RESUMO
AIM: To analyse differences in children and adolescents aged ≤18 years admitted to the leprosy ward in a rural Ethiopian hospital >16 years. METHODS: We retrospectively collected data from leprosy admission registry books on patients with leprosy who were admitted to a referral hospital from September 2000 to September 2016. RESULTS: There were 2129 admissions for leprosy during the study period: 180 (8.4%) patients were s ≤ 18 years old. Of these, 98 (54.4%) were male and 82 (45.6%) were female. The proportion of new diagnoses in children and adolescents was 31.7%, significantly higher than in adults (11.7%; p < 0.001). There were also significant differences in the prevalence of lepromatous ulcers (46.9 vs. 61.7%), leprosy reaction (29.4 vs. 13.0%) and neuritis (16.9 vs.5.3%) between these age groups. CONCLUSIONS: There were more new diagnoses, leprosy reactions and neuritis, and fewer lepromatous ulcers, in children and adolescents compared with adults, with younger patients being referred more frequently to reference centres.
Assuntos
Hospitalização/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Hanseníase/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Criança , Pré-Escolar , Etiópia/epidemiologia , Feminino , Hospitais Rurais/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Distribuição por SexoRESUMO
INTRODUCTION: In previous studies, women are less aware of causation and symptoms of leprosy and have less access to health care coverage than men, thus contributing to their delay in seeking for treatment. We assess the gender differences in leprosy cases admitted to a rural referral hospital in Ethiopia for 7 and a half years. METHODS: Retrospective data of the leprosy patients admitted to referral hospital were collected using leprosy admission registry books from September 2002 to January 2010. Variables were entered in an Excel 97 database. RESULTS: During the period of study, 839 patients with leprosy were admitted; 541 (64.5%) were male, and 298 (35.6%) female. Fifteen per cent of female patients, and 7.3% of male patients were paucibacillary leprosy cases while 84.8% of female patients and 92.7% of males were multibacillary leprosy cases (p<0.001). Female leprosy patients were younger than male ones (median: 36 versus 44 years) (p<0.001). In the multivariate analysis, age (odds ratio [OR]: 0.97; 95% confidence interval [CI]: 0.96-0.98; p<0.001), admission for cardiovascular diseases (OR: 7.6, 95% CI: 1.9-29.3; p=0.004), admission for gastroenteritis (OR: 14.0; 95% CI: 1.7-117; p=0.02), admission from out patients clinic (OR: 2.04; 95% CI: 1.1-4.01; p=0.02), and mortality as final outcome (OR: 3.1, 95% CI: 1.2-8.0; p=0.02) were independently associated with female gender. CONCLUSIONS: Female patients with leprosy admitted to hospital were younger, had a different profile of admission and a higher mortality rate than male ones.
Assuntos
Disparidades em Assistência à Saúde/estatística & dados numéricos , Hanseníase/terapia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Etiópia/epidemiologia , Feminino , Hospitalização/estatística & dados numéricos , Hospitais Rurais/estatística & dados numéricos , Humanos , Hanseníase/diagnóstico , Hanseníase/mortalidade , Assistência de Longa Duração/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Fatores Sexuais , Resultado do Tratamento , Adulto JovemRESUMO
We assessed the epidemiology of disabilities in leprosy cases treated in a rural hospital over a 10-year period. This is a retrospective data collection using leprosy registers and treatment cards in a rural private mission hospital. Over the 10-year period, 210 patients with leprosy were registered for treatment. One hundred and twenty-eight (61.5%) had disabilities (26.0% grade 1 and 35.6% grade 2): 13.5% ocular disabilities, 44.5% disabilities in hands and 44.7% foot impairment. Patients >19 years had more disabilities (66.7% versus 50.7%) (P = 0.03), especially ocular disabilities (16.7% in >20 versus 6.0% in <20 years) (P = 0.03). This study detected a high prevalence of disabilities.
Assuntos
Avaliação da Deficiência , Infecções Oculares Bacterianas/epidemiologia , Deformidades Adquiridas do Pé/epidemiologia , Deformidades Adquiridas da Mão/epidemiologia , Hospitais Rurais/estatística & dados numéricos , Hanseníase/complicações , Adolescente , Adulto , Criança , Pessoas com Deficiência/estatística & dados numéricos , Etiópia/epidemiologia , Infecções Oculares Bacterianas/etiologia , Feminino , Deformidades Adquiridas do Pé/etiologia , Deformidades Adquiridas da Mão/etiologia , Humanos , Hanseníase/diagnóstico , Hanseníase/tratamento farmacológico , Hanseníase/epidemiologia , Masculino , Prevalência , Sistema de Registros , Adulto JovemRESUMO
La lepra es un problema de Salud Pública en Etiopía con 0,8 casos por cada 10.000 habitantes. El Hospital General Rural de Gambo es un centro de referencia de la provincia d eArsi (Etiopía) para el tratamiento de la lepra. Durante los 9 años del estudio ingresaron889 pacientes con lepra. La estancia media de los pacientes fue de 84,12 días. Los motivos del ingreso hospitalario fueron: ulceración de las extremidades (52,3%) reacción reversa (20,3%), neuritis (9,1%) eritema nudoso leproso (4,5%), problemas oculares (1,3%) y otros problemas no relacionados con la lepra (13,5%). En los últimos 5 años fueron diagnosticados 98 nuevos casos de lepra. Nueve (99,5%) pacientes eran menores de 15 años. El estudio bacteriológico de piel y mucosa se realizó en 93 (94,8%) caso; de ellos en 55 (56,1%) pacientes la prueba fue positiva. La mayoría de los casos fueron lepra multibacilar (n=84; 85%) y solo 14 (14,3%) lepra paucibacilar. Treinta y siete (37,8%) pacientes no tenían ningún grado de incapacidad, 25 825,5%) tenían una incapacidad grado 1 y 36 (36,7%) una de grado 2. La lepra debe seguir recibiendo esfuerzos para mejorar la atención de los pacientes y disminuir las limitaciones funcionales que causan
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Assuntos
Humanos , Masculino , Feminino , Hospitais Rurais/organização & administração , Hospitais Rurais/estatística & dados numéricos , Hanseníase/epidemiologia , Hanseníase/terapia , Saúde Pública/tendências , Neurite (Inflamação)/complicações , Neurite (Inflamação)/epidemiologia , Eritema Nodoso/complicações , Eritema Nodoso/diagnóstico , Hospitais Rurais/tendências , Hospitais Rurais , Etiópia/epidemiologia , Saúde Pública/métodos , Saúde Pública/normasRESUMO
We report our experience of leprosy surgery in terms of feasibility and efficacy in a small hospital of bush in Madagascar during the period of September 1989 to January 1993. Operations of neurolysis, corrections of claw hands by the techniques of Lasso-Zancolli or Van Droogenbroeck, arthrodesis, resections and amputations have been performed. Our results suggest that at least a part of these surgical procedures may be performed by a non specialized medical team, taught on the premises. Thus, the cost of treatment will be low and accessible to more leprosy patients.