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J Med Microbiol ; 73(2)2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38362924


Introduction. We have examined four burials from the St Mary Magdalen mediaeval leprosarium cemetery in Winchester, Hampshire, UK. One (Sk.8) was a male child, two (Sk.45 and Sk.52) were adolescent females and the fourth (Sk.512) was an adult male. The cemetery was in use between the 10th and 12th centuries. All showed skeletal lesions of leprosy. Additionally, one of the two females (Sk.45) had lesions suggestive of multi-cystic tuberculosis and the second (Sk.52) of leprogenic odontodysplasia (LO), a rare malformation of the roots of the permanent maxillary incisors.Gap statement. Relatively little is known of the manifestations of lepromatous leprosy (LL) in younger individuals from the archaeological record.Aims and Methodology. To address this, we have used ancient DNA testing and osteological examination of the individuals, supplemented with X-ray and microcomputed tomography (micro-CT) scan as necessary to assess the disease status.Results and Conclusions. The presence of Mycobacterium leprae DNA was confirmed in both females, and genotyping showed SNP type 3I-1 strains but with a clear genotypic variation. We could not confirm Mycobacterium tuberculosis complex DNA in the female individual SK.45. High levels of M. leprae DNA were found within the pulp cavities of four maxillary teeth from the male child (Sk.8) with LO, consistent with the theory that the replication of M. leprae in alveolar bone may interfere with root formation at key stages of development. We report our biomolecular findings in these individuals and review the evidence this site has contributed to our knowledge of mediaeval leprosy.

Hanseníase Multibacilar , Hanseníase , Adulto , Criança , Humanos , Masculino , Feminino , Adolescente , Microtomografia por Raio-X , Hanseníase/microbiologia , Mycobacterium leprae/genética , DNA Bacteriano/genética , Reino Unido
Dan Med J ; 70(10)2023 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-37897389


INTRODUCTION: Groin hernias in adolescents are rare and their management is associated with challenges for surgeons as some adolescents are fully grown, whereas others are not. Current groin hernia guidelines only differentiate between young children and adults; hence, no guidelines exist that may aid surgeons in handling adolescents. The aim of this study was to explore surgeons' considerations on the management of groin hernias in adolescents. METHODS: We conducted a qualitative study using pilot-tested individual semi-structured interviews. The participants were surgical specialists with experience in groin hernia repair in adolescents aged 10-17 years. Data were analysed using content analysis where essential quotes were extracted from transcripts and coded, categorised and interpreted into themes. RESULTS: Sixteen surgeons were included. Their considerations were reflected in four themes: 1) mesh-related concerns, 2) watchful waiting, 3) growth and 4) lack of evidence and guidelines. Surgeons performed sutured repairs on adolescents who are still growing due to concerns about mesh-related complications. A watchful waiting strategy was used by some to postpone surgery until adolescents were fully grown, thereby enabling mesh repair. Methods for evaluating growth varied and were not standardised. Finally, surgeons highlighted the need for evidence and guidelines to support their decision-making. CONCLUSIONS: This study found a lack of consensus and uniformity on the management of groin hernias in adolescents. Increased research efforts producing clinical guidelines are needed. FUNDING: This study was funded by the Michaelsen Foundation, the Aage and Johanne Louis-Hansens Foundation, Direktør Emil C. Hertz and Hustru Inger Hertz' Foundation, and the Torben and Alice Frimodts Foundation. The funders had no role in the design, conduct or reporting of the study. TRIAL REGISTRATION: not relevant.

Hérnia Femoral , Hérnia Inguinal , Laparoscopia , Cirurgiões , Adulto , Criança , Humanos , Adolescente , Pré-Escolar , Virilha/cirurgia , Hérnia Femoral/cirurgia , Hérnia Inguinal/cirurgia , Herniorrafia/efeitos adversos , Herniorrafia/métodos , Telas Cirúrgicas
Ann Agric Environ Med ; 30(3): 570-576, 2023 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-37772537


Leprosy is a neglected tropical disease that is still present worldwide despite efforts aimed at elimination of the disease. The BaAka Pygmy community inhabiting rural areas in the Central African Republic is one of the most leprosy-vulnerable populations. The aim of the study was to assess the prevalence of leprosy in the BaAka Pygmy population. People living in the Dzanga Sangha protected area were regularly visited by a mobile clinic in 2019/2020. The diagnosis was based on the clinical manifestation of the disease. Deformations of skin and extremities were assessed. In a 12-month period 26 cases of leprosy were diagnosed and 25 patients received treatment. 24 of those patients were BaAka Pygmies, 10 were women, 7 were children under 15 years old and 8 were diagnosed with grade 2 disability. Presented data shows that leprosy in Dzanga Sangha region is not well controlled due to the high transmission rate. Efforts to diagnose and report new leprosy cases should be intensified.

Hanseníase , Criança , Humanos , Feminino , Adolescente , Masculino , República Centro-Africana/epidemiologia , Hanseníase/diagnóstico , Hanseníase/epidemiologia , Hanseníase/tratamento farmacológico , Prevalência
Zhongguo Gu Shang ; 36(8): 737-43, 2023 Aug 25.
Artigo em Chinês | MEDLINE | ID: mdl-37605912


OBJECTIVE: To explore curative effect of conservative treatment of supination-lateral rotation (SER) with type Ⅲ and Ⅳ ankle fracture by bone setting technique. METHODS: From January 2017 to December 2019, 64 patients diagnosed with SER with type Ⅲ and Ⅳ ankle fracture were treated with manipulative reduction and conservative treatment (manipulation group) and surgical treatment with open reduction and internal fixation (operation group), 32 patients in each group. In manipulation group, there were 17 males and 15 females, aged from 15 to 79 years old with an average of (51.42±13.68) years old;according to Lauge-Hansen classification, there were 8 patients with supination external rotation type Ⅲ and 24 patients with type Ⅳ. In operation group, there were 13 males and 19 females, aged from 18 to 76 years old with an average of (47.36±15.02) years old;7 patients with type Ⅲ and 25 patients with type Ⅳ. Displacement of ankle fracture was measured by Digimizer software, and compared before treatment, 3 and 12 months after treatment between two groups. Lateral medial malleolus displacement, lateral medial malleolus displacement, lateral malleolus displacement, lateral malleolus displacement, lateral malleolus contraction displacement and posterior malleolus displacement were measured and compared between two groups. Mazur score was used to evaluate ankle joint function. RESULTS: All patients were followed up from 12 to 36 months with an average of (17.16±9.36) months. There were statistical differences in lateral medial malleolus displacement, lateral medial malleolus displacement, lateral malleolus displacement, lateral malleolus displacement, lateral malleolus contraction displacement and posterior malleolus displacement in manipulation group before and after reduction(P<0.05). Compared with operation group, there were no statistically significant differences in lateral malleolus shift, lateral malleolus shift, lateral malleolus contraction shift(P>0.05), while there were statistically significant differences in lateral malleolus shift, posterior malleolus shift up and down (P<0.05). Mazur scores of ankle joint at 3 months after treatment in manipulation group and operation group were 68.84±13.08 and 82.53±7.31, respectively, and had statistical differences(P<0.05), while there was no difference in evaluation of clnical effect(P>0.05). There were no differences in Mazur score and evaluation of clnical effect between two groups at 12 months after treatment (P>0.05). CONCLUSION: Bone setting technique could effectively correct lateral displacement of medial malleolus, lateral displacement of medial malleolus, lateral displacement of lateral malleolus and lateral contraction displacement of lateral malleolus in supination lateral rotation type Ⅲ and Ⅳ ankle fracture, and has good long-term clinical effect, which could avoid operation for some patients and restore ankle function after fracture.

Fraturas do Tornozelo , Tratamento Conservador , Feminino , Masculino , Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Fraturas do Tornozelo/cirurgia , Supinação , Fíbula , Articulação do Tornozelo/cirurgia
Med Trop Sante Int ; 3(2)2023 06 30.
Artigo em Francês | MEDLINE | ID: mdl-37525686


Introduction: Leprosy is a chronic infectious disease that mainly affects the skin, mucous membranes and the peripheral nervous system. Its elimination as a public health problem seems to lead to its ignorance and therefore to a risk of late diagnosis. An analysis of leprosy surveillance data in Mauritania was conducted to determine epidemiological trends and clinical forms of reported cases. Material and method: The retrospective study was based on the epidemiological records of leprosy in Mauritania from 2009 to 2019. The diagnosis of leprosy was made on the basis of the diagnostic criteria of the World Health Organization (WHO). Data were analyzed using Epi Info version The frequencies, proportions, and rates were calculated. Results: Over the past 11 years, 164 cases have been notified. Among the notified cases, 96/164 (58.5%) were males and 68/164 (41.5%) females, with a sex ratio of 1.4. The mean age (± standard deviation) was 44.0 ± 17.1 years [range, 9 - 86 years], and the median was 45 years [interquartile range, 32.5; 57.5]. Children under the age of 16 accounted for 9/164 (5.5%). The wilayas (i.e. "regions") of Nouakchott were the most endemic regions in the country. The multibacillary form (MB) represented 109/164 (66.5%) cases among the observed clinical forms. The average annual incidence was 0.3 case/100,000 population for MB and 0.1 case/100,000 for PB (paucibacillary). All reported cases were treated with multidrug therapy. Conclusion: The results of leprosy surveillance showed a persistence of this disease in Mauritania. It is necessary to relaunch leprosy services at all levels in order to continue to reduce the morbidity associated with this disease, and eventually eliminate it from the country.

Hansenostáticos , Hanseníase , Masculino , Criança , Feminino , Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Estudos Retrospectivos , Mauritânia/epidemiologia , Quimioterapia Combinada , Hansenostáticos/uso terapêutico , Hanseníase/epidemiologia
J Infect Dev Ctries ; 17(6): 846-853, 2023 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-37406066


INTRODUCTION: The analysis of factors associated with multibacillary leprosy is important for the development of strategies to mitigate the disease, which persists as a public health problem in Brazil and the world. The objective of this study was to verify the associations between sociodemographic and clinical-epidemiological variables and multibacillary leprosy in the state of northeastern Brazil. METHODOLOGY: This is a cross-sectional, analytical, and retrospective study, with a quantitative approach, carried out in 16 municipalities in the southwest of Maranhão State, northeastern Brazil. All cases of leprosy reported between January 2008 and December 2017 were considered. Sociodemographic and clinical-epidemiological variables were analyzed using descriptive statistics. The identification of the risk factors associated with multibacillary leprosy was conducted using Poisson regression models. The prevalence ratios and respective 95% confidence intervals were estimated using regression coefficients at a 5% significance level. RESULTS: A total of 3,903 leprosy cases were analyzed. Individuals older than 15 years, males, with less than 8 years of education, with level I, II, or "not evaluated" disability, and with type 1 or 2 or both reactional states were more likely to have multibacillary leprosy. Therefore, these characteristics may be considered risk factors. No protective factors were identified. CONCLUSIONS: The investigation revealed important associations between risk factors and multibacillary leprosy. The findings can be considered during the creation of strategies to control and combat the disease.

Hanseníase Multibacilar , Hanseníase , Humanos , Masculino , Brasil/epidemiologia , Estudos Transversais , Hanseníase/epidemiologia , Hanseníase Multibacilar/epidemiologia , Estudos Retrospectivos , Adolescente , Feminino , Adulto
PLoS Negl Trop Dis ; 17(5): e0011314, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-37172044


CONTEXT: Since 2013, the World Health Organization has recommended integrated control strategies for neglected tropical diseases (NTDs) with skin manifestations. We evaluated the implementation of an integrated approach to the early detection and rapid treatment of skin NTDs based on mobile clinics in the Ouémé and Plateau areas of Benin. METHODS: This descriptive cross-sectional study was performed in Ouémé and Plateau in Benin from 2018 to 2020. Consultations using mobile teams were performed at various sites selected by reasoned choice based on the epidemiological data of the National Program for the Control of Leprosy and Buruli Ulcer. All individuals presenting with a dermatological lesion who voluntarily approached the multidisciplinary management team on the day of consultation were included. The information collected was kept strictly anonymous and was entered into an Excel 2013 spreadsheet and analyzed with Stata 11 software. RESULTS: In total, 5,267 patients with various skin conditions consulted the medical team. The median age of these patients was 14 years (IQR: 7-34 years). We saw 646 (12.3%) patients presenting NTDs with skin manifestations, principally scabies, in 88.4% (571/646), followed by 37 cases of Buruli ulcer (5.8%), 22 cases of leprosy (3.4%), 15 cases of lymphatic filariasis (2.3%) and one case of mycetoma (0.2%). We detected no cases of yaws. CONCLUSION: This sustainable approach could help to decrease the burden of skin NTDs in resource-limited countries.

Úlcera de Buruli , Hanseníase , Dermatopatias , Humanos , Criança , Adolescente , Adulto Jovem , Adulto , Úlcera de Buruli/diagnóstico , Úlcera de Buruli/tratamento farmacológico , Úlcera de Buruli/epidemiologia , Benin/epidemiologia , Estudos Transversais , Hanseníase/diagnóstico , Hanseníase/epidemiologia , Dermatopatias/diagnóstico , Dermatopatias/epidemiologia , Dermatopatias/terapia , Doenças Negligenciadas/diagnóstico , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/prevenção & controle , Encaminhamento e Consulta
PLoS Negl Trop Dis ; 17(2): e0011092, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36800375


BACKGROUND: Leprosy, caused by Mycobacterium leprae infection, mainly affects skin and peripheral nerves and may further lead to disability and deformity if not treated timely. The new case detection rate of leprosy in children reflects the active transmission of leprosy infection. This study aims to present the epidemiology and clinical characteristics of new leprosy cases in children in China from 2011 to 2020. METHODOLOGY/PRINCIPAL FINDINGS: All data from leprosy patients younger than 15 years old were extracted from the Leprosy Management Information System in China (LEPMIS). Statistical Package for the Social Sciences (SPSS) version 12.0 was used for descriptive and analytical statistics of the epidemiological and clinical indicators by the Mann-Whitney test, Kruskal-Wallis test, and Fisher's exact test. And geographical distribution was analyzed by ArcGIS 10.5. A total of 152 pediatric new cases of leprosy were found over the last decade. The new case detection rate of pediatric leprosy cases decreased from 0.13 to 0.02 per 1,000,000 population over the last ten years. New pediatric cases had a higher new case detection rate in Guizhou, Sichuan, and Yunnan Provinces. All but 7 provinces in China achieved zero new child case for consecutive five years. The onset of leprosy peaked between 10 and 14 years of age, and the male to female ratio was 1.71:1. Pediatric patients were predominantly infected from symptomatic household adult contacts HHCs. Multibacillary leprosy (MB) was the most common. However, a low proportion of patients developed leprosy reaction and grade 2 disability. CONCLUSIONS/SIGNIFICANCE: The new case detection rate of pediatric leprosy cases has decreased over the past ten years in China. Spatial analysis indicated clusters in high-endemic areas. Leprosy transmission has stopped in the majority of provinces in China. However, sporadic cases may continue to exist for a long time. Active surveillance especially contact tracing should be focused on in future plan for management of leprosy, and interventions in leprosy clusters should be prioritized.

Pessoas com Deficiência , Hanseníase , Adulto , Humanos , Masculino , Criança , Feminino , Adolescente , China/epidemiologia , Hanseníase/diagnóstico , Hanseníase/epidemiologia , Hanseníase/microbiologia , Busca de Comunicante , Características da Família , Mycobacterium leprae
Porto Alegre; Editora Rede Unida; jun. 2023. 100 p.
Monografia em Português | LILACS | ID: biblio-1437748


A coletânea "Educação e trabalho na saúde sob participação social organizada e disseminada: a acumulação das conferências livres nacionais 2022 ­ 2023", reunida por Maria Luiza Jaeger, Ricardo Burg Ceccim e Priscila Viégas Barreto de Oliveira, é uma obra decorrente do cotejamento de seis conferências livres nacionais, realizadas entre final de 2022 e início de 2023, como parte da construção da 17ª Conferência Nacional de Saúde, das quais participou a Associação Científica Rede Unida […]. O foco da entidade é a Educação e Trabalho na Saúde, fazendo parte da comunidade de entidades/sociedades científicas com forte presença junto ao Conselho Nacional de Saúde, inclusive integrando várias de suas Comissões, em especial a Comissão Intersetorial de Recursos Humanos e Relações de Trabalho. A entidade também integra o Fórum de Entidades Nacionais de Trabalhadores da Área da Saúde, instância que congrega Conselhos, Federações e Associações presentes no campo da saúde. Considerada essa personalidade institucional, a Rede Unida integrou conferências nacionais livres onde o tema da Educação e Trabalho na Saúde formaram tópicos estratégicos ao debate dos rumos no Sistema Único de Saúde. […] A obra representa um esforço de memória e apoio ao exercício do controle social em saúde nos termos da Constituição Federal relativamente ao setor da saúde e especialmente no tocante à Lei Federal 8.142, de 28 de dezembro de 1990. A anotação "participação social organizada e disseminada" ao título da coletânea diz respeito à congregação de participantes país afora de modo orquestrado pelo Conselho Nacional de Saúde em um dispositivo inovador à democracia: a chancela às estratégias autogeridas, capazes de acumular engajamento, reflexão e contribuição cidadã às políticas públicas de saúde. Essa nova realidade certamente se tornará mais um patrimônio brasileiro aos sistemas de saúde. A coletânea inicia a acaba no escopo da Educação e Trabalho na Saúde, este é seu propósito: recolher da participação social organizada e disseminada as contribuições de um campo particular pouco reconhecido como campo nas áreas de Ensino da Saúde e da Saúde Coletiva. Contudo, um campo germinativo, potente e aglutinador à ciência, à docência, à intervenção e à inovação.

Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Educação em Saúde , Promoção da Saúde
Rev Bras Epidemiol ; 26: e230006, 2023.
Artigo em Português, Inglês | MEDLINE | ID: mdl-36629618


OBJECTIVE: This study aimed to analyze the spatial distribution of leprosy and disabilities in children under 15 years of age in Cuiabá. METHODS: Ecological study carried out in the city of Cuiabá, Mato Grosso, Brazil. The study population consisted of leprosy cases in children under 15 years old notified in the Notifiable Diseases Information System, between 2008 and 2018. Based on residential addresses, cases were georeferenced. In the analysis of the spatial distribution of the cases, the estimation of the Kernel density was used and, later, the statistics of spatial, spatio-temporal and Spatial Variation in Temporal Trends were applied. RESULTS: 514 cases of leprosy were reported in children under 15 years of age in Cuiabá, with a percentage of 10.1% of cases with degree of physical disability 1 and 2.3% with degree of physical disability 2 at the time of diagnosis. With the techniques of spatial and spatio-temporal scanning, clusters of risk for leprosy were identified in the North, West, East and South regions of Cuiabá, and with the technique of Spatial Variation in Temporal Trends, a cluster was identified in the West region of Cuiabá. CONCLUSION: In Cuiabá, cases of leprosy in children under 15 years of age with disabilities were distributed throughout the urban area of the city, with the highest density of cases in the North and West regions, followed by the East region. The clusters with the highest Relative Risk were identified in the East and West regions, characterized by having low and medium income levels.

OBJETIVO: Este estudo teve como objetivo analisar a distribuição espacial da hanseníase e as incapacidades em menores de 15 anos de idade em Cuiabá. MÉTODOS: Estudo ecológico realizado na cidade de Cuiabá, Mato Grosso, Brasil. A população do estudo foi composta de casos de hanseníase em menores de 15 anos notificados no Sistema de Informações de Agravos de Notificação, entre os anos de 2008 e 2018. Com base nos endereços residenciais, os casos foram georreferenciados. Na análise da distribuição espacial dos casos, foi utilizada a estimativa da densidade de Kernel e, posteriormente, aplicada a estatística de varredura espacial, espaço-temporal e variação espacial nas tendências temporais. RESULTADOS: Foram notificados 514 casos de hanseníase em menores de 15 anos em Cuiabá, com percentual de 10,1% de casos com grau de incapacidade física 1 e 2,3% com grau de incapacidade física 2 no momento do diagnóstico. Com as técnicas de varredura espacial e espaço-temporal, foram identificados aglomerados de risco para hanseníase nas regiões norte, oeste, leste e sul de Cuiabá, e com a técnica de variação espacial nas tendências temporais foi identificado um aglomerado na região oeste de Cuiabá. CONCLUSÃO: Em Cuiabá, os casos de hanseníase em menores de 15 anos com incapacidades estavam distribuídos em toda a extensão urbana da cidade, com maior densidade de casos nas regiões norte e oeste, seguida da região leste. Os aglomerados de maior risco relativo foram identificados nas regiões leste e oeste, caracterizadas por apresentar baixo e médio níveis de renda.

Pessoas com Deficiência , Hanseníase , Humanos , Criança , Adolescente , Brasil/epidemiologia , Hanseníase/epidemiologia , Cidades
Indian J Dermatol Venereol Leprol ; 89(4): 572-577, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35962511


Background Despite acne being a common dermatological problem, there is a paucity of literature addressing the knowledge, attitude and practice about it. Aims/Objectives To find out what patients know about acne, its cause and treatment, as well as myths, misconceptions and attitude towards it. Methods A cross-sectional, descriptive questionnaire-based study on acne patients at Maharana Bhupal Hospital, RNT Medical College, Udaipur, Rajasthan, India. Results Most (84.8%) patients belonged to the age group of 16-25 years. The majority (63.9%) presented 12 months after the onset of acne. More than half had average knowledge, a positive attitude and good practices, related significantly to gender and education. Limitations A standardized questionnaire suitable for all dialects and regional languages would have yielded more uniform results. Conclusion Study revealed that acne patients still need to acquire accurate, adequate and easily accessible information to seek timely and appropriate treatment, and alleviate their psychological suffering.

Acne Vulgar , Humanos , Adolescente , Adulto Jovem , Adulto , Estudos Transversais , Índia/epidemiologia , Acne Vulgar/diagnóstico , Acne Vulgar/epidemiologia , Acne Vulgar/terapia , Inquéritos e Questionários , Escolaridade
Rev. enferm. atenção saúde ; 12(2): 202381, Mar.-Jun. 2023. ilus, tab
Artigo em Inglês, Espanhol, Português | BDENF | ID: biblio-1444557


Objetivo: Avaliar o efeito de uma intervenção educativa no conhecimento de adolescentes sobre a hanseníase. Métodos: Trata-se de um estudo quase-experimental, com um componente avaliativo do conhecimento de adolescentes, antes e após a aplicação de uma oficina educativa sobre hanseníase com 53 adolescentes de 10 a 14 anos. Resultados: Observou-se aumento no percentual do conhecimento ótimo imediatamente após a intervenção (p<0,01), mantendo-se no pós-teste tardio (p=0,24). A média da quantidade de acertos foi estatisticamente diferente entre o pré e pós-teste imediato (p<0,01) e foi estatisticamente igual entre o pós-teste imediato e tardio (p=0,99). Verificou-se aumento no número de acertos em todos os itens do instrumento após a intervenção (p<0,01). Conclusão: Conclui-se que houve melhora no conhecimento dos adolescentes entre o pré e o pós-teste imediato. Ainda, o conhecimento manteve-se estatisticamente similar entre o pós-teste imediato e tardio, sugerindo um efeito positivo da intervenção tanto imediatamente, quanto tardiamente (AU).

Objective: To evaluate the effect of an educational intervention on the knowledge of adolescents about leprosy. Methods: This is a quasi-experimental study, with an evaluative component of the knowledge of adolescents, before and after the application of an educational workshop on leprosy with 53 adolescents aged 10 to 14 years. Results: There was an increase in the percentage of optimal knowledge immediately after the intervention (p<0.01), remaining in the late post-test (p=0.24). The mean number of correct answers was statistically different between the immediate pre- and post-test (p<0.01) and was statistically equal between the immediate and late post-test (p=0.99). There was an increase in the number of correct answers in all items of the instrument after the intervention (p<0.01). Conclusion: It is concluded that there was an improvement in the adolescents' knowledge between the pre- and post-test immediately. Furthermore, knowledge remained statistically similar between the immediate and late post-test, suggesting a positive effect of the intervention both immediately and later (AU).

Objetivo: Evaluar el efecto de una intervención educativa sobre el conocimiento de los adolescentes sobre la lepra. Métodos: Se trata de un estudio cuasi-experimental, con un componente evaluativo del conocimiento de los adolescentes, antes y después de la aplicación de un taller educativo sobre lepra con 53 adolescentes de 10 a 14 años. Resultados: Hubo un aumento en el porcentaje de conocimiento óptimo inmediatamente después de la intervención (p <0.01), permaneciendo en el post-test tardío (p = 0.24). La media del número de respuestas correctas fue estadísticamente diferente entre la prueba previa y posterior inmediata (p <0.01) y fue estadísticamente igual entre la prueba posterior inmediata y tardía (p = 0.99). Hubo un aumento en el número de respuestas correctas en todos los ítems del instrumento luego de la intervención (p <0.01). Conclusión: Se concluye que hubo una mejora en el conocimiento de los adolescentes entre el pre y post test de forma inmediata. Además, el conocimiento se mantuvo estadísticamente similar entre la prueba posterior inmediata y tardía, lo que sugiere un efecto positivo de la intervención tanto inmediatamente como más tarde (AU).

Humanos , Masculino , Feminino , Adolescente , Jogos e Brinquedos , Educação em Saúde , Adolescente , Conhecimento , Hanseníase , Estudantes
Porto Alegre; Editora Rede Unida; dez. 2022. 144 p.
Monografia em Português | LILACS | ID: biblio-1516788


Com esta obra buscamos apresentar ao leitor reflexões sobre a COVID -19 e seus impactos no mercado de trabalho, especialmente num contexto de desigualdade social, onde muitos trabalhadores de ocupações essenciais ou não precisaram se expor ao vírus para manter a sua sobrevivência e a de sua família. Ao final das análises, pontuamos a necessidade proteção dos trabalhadores em tempos de Covid, orientações para os serviços e gestores de saúde, com a finalidade de desencadear a discussão sobre a invisibilidade de muitos trabalhadores que ficaram desprotegidos pelas políticas sociais brasileiras durante a pandemia de COVID-19. Com esse conjunto de textos, esperamos ampliar a compreensão sobre os efeitos da pandemia nos trabalhadores e trabalhadoras e, ao mesmo tempo, ativar o pensamento para iniciativas que são visibilizadas pelas autoras e autores. Ou seja, mais do que buscar aprendizagem com a experiência trágica da pandemia, pretendemos também construir novas manhãs para o trabalho na saúde. Objetivo oportuno, já que estamos diante da preparação da 17ª Conferência Nacional de Saúde, que terá o tema "Garantir Direitos e Defender o SUS, a Vida e a Democracia ­ Amanhã Vai Ser Outro Dia". Acreditamos que a pandemia será memória, aprendizagem e mobilização para retomarmos a agenda da proteção do trabalho, ampliarmos a compreensão de que o trabalho é direito humano e não dependência do capital, expandirmos iniciativas de políticas de proteção da vida e avançarmos no processo civilizatório que é necessário, como bem nos lembrou Sérgio Arouca na abertura da 8ª Conferência Nacional de Saúde, para que o SUS seja possível. Por fim, nossa homenagem às trabalhadoras e trabalhadores que, asfixiados pela pandemia e órfãos da ação governamental responsável, tiveram suas vidas tomadas nesses anos. Especialmente àqueles que foram vitimados desde sua inserção no trabalho em saúde. Aliás, não somente aos que partiram, também a todas as pessoas que se ocupam do trabalho em saúde nos sistemas, redes e serviços de saúde, mas também nos pontos de atenção nos territórios, com trabalhos informais e, muitas vezes, invisíveis. A vocês, nossas palmas, nosso reconhecimento e nossa luta para novas manhãs!

Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Políticas de Controle Social , Vulnerabilidade em Saúde , COVID-19
PLoS Negl Trop Dis ; 16(10): e0010799, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36264976


BACKGROUND: Leprosy is rare in the United Kingdom (UK), but migration from endemic countries results in new cases being diagnosed each year. We documented the clinical presentation of leprosy in a non-endemic setting. METHODS: Demographic and clinical data on all new cases of leprosy managed in the Leprosy Clinic at the Hospital for Tropical Diseases, London between 1995 and 2018 were analysed. RESULTS: 157 individuals with a median age of 34 (range 13-85) years were included. 67.5% were male. Patients came from 34 different countries and most contracted leprosy before migrating to the UK. Eighty-two (51.6%) acquired the infection in India, Sri Lanka, Bangladesh, Nepal and Pakistan. 30 patients (19.1%) acquired leprosy in Africa, including 11 from Nigeria. Seven patients were born in Europe; three acquired their leprosy infection in Africa, three in South East Asia, and one in Europe. The mean interval between arrival in the UK and symptom onset was 5.87 years (SD 10.33), the longest time to diagnosis was 20 years. Borderline tuberculoid leprosy (n = 71, 42.0%), and lepromatous leprosy (n =, 53 33.1%) were the commonest Ridley Jopling types. Dermatologists were the specialists diagnosing leprosy most often. Individuals were treated with World Health Organization recommended drug regimens (rifampicin, dapsone and clofazimine). CONCLUSION: Leprosy is not a disease of travellers but develops after residence in an leprosy endemic area. The number of individuals from a leprosy endemic country reflect both the leprosy prevalence and the migration rates to the United Kingdom. There are challenges in diagnosing leprosy in non-endemic areas and clinicians need to recognise the symptoms and signs of leprosy.

Hanseníase Dimorfa , Hanseníase Virchowiana , Hanseníase , Humanos , Masculino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Feminino , Londres , Hanseníase/epidemiologia , Hanseníase Virchowiana/tratamento farmacológico , Hanseníase Dimorfa/tratamento farmacológico , Nigéria
PLoS Negl Trop Dis ; 16(9): e0010695, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36094952


BACKGROUND: Leprosy or Hansen's disease is known to cause disability and disfigurement. A delay in case detection of leprosy patients can lead to severe outcomes. In Ethiopia, the disability rates caused by leprosy among new cases are relatively high compared to other endemic countries. This suggests the existence of hidden leprosy cases in the community and a delay in timely detection. To reduce disability rates, it is crucial to identify the factors associated with this delay. This study aimed to determine the extent of delay in case detection among leprosy cases in Eastern Ethiopia. METHODS: This cross-sectional explorative study was conducted in January and February 2019 among 100 leprosy patients diagnosed ≤6 months prior to inclusion. A structured questionnaire was used to collect data, including the initial onset of symptoms, and the reasons for delayed diagnosis. Descriptive statistics, including percentages and medians, were used to describe the case detection delay. Logistic regression analysis was carried out to evaluate the predictors of delay in case detection of >12 months. FINDINGS: The median age of patients was 35 years, with a range of 7 to 72 years. The majority were male (80%) and rural residents (90%). The median delay in case detection was 12 months (interquartile range 10-36 months) among the included patients. The mean delay in case detection was 22 months, with a maximum delay of 96 months. The overall prevalence of disability among the study population was 42% (12% grade I and 30% grade II). Fear of stigma (p = 0.018) and experiencing painless symptoms (p = 0.018) were highly associated with a delay in case detection of >12 months. CONCLUSIONS: Being afraid of stigma and having painless symptoms, which are often misinterpreted as non-alarming at the onset of the disease, were associated with a delay in case detection. This study showed the need to increase knowledge on early symptoms of leprosy among affected communities. Furthermore, it is important to support initiatives that reduce leprosy related stigma and promote health worker training in leprosy control activities.

Pessoas com Deficiência , Hanseníase , Adolescente , Adulto , Idoso , Criança , Estudos Transversais , Etiópia/epidemiologia , Feminino , Promoção da Saúde , Humanos , Hanseníase/complicações , Hanseníase/diagnóstico , Hanseníase/epidemiologia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
Porto Alegre; Editora Rede Unida;Organização Pan-Americana da Saúde; 20220906. 212 p.
Monografia em Português | LILACS | ID: biblio-1397766


Olhando para a trajetória histórica compreende-se melhor a relação entre "Democracia e Saúde" estabelecida para 16ª Conferência Nacional de Saúde realizada em 2019, pois a luta pelo direito à saúde e a implementação do SUS está vinculada a busca pela redemocratização e a ampliação dos direitos sociais no Brasil. As instâncias do controle social se consolidaram no decorrer das três décadas de sua existência, os movimentos sociais, bem como, as mais diversas organizações da sociedade civil, ocuparam estes espaços e buscaram transformá-los numa arena democrática de defesa da sua concepção de saúde, de política pública, de Estado, de desenvolvimento e de direitos humanos.

Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Conferências de Saúde , Conselhos de Saúde , Participação Social , Política de Saúde , Política Pública , Controle Social Formal , Democracia , Direito à Saúde
BMC Health Serv Res ; 22(1): 1074, 2022 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-35996175


BACKGROUND: Despite national implementation of several high impact interventions and innovations to bolster tuberculosis (TB) detection and improve quality of TB services in Zambia, notifications have been declining since 2004. A countrywide data quality assessment (DQA) of Zambia's National TB and Leprosy Programme (NTLP) was undertaken to quantify the degree to which undernotification and underreporting of TB notifications may be occurring. METHODS: The NTLP conducted a retrospective DQA of health facilities in high burden districts in all ten Zambian provinces. Multiple routine programmatic data sources were triangulated through a multi-step verification process to enumerate the total number of unique TB patients diagnosed between 1st January and 31st August 2019; both bacteriologically confirmed and clinically diagnosed TB patients were included. Undernotification was defined as the number of TB patients identified through the DQA that were not documented in facility treatment registers, while underreporting was defined as the number of notified TB cases not reported to the NTLP. RESULTS: Overall, 265 health facilities across 55 districts were assessed from which 28,402 TB patients were identified; 94.5% of TB patients were ≥ 15 years old, 65.1% were male, 52.0% were HIV-positive, and 89.6% were a new/relapse case. Among all TB cases, 32.8% (95%CI: 32.2-33.3) were unnotified. Undernotification was associated with age ≥ 15 years old (adjusted prevalence odds ratio [aPOR] = 2.4 [95%CI: 2.0-2.9]), HIV-positive status (aPOR = 1.6 [95%CI: 1.5-1.8]), being a new/relapse TB case (aPOR = 17.5 [95%CI: 13.4-22.8]), being a clinically diagnosed TB case (aPOR = 4.2 [95%CI:3.8-4.6]), and being diagnosed at a hospital (range, aPOR = 1.5 [95%CI: 1.3-1.6] to 2.6 [95%CI: 2.3-2.9]). There was substantial heterogeneity in the proportion of unnotified TB cases by province (range, 18.2% to 43.6%). In a sub-analysis among 22,199 TB patients with further data available, 55.9% (95%CI: 55.2-56.6) were notified and reported to the NTLP, 32.8% (95%CI: 32.2-33.4) were unnotified, and 11.3% (95%CI: 10.9-11.7) went unreported to the NTLP. CONCLUSIONS: The findings from Zambia's first countrywide TB programme DQA demonstrate substantial undernotification and underreporting of TB cases across all provinces. This underscores the urgent need to implement a robust and integrated data management system to facilitate timely registration and reporting of all TB patients who are diagnosed and treated.

Soropositividade para HIV , Tuberculose , Adolescente , Confiabilidade dos Dados , Feminino , Humanos , Masculino , Recidiva , Estudos Retrospectivos , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Zâmbia/epidemiologia
Cien Saude Colet ; 27(6): 2255-2258, 2022 Jun.
Artigo em Português, Inglês | MEDLINE | ID: mdl-35649013


Leprosy is a debilitating, infectious, systemic or localized dermato-neurological disease caused by Mycobacterium lepra. In Brazil, the magnitude and high disabling power keep the disease as a public health problem. Skin spotting and numbness are pathognomonic signs and symptoms in leprosy. The Instituto Brasileiro de Geografia e Estatística (IBGE) 2019 National Health Survey (PNS-2019) considered the following question as a proxy to estimate its magnitude in the country. "Do you have a spot with numbness or part of the skin with numbness?". In Brazil, 1,921,289 adults reported having a patch or part of the skin with numbness, with no regional differences. As for the age group, the older, the higher the prevalence, for example, between 18 to 29 years old (235,445) and 30 to 39 years old (236,485), 0.7% had the condition, between 40 to 59 years old (827,887), 1.5% and among the elderly, 1.8% (621,472). Being able to estimate, in population-based surveys, with statistical representativeness, a reported morbidity such as leprosy is essential to support the formulation of public policies, notably those related to primary health care actions. In this way, the IBGE fulfills its constitutional role of portraying the reality of the Brazilian population and today it is the main external evaluator of the Unified Health System (SUS) and of public policies developed by the federal level.

A hanseníase é uma doença dermato-neurológica, infecciosa, sistêmica ou localizada, debilitante, causada por Mycobacterium leprae. No Brasil, a magnitude e o alto poder incapacitante mantêm a doença como um problema de saúde pública. Mancha na pele e dormência são sinais e sintomas patognomônicos na hanseníase. A Pesquisa Nacional de Saúde de 2019 (PNS-2019), do Instituto Brasileiro de Geografia e Estatística (IBGE), considerou a seguinte pergunta como proxy para estimar sua magnitude no país. "O(a) sr(a). tem mancha com dormência ou parte da pele com dormência?". No Brasil, 1.921.289 adultos referiram ter mancha ou parte da pele com dormência, sem diferenças regionais. Com relação ao grupo etário, quanto mais velho, maior a prevalência. Por exemplo, entre os de 18 a 29 anos (235.445) e de 30 a 39 anos (236.485), 0,7% possuía a condição, entre 40 e 59 anos (827.887), 1,5%, e entre os idosos, 1,8% (621.472). Poder estimar, em pesquisas de base populacional, com representatividade estatística, uma morbidade referida tal como a hanseníase é fundamental para apoiar a formulação de políticas públicas, notadamente as relativas às ações da atenção primária à saúde. Dessa forma, o IBGE cumpre seu papel constitucional de retratar a realidade da população brasileira e hoje é o principal avaliador externo do Sistema Único de Saúde (SUS) e das políticas públicas instituídas no âmbito federal.

Hipestesia , Hanseníase , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Inquéritos Epidemiológicos , Humanos , Hanseníase/diagnóstico , Hanseníase/epidemiologia , Pessoa de Meia-Idade , Saúde Pública , Adulto Jovem
Pan Afr Med J ; 41: 120, 2022.
Artigo em Francês | MEDLINE | ID: mdl-35465364


Introduction: leprosy is a disease found and unevenly distributed in Chad. Since 1997, the annual national prevalence has been less than 1/10000 inhabitants, the elimination threshold set by the World Health Organization (WHO). The purpose of this study is to describe epidemiological trends of leprosy in Chad between 2015 and 2019, in order to provide the necessary data for the development of more effective strategies for leprosy control. Methods: we conducted a retrospective, descriptive study of patients with leprosy diagnosed between 2015 and 2019 at national level. Data were collected from the database of the National Program for the Control of Leprosy in Chad (NPCLC). Results: a total of 1896 new cases of leprosy were detected in Chad between 2015 and 2019. The rates of patients aged 15 to 70 years and children under 15 years were 92.08% and 7.92% respectively. Sex ratio (M/F) was 1.68. The annual average detection rate was 2.6/100 000, with an average rate of multi-bacillary leprosy of 83.10% and degree 2 disability (2DD) of 20.38%. The average rate of degree 2 disability in children under 15 years of age was 0.92% . However, our study identified five districts as endemic (Adré, Abéché, Aboudeia, Koukou, et Bebedjia) in 2019, where the prevalence rate was above 1/10000 inhabitants. Conclusion: epidemiological trends are in favor of the persistence of the disease and a delay in diagnosis and in the management of leprosy cases.

Pessoas com Deficiência , Hanseníase , Adolescente , Chade/epidemiologia , Criança , Humanos , Hanseníase/epidemiologia , Prevalência , Estudos Retrospectivos
Nursing (Ed. bras., Impr.) ; 25(287): 7553-7567, abr.2022.
Artigo em Inglês, Português | LILACS, BDENF | ID: biblio-1372473


Objetivo: identificar a prevalência de pacientes notificados com hanseníase em São Luís, Maranhão, durante 2010-2020. Método: estudo descritivo, exploratório, retrospectivo, transversal, quantitativo, realizado no Banco de Dados público do DATASUS cuja coleta ocorreu em agosto de 2021. A amostra foi composta por 9.387 pacientes notificados com Hanseníase. Resultados: observa-se prevalência amostral em maio de 2012, sexo masculino, faixa etária entre 30-39 anos, Ensino Médio completo, pardos, casos multibacilares, avaliação de incapacidade física e de cura no estágio Grau 0, apresentaram mais que cinco lesões, baciloscopia negativa, episódios sem reação,sendo abordados como casos novos cuja forma prevalente foi a dimorfa, tendo como esquema terapêutico mais prescrito a poliquimioterapia durante 12 meses e prevalência de cura. Conclusão: houve uma prevalência dos casos de hanseníase em homens jovens com bom grau de instrução escolar. Apesar da alta prevalência de casos novos, o tratamento foi efetivo de modo a levá-los à cura.(AU)

Objective: to identify the prevalence of patients notified with leprosy in São Luís, Maranhão, during 2010-2020. Method: descriptive, exploratory, retrospective, cross-sectional, quantitative study, conducted in the public database of the DATASUS whose collection occurred in August 2021. The sample was composed of 9,387 patients notified with Leprosy. Results: sample prevalence was observed in May 2012, male gender, age range 30-39 years, complete High School, brown, multibacillary cases, evaluation of physical disability and cure in Grade 0 stage, presented more than five lesions, negative bacilloscopy, episodes without reaction, being addressed as new cases whose prevalent form was the dimorphic, having as the most prescribed therapeutic scheme the polychemotherapy for 12 months and prevalence of cure. Conclusion: there was a prevalence of leprosy cases in young men with good schooling. Despite the high prevalence of new cases, the treatment was effective in order to lead them to cure(AU)

Objetivo: identificar la prevalencia de pacientes con lepra notificados en São Luís, Maranhão, durante 2010-2020. Método: estudio descriptivo, exploratorio, retrospectivo, transversal, cuantitativo, realizado en la base de datos pública DATASUS, la cual fue recolectada en agosto de 2021. La muestra estuvo conformada por 9.387 pacientes reportados con lepra. Resultados: se tiene una muestra de prevalencia en mayo de 2012, sexo masculino, grupo etario entre 30-39 años, bachillerato completo, pardos, casos multibacilares, valoración de incapacidad física y curación en la etapa Grado 0, presentaba más de cinco lesiones, baciloscopía negativa , episodios sin reacción, siendo abordados como casos nuevos cuya forma prevalente fue borderline, siendo el régimen terapéutico más prescrito la polimedicación durante 12 meses y prevalencia de cura.Conclusión: había una prevalencia de casos de lepra en hombres jóvenes con buena escolaridad. A pesar de la alta prevalencia de casos nuevos, el trataminto fue eficaz de manera que los curará(AU)

Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Notificação de Doenças , Hanseníase/epidemiologia , Prevalência , Estudos Transversais , Estudos Retrospectivos , Sistemas de Informação em Saúde , Fatores Sociodemográficos