Aspectos nutricionais de pessoas acometidas por hanseníase, entre 2001 e 2014, em municípios do semiárido brasileiro / Nutritional aspects of people affected by leprosy, between 2001 and 2014, in semi-arid Brazilian municipalities

Resumo O estudo buscou caracterizar a insegurança alimentar, o estado nutricional e os hábitos alimentares de pessoas acometidas por hanseníase. Trata-se de um estudo transversal descritivo, de população censitária, em que foram avaliados 276 casos, notificados no Sistema de Informação de Agravos de Notificação, entre 2001 e 2014, nos municípios de Vitória da Conquista e Tremedal, Bahia. Na análise foi empregada a Escala Brasileira de Insegurança Alimentar. Foram coletadas medidas de peso e altura, frequência alimentar, variáveis domiciliares, socioeconômicas, psicossociais e clínicas. A prevalência de insegurança alimentar foi de 41,0% na população; sendo 28,3% leve, 8,0% moderada e 4,7% grave. O sobrepeso/obesidade foi estimado em 60,1% das pessoas avaliadas e o consumo excessivo de sal foi relatado por 8,6%. O feijão e a carne vermelha foram os alimentos mais regularmente consumidos e houve baixo consumo de leite, hortaliças cruas e cozidas e frutas. A insegurança alimentar apresentou elevada prevalência, associada à inadequação do hábito alimentar e estado nutricional, refletindo a vulnerabilidade nutricional desta população. Recomenda-se a inserção da assistência nutricional às políticas públicas da hanseníase, como forma de qualificar a atenção à saúde.

Abstract The study aimed to characterize food insecurity, nutritional status, and eating habits of people affected by leprosy. This is a descriptive cross-sectional study based on a census population. We evaluated 276 cases, reported in the Notifiable Diseases Information System, between 2001 and 2014, in the municipalities of Vitória da Conquista and Tremedal, in the state of Bahia. Food insecurity was estimated according to the Brazilian Food Insecurity Scale. We collected weight and height measurements, meal frequency, and household, socioeconomic, psychosocial and clinical variables. The prevalence of food insecurity was 41.0% among the study population - 28.3% mild, 8.0% moderate and 4.7% severe. Overweight/obesity was estimated in 60.1% of the study participants, and excessive salt intake was reported by 8.6%. Beans and red meat were the most regularly consumed foods; there was low consumption of milk, raw and cooked vegetables, and fruits. This population presented high food insecurity prevalence, inadequate eating habits and nutritional status, reflecting nutritional vulnerability. The insertion of nutritional assistance in the leprosy control programmes is recommended, to improve health care.

Protein profile of leprosy patients with plantar ulcers from the Eastern Amazon region.

BACKGROUND: Studies investigating the nutritional status of patients with leprosy and plantar ulcers are sparse. Therefore, the objective of this study was to describe the protein profile of leprosy patients with plantar ulcers from the Eastern Amazon region. METHODS: A case record form was created for 75 patients with leprosy (31 with plantar ulcers and 44 without plantar ulcers) with the following data: sociodemographic characteristics, clinical form of leprosy, presence or absence of plantar ulcers, and nutritional assessment using anthropometry consisting of the measurement of body mass index, arm circumference, arm muscle circumference, and triceps skinfold. Levels of blood albumin, transferrin, and C-reactive protein (CRP) were also measured. Data regarding protein intake were obtained using a Food Frequency Questionnaire. RESULTS: Plantar ulcers occurred more frequently in male patients (67.7%), patients aged 40-49 years (mean ± SD: 47.3 ± 8.0 years), and patients receiving 300 or 600 USD (71.0%). The mean weight and height of patients were 71.6 ± 11.4 kg and 1.62 ± 0.1 m, respectively. High levels of CRP were detected in 51.6% of leprosy patients with plantar ulcers and only 9.1% of patients without plantar ulcers (P < 0.001). Nutritional depletion of transferrin was observed in 14.3% of patients with paucibacillary leprosy and 44.3% of patients with multibacillary leprosy (P = 0.0447). Most patients had normal levels of serum albumin (74.2% with plantar ulcers and 77.3% without plantar ulcers). CONCLUSIONS: Most leprosy patients with plantar ulcers have normal levels of serum albumin and transferrin and high CRP levels, which indicates the presence of an inflammatory process. Our findings suggest the need to monitor patients with leprosy to prevent the occurrence of plantar ulcers and to provide adequate treatment for patients with existing plantar ulcers.

Correlation between therapy and lipid profile of leprosy patients: is there a higher risk for developing cardiovascular diseases after treatment?

BACKGROUND: The impact of leprosy reduces health-related quality of life of affected patients, interfering with different factors such as nutrition. This study investigated the lipid profile, nutritional status, and risk for cardiovascular disease (CVD) in patients who underwent leprosy treatment in Brazil. METHODS: Eighty-four adult patients of both genders ranging in age from 20 to 60 years and diagnosed with paucibacillary (PB) or multibacillary (MB) leprosy were selected after undergoing multidrug treatment. The following data were collected: sociodemographic and clinical data; food intake; anthropometric measures (weight, height, and waist circumference); and lipid profile components (total cholesterol, high-density lipoprotein cholesterol [HDL-c], low-density lipoprotein cholesterol [LDL-c], and triglycerides). RESULTS: Among the study population, there was a predominance of males (65.48%) aged 50 to 60 years, patients with an income of 248-496 American dollars (63.10%), patients who completed elementary school (65.48%), inactive patients (76.19%), non-smokers (46.43%), and non-drinking patients (69.05%). The levels (mean ± standard deviation) of total cholesterol were 193.8 ± 29.4 mg/dL in the PB form and 203.5 ± 41.7 mg/dL in the MB form. The mean LDL-c was 116.9 ± 22.7 mg/dL in PB patients and 121 ± 31.3 mg/dL in MB patients. Mean triglyceride levels were 123.4 ± 45.2 mg/dL in the PB form and 147.4 ± 88.9 mg/dL in the MB form. The evaluation of nutritional status showed that 41.67% of the patients were eutrophic, while 55.96% had excess weight. Food intake was significantly associated with HDL-c in male patients (P = 0.0264) and with triglycerides in patients above the ideal weight (P = 0.0049). CONCLUSIONS: The risk of acquiring CVDs was observed to be high due to patients' excess weight and increased waist circumference. This study will guide clinicians in the adequate treatment of patients with leprosy in order to avoid adverse cardiovascular events.

Caracterização Nutricional de Pacientes com Úlceras Crônicas de Membros Inferiores em Tratamento no Ambulatório de Feridas do Campus Cedeteg da UNICENTRO, Guarapuava-PR / Nutritional Characterization of Patients with Chronic Ulcer of Lower Limb in the Outpatient Treatment of Wounds of the Campus Cedeteg Unicentro, Guarapuava-PR

Pacientes com úlceras crônicas, muitas vezes, apresentam hábitos alimentares inadequados que dificultam a cicatrização, seja pela falta denutrientes ou pelo excesso destes. Sendo assim, objetivou-se caracterizar o estado nutricional e a prevalência de doenças crônicas de pacientescom úlceras nos membros inferiores em tratamento no Ambulatório de Feridas do Campus Cedeteg da Unicentro, Guarapuava - PR. Estudotransversal quantitativo, constituído por 36 pacientes. Os dados foram obtidos em formulários estruturados. Para análise estatística foi utilizadoo programa SPSS versão 15.0 para Windows, considerando-se 5% de significância. As idades variaram de 40 a 76 anos. O tipo de úlcera maispresente na amostra foi a venosa com 72% (n=26), seguido de neuropática por hanseníase com 20% (n=7). A doença crônica mais prevalentefoi hipertensão arterial sistêmica (52,8%), seguido de insuficiência venosa (30,6%), diabetes melittus (19,4%) e obesidade (33,3%). Segundoo Índice de Massa Corporal (IMC), 41,6% apresentou eutrofia e de acordo com a circunferência da cintura (CC), 75% da amostra apresentoua medida acima do recomendado. Os valores de ingestão de nutrientes encontraram-se abaixo do recomendado para homens e para mulherespara vitamina A (p=0,0001 e p=0,002), vitamina C (p=0,001 e 0,016), zinco (p=0,080 e p=0,001) e de proteínas somente para as mulheres(p=0,020). Ainda, o grupo dos homens, apresentou uma ingestão adequada de calorias e elevada de proteínas e ferro. Percebeu-se que essespacientes necessitam de estratégias voltadas para a alimentação e controle das comorbidades, a fim de favorecer a cicatrização das úlceras.

Patients with chronic ulcers often have poor dietary habits that hinder the healing process, or by the lack of nutrients or excess thereof.Therefore, the objective was to characterize the nutritional status and the prevalence of chronic diseases of patients with leg ulcers treated atthe Clinic Wound Campus CEDETEG of Unicentro, Guarapuava - PR. Quantitative cross-sectional study consisting of 36 patients. Data wereobtained from structured forms. Statistical analysis was performed using the SPSS version 15.0 for Windows, considering 5% significance level.Their ages ranged from 40 to 76 years. The type of ulcer longer present in the venous sample was 72% (n=26), followed by neuropathic leprosywith 20% (n=7). The disease was most prevalent chronic hypertension (52.8%), followed by venous insufficiency (30.6%), diabetes mellitus(19.4%) and obesity (33.3%). According to the body mass index (BMI), 41.6% had normal weight and according to waist circumference (WC),75% showed the measure above recommended. The values of nutrient intake were found below recommended for men and women for vitaminA (p = 0.000 and p=0.002), vitamin C (p=0.00 and 0.016), zinc (p=0.080 and p=0.001) and protein only for women (p=0.020). Still, the groupof men had an adequate intake of calories and high in protein and iron. It was noticed that these patients need strategies for power and controlof comorbidities in order to promote the healing of ulcers.

Hanseníase e a nutrição: uma revisão da literatura / Leprosy and Nutrition: a review of literature

O presente estudo é uma revisão da literatura sobre hanseníase e nutrição, mostrando a importância do estado nutricional de hansenianos na melhoria da resposta ao tratamento. Foram selecionados estudos sobre hanseníase e nutrição em livros técnicos e artigos publicados no período de 2009 a 2013 utilizando-se as bases de dados Medline, LILACS, SciELO, PubMed e Bireme. Os achados do presente estudo evidenciam a importância de se avaliar estado nutricional e hábitos alimentares de pacientes portadores de hanseníase. Esses pacientes possuem déficits nutricionais em relação a dados antropométricos e a ingestão de nutrientes, que aumentam sua vulnerabilidade para baixa imunidade e consequentemente o agravo da doença. Há necessidade de novos estudos na área, pois existe uma carência de informações sobre o assunto. A implementação de programas de reeducação alimentar, educação nutricional e hábitos de vida saudáveis relacionados à promoção da saúde em pacientes com hanseníase são necessários.

The present study is a review of literature about nutrition and leprosy, showing how important nutritional status of leper are in order to improve the treatment response.The bibliographic search on leprosy and nutrition was conducted using databases such as Medline, LILACS,SciELO, PubMed and Bireme in technical books and articles published from 2009 to 2013. The findings of the study highlight the importance of assessing the nutritional status and the food habits of patients with leprosy.Those patients have nutritional deficits in relation to anthropometric data and to nutrient intake which increase their vulnerability for low immunity and, consequently, the aggravation of disease. There is a need for new studies in the area because of the lack of information about this subject. The implementation of nutritional re-education programs, nutrition education and healthy life habits related to health promotion for patients with leprosy are necessary.