Lepra infantil: Estudio clinico y epidemiologico en dos servicios de dermatología del Paraguya. Periodo 2005-2011 / No disponible

Introducción: La lepra en niños es más frecuente de lo que se solía pensarse, sobre todo en países tropicales y subtropicales, como el Paraguay. Pediatras y dermatólogos deberían pensar en esta enfermedad para realizar de esta manera un diagnóstico precoz con el tratamiento específico. Objetivos: Generales: Conocer las características epidemiológicas y clínicas de la lepra infantil en dos Servicios de Dermatología del Paraguay. Específicos: Establecer las características epidemiológicas de la población en estudio. Determinar la frecuencia, tipo, características clínicas y estados reaccionales relacionando con el índice bacilar. Describir el manejo terapéutico que recibieron estos pacientes y su evolución. Material y Método: Diseño del estudio: Retrospectivo, observacional de cortetransversal. El estudio se lleva a cabo en la Cátedra de Dermatología del Hospital de Clínicas, Facultad de Ciencias Médicas-Universidad Nacional de Asunción y en el Servicio de Dermatología del Hospital Nacional de Itauguá, ambos de Paraguay. Población de estudio: Pacientes de ambos sexos dentro de la definición de edad pediátrica de la OMS (0-18 años) con diagnóstico confirmado de Lepra, durante el periodo de enero de 2005 a octubre de 2011. Criterios de inclusión: Todos los pacientes en edad pediátrica diagnosticados clínicamente y con confirmación anatomopatológica. Criterios de exclusión: Pacientes lepra que no estén comprendidos en la edad pediátrica en el momento del diagnóstico y que no tengan confirmación anatomopatológica. Fuentes de información: Historias clínicas de pacientes con diagnóstico de lepra.Resultados: Total de pacientes con lepra en ambos servicios fue de 416, y de éstos 9 estaban en edad pediátrica (2.2%). Predominio de pacientes de sexo masculino; la franja estaria más afectada es la de los escolares con 5 casos (56%) El IB osciló entre negativo a 3+. Seis de los nueve casos presentaron formas multibacilares, siendo la lepra lepromatosa la forma más frecuente. La evolución fue buena en todos los casos y tres desarrollaron leprorreacciones. Fue predominante la localización facial de las lesiones. Conclusiones: Los niños con lepra constituyen un grupo significativo de enfermos donde los contactos familiares probablemente representen un rol importante en su desarrollo. Las publicaciones actuales muestran un aumento de la incidencia de la lepra en niños (AU)

Background: Leprosy among children is more common than usually thought, especially in tropical and subtropical countries like ours. Pediatricians and dermatologists should consider this disease for so early diagnosis with specific treatment. Objectives: General: To determine the epidemiological and clinical characteristics of Hansen’s disease in children in two Dermatology Services of Paraguay. Specific: To establish the epidemiological characteristics of the study population. Describe the frequency, type and clinical characteristics of Hansen’s disease. Relate the bacillary index with the type of reactions. Describe the therapeutic management of these patients. Material and Methods: Study design: Retrospective, observational cross-sectional. The study was conducted at the Department of Dermatology, Hospital de Clinicas, Faculty of Medical Sciences, National University of Asuncion and the Dermatology Service of the National Hospital Itauguá, both of Paraguay. Study population: Patients of both sexes within the definition of pediatric by the WHO (0-18 years) with confirmed diagnosis of leprosy during the period January 2005 to October 2011. Inclusion criteria: All pediatric patients clinically diagnosed with Hansen’s disease and pathologic confirmation. Exclusion Criteria: Patients with Hansen’s disease not included in the pediatric age at the diagnosis and who have no pathological confirmation. Information sources: Clinical records of pediatric patients with clinical diagnosis of Hansen’s disease, confirmed by smear and pathology. Results: Total patients with leprosy in both services was 416, and of these 9 children had Hansen’s disease (2.2%). Predominance of male patients, the most affected age group is school children with 5 cases (56%). The IB ranged from negative to 3+. Six of the nine cases had multibacillary forms (MB), the diagnosis of HL being the most frequent. The evolution was good in all cases and only three developed reactions. Facial location of the lesions was predominant. Conclusions: Children with leprosy are a significant group of patients where family contacts are likely to represent an important role in its development. Theexisting literature shows an increased incidence of childhood leprosy (AU)

Availability of childhood social services in leprosy settlements in southern Nigeria.

BACKGROUND: Children of leprosy patients deserve social services such as free education, health care services including HIV/AIDS prevention like others. The extent to which these children benefit from such services is not clear. One expects that since they are exposed to health hazards in settlements that they would benefit immensely from preventive health care and other services. Study investigates the extent to which such services are available to them. METHODS: Study was carried out in 3 purposively selected leprosy settlements, Uzuakoli in Abia State, Ohaozara in Ebonyi State and Ogbomoso in Oyo State using 86 children from 10 years and above who are available during study. Structured questionnaire and interview schedule were instruments used. Data were analyzed with Stat Pac Gold package. RESULTS: Provision of social services to children of leprosy patients studied is limited. Only 13 (16.5%) of the children said their parents did not pay school fees. The rest paid. However, despite payment of fees, higher proportion of children in Abia State 43 (95.6%) more than in Oyo State 36 (87.9%) went to school P = .03. About 42 (97.7%) of children in Abia State and 30 (83.3%) in Oyo State lack knowledge of HIV prevention. Neither reproductive health services including HIV/AIDS prevention nor prophylactic treatments are available to them. CONCLUSION: In view of above results, increased social services including HIV/AIDS prevention, prophylactic treatments and health promotions are recommended.