


Assuntos
Hanseníase/prevenção & controle , Atenção Primária à Saúde , Programas Médicos Regionais/organização & administração , Brasil/epidemiologia , Indicadores Básicos de Saúde , Humanos , Incidência , Hanseníase/diagnóstico , Hanseníase/epidemiologia , Prevalência , Fatores Socioeconômicos
12.
Bull Pan Am Health Organ ; 23(3): 284-94, 1989.
Artigo em Inglês | MEDLINE | ID: mdl-2790355

RESUMO

To assess the leprosy situation prevailing in 12 countries of Latin America and the Caribbean in 1980-1983, the authors reviewed data on eight indicators--four relating specifically to leprosy cases and four to general health conditions. On the basis of scores derived from these indicators, the 12 countries were classified into three groups wherein the leprosy endemic appeared to be declining, stationary, or increasing. Countries of the first group, where the leprosy endemic appeared to be receding, exhibited generally favorable leprosy-specific indicators and general health indicators, and the findings generally agreed with those of prior leprosy prevalence surveys. Similarly, those in the third group, where the endemic seemed to be increasing, showed generally unfavorable leprosy-specific indicators and general health indicators plus general agreement with prior leprosy prevalence surveys. In contrast, the results obtained for the three countries where the leprosy endemic seemed "stationary" differed substantially from one country to the next--but in all cases the "stationary" situation appeared to depend less upon a stable equilibrium than upon interaction of opposing trends.


Assuntos
Comparação Transcultural , Países em Desenvolvimento , Hanseníase/epidemiologia , Adulto , Criança , Estudos Transversais , Avaliação da Deficiência , Humanos , Incidência , América Latina
15.
Hansenol Int ; 13(1): 1-12, 1988 Jun.
Artigo em Português | MEDLINE | ID: mdl-3271235

RESUMO

This study was dedicated to the analysis the behaviour of the Hansen's, disease in Maringá, State of Paraná. Three hundred and forty eight clinical-epidemic cards were studied in patients who had Hansen's disease in the periods from 1977 to 1986. It was verified that the clinical forms Virchowian + Borderline had the highest percentual and prevailed in the age limit where people are economically active, concluding the same of a previous study which was performed by Belda & Lombardi and by Asseis et al. Tables and Figuras of the disease distribution are presented according to sex, origins, year of the detection, clinical form, age when it was diagnosed (the disease), time when symptoms appeared until the diagnosis with short comments, and its importance to the epidemic valuation of Hansen's disease in this city.


Assuntos
Hanseníase/epidemiologia , Brasil , Feminino , Humanos , Hanseníase Dimorfa/epidemiologia , Hanseníase Tuberculoide/epidemiologia , Masculino , Estudos Retrospectivos , Fatores Sexuais
20.
Hansen. int ; 6(2): 136-45, 1981.
Artigo em Português | LILACS | ID: lil-11632

RESUMO

Procedeu-se a uma reuniao bibliografica extensiva sobre a talidomida, em seus aspectos farmacologicos, metabolicos, teratogenicidade e especialmente quanto as suas aplicacoes terapeuticas em Dermatologia, destacando-se o uso na reacao hansenica


Assuntos
Humanos , Animais , Ratos , Eritema Nodoso , Hanseníase , Talidomida , Teratógenos
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