Leprosy among female prisoners in Brazil.

To estimate the prevalence of leprosy among Brazilian female prisoners and identify factors associated with the disease. Cross-sectional study conducted between 2014 and 2015 in 15 Brazilian female prisons. The data of 1,327 women were collected using Audio Computer-Assisted Self-Interviewing and dermatological and neurological examination to identify suspicious lesions of leprosy. The average age was 33.4 years. Suspicion of leprosy was identified in 5.1% of women in prison, and lifetime self-reported prevalence was 7.5%. The variables that were associated with lifetime self-reported leprosy were: women in prison once being twice as likely to have leprosy; white women were 1.4 time more likely to have leprosy than non-white women; women who knew someone with leprosy was 1.9 time more likely to have leprosy; and women who shared a cell with 11 or more women were 2.5 times more likely to have leprosy than women who shared a cell with two or fewer people. The leprosy prevalence among female prisoners in Brazil were greater than that found in a Brazilian woman of the general population and show the extremely high vulnerability of this population generated through pre-incarceration poverty, as well as potential transmission in prison.

Leprosy in a prison population: A new active search strategy and a prospective clinical analysis.

BACKGROUND: This study evaluates an active search strategy for leprosy diagnosis based on responses to a Leprosy Suspicion Questionnaire (LSQ), and analyzing the clinical, immunoepidemiological and follow-up aspects for individuals living in a prison population. METHODS: A cross-sectional study based on a questionnaire posing 14 questions about leprosy symptoms and signs that was distributed to 1,400 prisoners. This was followed by dermatoneurological examination, anti-PGL-I serology and RLEP-PCR. Those without leprosy were placed in the Non-leprosy Group (NLG, n = 1,216) and those diagnosed with clinical symptoms of leprosy were placed in the Leprosy Group (LG, n = 34). FINDINGS: In total, 896 LSQ were returned (64%), and 187 (20.9%) of the responses were deemed as positive for signs/symptoms, answering 2.7 questions on average. Clinically, 1,250 (89.3%) of the prisoners were evaluated resulting in the diagnosis of 34 new cases (LG), based on well-accepted clinical signs and symptoms, a new case detection rate of 2.7% within this population, while the NLG were comprised of 1,216 individuals. The confinement time medians were 39 months in the LG while it was 36 months in the NLG (p>0.05). The 31 leprosy cases who responded to the questionnaire (LSQ+) had an average of 1.5 responses. The symptoms "anesthetized skin area" and "pain in nerves" were most commonly mentioned in the LG while "tingling, numbness in the hands/feet", "sensation of pricks and needles", "pain in nerves" and "spots on the skin" responses were found in more than 30% of questionnaires in the NLG. Clinically, 88.2% had dysesthetic macular skin lesions and 97.1% presented some peripheral nerve impairment, 71.9% with some degree of disability. All cases were multibacillary, confirming a late diagnosis. Anti-PGL-I results in the LG were higher than in the NLG (p<0.0001), while the RLEP-PCR was positive in 11.8% of the patients. INTERPRETATION: Our findings within the penitentiary demonstrated a hidden prevalence of leprosy, although the individuals diagnosed were likely infected while living in their former communities and not as a result of exposure in the prison. The LSQ proved to be an important screening tool to help identify leprosy cases in prisons.

Prevenção à hanseníase em unidades prisionais: relatando a experiência de atividades extensionistas / Leprosy prevention in prison units: reporting the experience of extension activities / Prevención de la lepra en unidades prisionales: reportar la experiencia de las actividades de extensión

Objetivo: relatar a experiência sobre atividades educativas e investigação epidemiológica da hanseníase em unidades prisionais. Método: estudo descritivo, do tipo relato de experiência, desenvolvido em duas instituições carcerárias de Petrolina/PE. Resultados: evidenciou-se a lacuna de informações referente à hanseníase entre os detentos, bem como o elevado índice da doença e a carência de profissionais da saúde trabalhando neste meio. A educação em saúde corroborou uma ferramenta importante para a prevenção da hanseníase neste ambiente, tendo como estratégia o diálogo e o empoderamento dos envolvidos. Conclusão: é relevante o acompanhamento dos detentos com práticas extensionistas em saúde, no intuito de prevenir os elevados índices de hanseníase na comunidade carcerária e romper a cadeia de transmissão da doença por meio do diagnóstico precoce e realização correta do tratamento.(AU)

Objective: reporting the experience about educational activities and epidemiological investigation of leprosy in prisons. Method: a descriptive study of type experience report developed in two prison institutions of Petrolina/PE. Results: it was evidenced the information gap related to leprosy among the detainees, as well as the high rate of the disease and the lack of health professionals working in this place. Health education corroborated an important tool for the prevention of leprosy in this environment, with the strategy of dialogue and empowerment of those involved. Conclusion: it is relevant monitoring of inmates with extension practices in health, in order to preventing the high leprosy rates in the prison community and break the chain of transmission of the disease through early diagnosis and correct completion of the treatment.(AU)

Objetivo: presentar la experiencia en actividades educativas y de investigación epidemiológica de la lepra en las cárceles. Método: es un estudio descriptivo, del tipo de informe de experiencia, desarrollado en dos instituciones de prisión de Petrolina/PE. Resultados: se presentaron el vacío de información relacionada con la lepra entre los detenidos, así como el alto índice de la enfermedad y la falta de profesionales de la salud que trabajan en este medio. Educación para la salud corroboró una herramienta importante para la prevención de la lepra en este entorno, con estrategia de diálogo y el empoderamiento de las personas involucradas. Conclusión: es relevante el control correspondiente de los reclusos con las prácticas de extensión en salud, con el fin de evitar que las altas tasas de lepra en la comunidad penitenciaria y romper la cadena de transmisión de la enfermedad mediante el diagnóstico precoz y correcta realización del tratamiento.(AU)

Estigma e preconceito: realidade de portadores de hanseníase em unidades prisionais / Estigma y prejuicio: realidad de los portadores de lepra en las unidades prisionales / Stigmata and prejudice: reality of carriers of leprosy in prisional units

Objective: Understand the perception of leprosy patients about the stigma and prejudice experienced in prisons. Method: A qualitative, descriptive and exploratory research. The participants were five men and two women incarcerated. Data was collected through the Association Free Word Test and semistructured interview and processed by content analysis. Results: Using the Test emerged the categories Treatment, Prejudice, Symptoms and Feelings. From the interviews emerged the following categories: Leprosy from the perspective of patients and family relations; Stigma of leprosy, the impact of the diagnosis and their feelings; Refusing leprosy and Resorting to divine faith to tackle the disease. Conclusion: Negative feelings, prejudice and stigma were present in the speeches of subjects. Research and monitoring of leprosy patients become indispensable for nursing actions and for spaces of care in relation to social aspects of leprosy.

Objetivo: Conhecer a percepção dos portadores de hanseníase acerca do estigma e preconceito que vivenciam em unidades prisionais. Método: Estudo qualitativo, descritivo e exploratório. Foram participantes cinco homens e duas mulheres encarceradas. Dados coletados através do Teste de Associação Livre de Palavras e entrevista semiestruturada e tratados por Análise de Conteúdo. Resultados: Com o uso do Teste, emergiram as categorias Tratamento, Preconceito, Sintomas e Sentimentos. Das entrevistas emergiram as seguintes categorias: A hanseníase sob a ótica dos portadores e as relações familiares; O estigma da hanseníase, o impacto do diagnóstico e seus sentimentos; e Negando a hanseníase e recorrendo à fé divina para enfrentar a doença. Conclusão: Sentimentos negativos, preconceito e estigma fizeram-se presentes nos discursos dos sujeitos. A investigação e o acompanhamento de portadores de hanseníase tornam-se indispensáveis para as ações de enfermagem e para os espaços de cuidados no que se refere aos aspectos sociais da hanseníase.

Objetivo: Conocer la percepción de los pacientes de lepra sobre el estigma y los prejuicios enfrentado en las prisiones. Método: Estudio cualitativo, descriptivo y exploratorio. Los participantes fueron cinco hombres y dos mujeres encarceladas. Los datos recogidos a través de la Teste de Asociación Libre de Palabras y la entrevista semi-estructurada y procesados por análisis de contenido. Resultados: Con el uso del Teste surgieron las categorías: tratamiento, los prejuicios, síntomas y sentimientos. De las entrevistas emergieran las siguientes categorías: La perspectiva de los enfermos acerca de la lepra y las relaciones familiares; Lepra y el estigma de la sociedad, el impacto del diagnóstico y sentimientos; Ocultándose de la lepra e Recurriendo a la fe divina para enfrentarse la enfermedad. Conclusión: Sentimientos negativos, los prejuicios y el estigma estuvieron presentes en los discursos de los sujetos. La investigación y el acompañamiento de los enfermos de lepra son indispensables para las acciones de enfermería y para los espacios de atención en relación con los aspectos sociales de la lepra.

Evaluation of pityriasis versicolor in prisoners: a cross-sectional study.

BACKGROUND: Pityriasis versicolor (PV) is a mild but recurrent superficial fungal infection of stratum corneum. Many predisposing factors such as late teen and young adulthood age, tropical and subtropical climate (and to a lesser extent temperate climate), immunosuppression, malnutrition, use of oral contraceptives, hyperhidrosis, poor hygiene and a few other factors have been proposed for this condition. AIM: Regarding these probable and possible risk factors, we felt that jail is a unique population which can be affected by this infection and therefore we decided to evaluate some aspects of this infection in this population. METHODS: In this cross-sectional study in male prisoners of Bandarabbas city, 230 prisoners were randomly selected. One hundred and five (45.67%) of them were diagnosed to be infected. They were also evaluated regarding age, duration of being imprisoned, skin color, site of lesion and its pigmentation change and any concomitant clinical manifestation such as pruritus, burning or cebure. Chi-square test or Fisher's exact test was used for data analysis. RESULTS: Mean age of infected population was 31.62 +/- 8.67 years while peak incidence of PV was in 28-32 years age group. The most common color change was hypopigmentation. No case of PV hyperpigmentation was seen. We could not also observe any association between skin color and duration of being imprisoned with the frequency of infection. CONCLUSION: There seems to be no difference between pattern of infection in the general population and prisoners' population in the aspects evaluated.

Leprosy among inmates of a prison.

A leprosy survey carried out in a district prison revealed a gross prevalence of 20 cases per 1000, and active prevalence of 10 cases per 1000 whereas, prevalence of leprosy in the state was 1.12 per 1000. Such prisons thus form hyperendemic pockets. The inmates are a closed community and there is a risk of cases among inmates spreading infection to others inside the prison during their sojourn there and to the community when they are released from the prison. Special efforts are required to identify and eliminate all identifiable sources of infection, especially at this point of time when we are aiming at elimination of leprosy as a public health problem.