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1.
Trop Doct ; 50(4): 311-317, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32576099

RESUMO

An observational pilot study was conducted to assess the nutritional status and morbidity profile of childhood contacts of leprosy in an endemic area (Chengalpattu) in India. A total of 70 such children were included in the study. Sociodemographic data were collected using a one-to-one interview method and the children were evaluated by dermatologists qualified in paediatric leprosy. The obtained data were computed. Three children were diagnosed to have leprosy through this study. Nutritional status assessment in these children demonstrated malnutrition, a common finding. Regular contact screening of children in endemic areas for early case detection, disability prevention and thereby prevention of community transmission is mandatory. Further research is needed concerning the role of malnutrition in children and its relation to morbidity in leprosy. The closeness and duration of contact of leprosy is also an important risk factor. Effective strategies to diagnose subclinical infection are needed.


Assuntos
Saúde da Criança , Hanseníase/epidemiologia , Hanseníase/transmissão , Saúde da População Rural , Adolescente , Criança , Diagnóstico Precoce , Feminino , Humanos , Índia/epidemiologia , Hanseníase/diagnóstico , Hanseníase/prevenção & controle , Masculino , Morbidade , Estado Nutricional , Projetos Piloto , Fatores de Risco
2.
Microb Pathog ; 137: 103714, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31493502

RESUMO

Leprosy, once considered as poor man's disease may cause severe neurological complications and physical disabilities. Classification of leprosy depends upon the cell mediated and humoral immune responses of the host, from tuberculoid to lepromatous stage. Current therapy to prevent the disease is not only very lengthy but also consists of expensive multiple antibiotics in combination. Treatment and the duration depend on the bacillary loads, from six months in paucibacillary to a year in multibacillary leprosy. Although as per WHO recommendations, these antibiotics are freely available but still out of reach to patients of many rural areas of the world. In this review, we have focused on the nutritional aspect during the multi-drug therapy of leprosy along with the role of nutrition, particularly malnutrition, on susceptibility of Mycobacterium leprae and development of clinical symptoms. We further discussed the diet plan for the patients and how diet plans can affect the immune responses during the disease.


Assuntos
Dieta , Hanseníase/tratamento farmacológico , Hanseníase/imunologia , Desnutrição , Antígenos de Bactérias/farmacologia , Citocinas/metabolismo , Alimentos , Predisposição Genética para Doença , Humanos , Imunidade , Imunidade Humoral , Hanseníase/diagnóstico , Hanseníase/metabolismo , Masculino , Mycobacterium leprae/imunologia , Estado Nutricional , Fatores de Risco , Selênio , Vitaminas , Zinco
3.
Cien Saude Colet ; 24(7): 2431-2441, 2019 Jul 22.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31340262

RESUMO

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.


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.


Assuntos
Comportamento Alimentar , Abastecimento de Alimentos/estatística & dados numéricos , Hanseníase/epidemiologia , Estado Nutricional , Brasil/epidemiologia , Cidades , Estudos Transversais , Humanos , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Fatores Socioeconômicos
4.
Ciênc. Saúde Colet ; 24(7): 2431-2441, jul. 2019. tab, graf
Artigo em Português | LILACS | ID: biblio-1011853

RESUMO

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.


Assuntos
Humanos , Estado Nutricional , Comportamento Alimentar , Abastecimento de Alimentos/estatística & dados numéricos , Hanseníase/epidemiologia , Fatores Socioeconômicos , Brasil/epidemiologia , Estudos Transversais , Cidades , Sobrepeso/epidemiologia , Obesidade/epidemiologia
5.
Salud(i)ciencia (Impresa) ; 23(5): 428-437, jun. 2019. tab., ilus.
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1025191

RESUMO

The purpose of this work was to analyze the prevalence of fetal mortality (FM) in mothers in early adolescence (10-14 years), late adolescence (15-19 years) and in adults (20-34 years), during the period 2014-2016, in the North Department of Santander-Colombia. The factors taken into account were: gestation time, fetal weight, childbirth, basic causes, area of residence, and educational level of the mothers. Method: The study was retrospective, correlational, analytical-comparative. The database was from a secondary public access source of the National Administrative Department of Statistics (DANE-Colombia). The analysis was performed using the following tests: chi-square, Kruskal-Wallis H, Cramer's V coefficient, Goodman and Kruskal's gamma, Tukey's post-hoc procedures and the Bonferroni method based on Student's t-test. Results: The prevalence of FM for the years 2014-2016 was 10.0 per 1000 live births in mothers in early adolescence, 19.2 in mothers in late adolescence and 18.6 in adult mothers. It emerged that the prevalence of FM in pregnancies of under 22 weeks was higher in adult mothers, before delivery and during childbirth (chi-square = 32.023; p = 0.021), and there was a slight negative relationship between mother's age and weight of the fetus (gamma = -0.186; p = 0.014). The prevalence of FM was higher in adult mothers residing in the municipal district (chi-square = 80.18; p = 0.000), in mothers with primary, secondary and professional-level basic education (chi-square = 105.56; p = 0.000), and greater in adult mothers due to obstetric complications and birth trauma


La lepra es una enfermedad infecciosa crónica causada por Mycobacterium leprae, la cual tiene una notoria afinidad por la piel y los troncos nerviosos periféricos. Esta enfermedad se caracteriza por tener una clínica polimorfa que depende de la respuesta inmune del hospedero. La inmunopatogénesis de esta enfermedad aún representa un reto para los investigadores, y un eslabón faltante en su comprensión es el estudio de los micronutrientes, los cuales se ha demostrado que tienen la capacidad de modular la respuesta inmune innata y adaptativa. El objetivo de esta revisión es describir y relacionar algunos nutrientes, como las vitaminas A, D, E, C y B6, el folato, el zinc y el hierro, con la respuesta inmune en la lepra. Además, proponemos que algunos micronutrientes (vitaminas A, D y C y zinc) serían importantes para mitigar la aparición de reacciones lepróticas por medio de la modulación de la respuesta inmune en el hospedero infectado por M. leprae, y que micronutrientes como las vitaminas A, D, B6 y D, el folato, el hierro y el zinc serían importantes para reducir la incidencia de la lepra, dado que promoverían una mejor respuesta inmune en convivientes. Por lo tanto, el estudio del estado nutricional y el aporte suplementario con micronutrientes en convivientes y en afectados con lepra sería clave en la eliminación de esta enfermedad que ha deformado cuerpos y ha destruido sueños a lo largo de los siglos.


Assuntos
Humanos , Vitaminas , Linfócitos , Estado Nutricional , Estresse Oxidativo , Micronutrientes , Imunidade , Inflamação , Hanseníase
6.
PLoS Negl Trop Dis ; 12(3): e0006317, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29534113

RESUMO

BACKGROUND: Poverty has long been considered a risk factor for leprosy and is related to nutritional deficiencies. In this study, we aim to investigate the association between poverty-related diet and nutrition with leprosy. METHODOLOGY/PRINCIPAL FINDINGS: In rural leprosy-endemic areas in Indonesia, we conducted a household-based case-control study using two controls for each case patient (100 recently diagnosed leprosy patients and 200 controls), matched for age and gender. All participants were interviewed to collect information on their demographics, socioeconomic situation, health, and diet. Body mass index, dietary diversity score, as well as anemia and iron micronutrient profiles were also obtained. By means of univariate, block-wise multivariate, and integrated logistic regression analyses, we calculated odds ratios between the variables and the occurrence of leprosy. Unstable income (odds ratio [OR], 5.67; 95% confidence interval [CI], 2.54-12.64; p = 0.000), anemia (OR, 4.01; 95% CI, 2.10-7.64; p = 0.000), and higher household food insecurity (OR, 1.13; 95% CI, 1.06-1.21; p = 0.000) are significantly associated with an increased risk of having leprosy. Meanwhile, higher education (OR, 0.34; 95% CI, 0.15-0.77; p = 0.009) and land ownership (OR, 0.39; 95% CI, 0.18-0.86; p = 0.019) have significant protective associations against leprosy. Although lower dietary diversity, lack of food stock, food shortage, low serum iron, and high ferritin were found more commonly in those with leprosy, the occurrence of leprosy was not significantly associated with iron deficiency (OR, 1.06; 95% CI, 0.10-11.37; p = 0.963). CONCLUSIONS/SIGNIFICANCE: Food poverty is an important risk factor for leprosy susceptibility, yet the mechanisms underlying this association other than nutrient deficiencies still need to be identified. With a stable incidence rate of leprosy despite the implementation of chemoprophylaxis and multidrug therapy, improving dietary diversity through food-based approaches should be initiated and directed toward high-prevalence villages. The possible underlying factors that link poverty to leprosy other than nutrient deficiencies also need to be identified.


Assuntos
Abastecimento de Alimentos , Hanseníase/epidemiologia , Estado Nutricional , Pobreza , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Características da Família , Feminino , Humanos , Renda , Indonésia , Modelos Logísticos , Masculino , Micronutrientes , Pessoa de Meia-Idade , Análise Multivariada , Fatores de Risco , Adulto Jovem
7.
Infect Dis Poverty ; 6(1): 105, 2017 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-28866982

RESUMO

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.


Assuntos
Proteínas na Dieta/análise , Úlcera do Pé/metabolismo , Hanseníase Multibacilar/metabolismo , Hanseníase Paucibacilar/metabolismo , Estado Nutricional , Adulto , Brasil , Feminino , Úlcera do Pé/etiologia , Humanos , Hanseníase Multibacilar/microbiologia , Hanseníase Paucibacilar/microbiologia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
8.
Int J Tuberc Lung Dis ; 20(11): 1477-1482, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27776588

RESUMO

SETTING: Successful treatment of drug-resistant tuberculosis (DR-TB) is crucial in preventing disease transmission and reducing related morbidity and mortality. A standardised DR-TB treatment regimen is used in Kenya. Although patients on treatment are monitored, no evaluation of factors affecting treatment outcomes has yet been performed. OBJECTIVE: To analyse treatment outcomes of DR-TB patients in Kenya and factors associated with successful outcome. DESIGN: Retrospective analysis of secondary data from Kenya's National Tuberculosis, Leprosy and Lung disease programme. DR-TB data from the national database for January to December 2012 were reviewed. RESULTS: Of 205 DR-TB patients included in the analysis, 169 (82.4%) had a successful treatment outcome, 18 (9%) died and 18 (9%) were lost to follow-up. Only sex (P = 0.006) and human immunodeficiency virus (HIV) status (P = 0.008) were predictors of successful treatment. Females were more likely to attain treatment success (OR 3.86, 95%CI 1.47-10.12), and HIV-negative status increased the likelihood of successful treatment (OR 3.53, 95%CI 1.4-8.9). CONCLUSION: Treatment success rates were higher than World Health Organization targets. Targeted policies for HIV-positive patients and males will improve treatment outcomes in these groups.


Assuntos
Antituberculosos/uso terapêutico , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Adolescente , Adulto , Índice de Massa Corporal , Criança , Pré-Escolar , Dieta , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Lactente , Recém-Nascido , Quênia/epidemiologia , Perda de Seguimento , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Setor Privado , Setor Público , Estudos Retrospectivos , Resultado do Tratamento , Organização Mundial da Saúde , Adulto Jovem
9.
Rev Inst Med Trop Sao Paulo ; 57(5): 421-6, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26603230

RESUMO

The aim of this study was to evaluate the effects of the protein-calorie malnutrition in BALB/c isogenic mice infected with Lacazia loboi, employing nutritional and histopathological parameters. Four groups were composed: G1: inoculated with restricted diet, G2: not inoculated with restricted diet, G3: inoculated with regular diet, G4: not inoculated with regular diet. Once malnutrition had been imposed, the animals were inoculated intradermally in the footpad and after four months, were sacrificed for the excision of the footpad, liver and spleen. The infection did not exert great influence on the body weight of the mice. The weight of the liver and spleen showed reduction in the undernourished groups when compared to the nourished groups. The macroscopic lesions, viability index and total number of fungi found in the footpads of the infected mice were increased in G3 when compared to G1. Regarding the histopathological analysis of the footpad, a global cellularity increase in the composition of the granuloma was observed in G3 when compared to G1, with large numbers of macrophages and multinucleated giant cells, discrete numbers of lymphocytes were present in G3 and an increase was observed in G1. The results suggest that there is considerable interaction between Jorge Lobo's disease and nutrition.


Assuntos
Lacazia , Lobomicose/complicações , Estado Nutricional , Desnutrição Proteico-Calórica/complicações , Animais , Modelos Animais de Doenças , Fígado/microbiologia , Fígado/patologia , Lobomicose/patologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Tamanho do Órgão , Desnutrição Proteico-Calórica/microbiologia , Desnutrição Proteico-Calórica/patologia , Baço/microbiologia , Baço/patologia
10.
Mycoses ; 58(9): 522-30, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26156007

RESUMO

There are no studies investigating the role of nutritional status and immunity associated with Jorge Lobo's disease. The objective of this study was to evaluate the effects of protein-calorie malnutrition on the immune response of BALB/c mice inoculated with Lacazia loboi. In this study,the animals were divided into four groups: G1: inoculated with restricted diet, G2: not inoculated with restricted diet, G3: inoculated with regular diet, G4: not inoculated with regular diet. The animals of groups G1 and G2 were submitted to malnutrition for 20 days and once installed the animals were inoculated intradermally into the footpad. After 4 months, they were euthanised for the isolation of peritoneal lavage cells and removal of the footpad. The production of IL-2, IL-4, IL-10, IL-12, IFN-γ, TNF-α, H2 O2 and nitric oxide (NO) was evaluated in the peritoneal lavage cells. The footpad was evaluated regarding the size of macroscopic lesions, number of fungi and viability index. The results showed that the infection did not exert great influence on the body weight of the mice and previous malnutrition was an unfavourable factor for viability index, number of fungi, macroscopic lesion size in the footpad and production of H2 O2 , NO, IL-12, IL-10 and IFN-γ, suggesting that malnutrition significantly altered fungal activity and peritoneal cells. The results suggest considerable interaction between nutrition and immunity in Jorge Lobo's disease.


Assuntos
Lacazia , Lobomicose/imunologia , Lobomicose/microbiologia , Desnutrição/complicações , Estado Nutricional , Animais , Peso Corporal , Citocinas/metabolismo , Modelos Animais de Doenças , Interleucina-12/metabolismo , Interleucina-2/metabolismo , Lacazia/imunologia , Lobomicose/complicações , Camundongos , Camundongos Endogâmicos BALB C , Lavagem Peritoneal , Peritônio/citologia , Peritônio/imunologia , Fator de Necrose Tumoral alfa/metabolismo
11.
Indian J Lepr ; 84(1): 17-22, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23077779

RESUMO

Across-sectional epidemiological study was carried out at a Leprosy Referral Hospital in Delhi to assess the nutritional status of multibacillary leprosy patients in comparison to the general population using BMI. 150 people affected with multibacillary leprosy were included in the study, of whom 108 (72%) had WHO Grade 2 disability. 100 non leprosy patients were also included as a control group. Socio-demographic and clinical details as well as their height and weight were measured and the BMI computed. The findings clearly showed that under-nutrition (BMI < 18.5) was more common in people affected by leprosy than in those without leprosy, regardless of age or sex. Presence of disability made the incidence of under-nutrition more likely. The duration of disease, number of lesions or bacterial index had no impact on the level of nutrition. There may be multiple factors working together to lead to this under-nutrition and these are discussed briefly. If, we aim to provide high quality services with a holistic approach, a mandatory BMI should be calculated for every patient and if under nourished, a qualitative diet summary should be done and suitable nutritional advice given. Further, studies are needed for a better understanding of the occurrence and progression of under-nutrition in leprosy to find efficient ways to combat this problem.


Assuntos
Hanseníase/patologia , Estado Nutricional , Índice de Massa Corporal , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Hansenostáticos/uso terapêutico , Hanseníase/tratamento farmacológico , Hanseníase/epidemiologia , Masculino
12.
Cad Saude Publica ; 28(1): 31-8, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22267063

RESUMO

Leprosy may present acute/subacute inflammatory processes (leprosy reactions). The study characterized the reactional states of patients at health clinics in Vitória, Espírito Santo State, Brazil, and associated them with sociodemographic factors and clinical/nutritional variables. between January and December 2009, longitudinal follow-up of patients with leprosy continued until leprosy reactions occurred or patients completed 6 months of multidrug therapy. Of the 151 patients participating, 78 (51.7%) were females, 48 (31.8%) had 5 to 8 years schooling, 93 (61.6%) worked and earned from 1 to 3 minimum wages, and 55 (36.4 %) had leprosy reactions, but with no statistical association to socioeconomic characteristics or nutritional status. However, absence of reaction was more common in the low-weight group, suggesting a trend in this group to protection from the reaction (p = 0.0906). The study found no association between nutritional status and leprosy reaction.


Assuntos
Hanseníase/epidemiologia , Estado Nutricional/fisiologia , Atenção Primária à Saúde/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Idoso , Índice de Massa Corporal , Tamanho Corporal , Brasil/epidemiologia , Criança , Feminino , Seguimentos , Humanos , Hanseníase/diagnóstico , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Fatores Socioeconômicos , Adulto Jovem
13.
Cad. saúde pública ; 28(1): 31-38, jan. 2012.
Artigo em Inglês | LILACS | ID: lil-610732

RESUMO

Leprosy may present acute/subacute inflammatory processes (leprosy reactions). The study characterized the reactional states of patients at health clinics in Vitória, Espírito Santo State, Brazil, and associated them with sociodemographic factors and clinical/nutritional variables. between January and December 2009, longitudinal follow-up of patients with leprosy continued until leprosy reactions occurred or patients completed 6 months of multidrug therapy. Of the 151 patients participating, 78 (51.7 percent) were females, 48 (31.8 percent) had 5 to 8 years schooling, 93 (61.6 percent) worked and earned from 1 to 3 minimum wages, and 55 (36.4 percent) had leprosy reactions, but with no statistical association to socioeconomic characteristics or nutritional status. However, absence of reaction was more common in the low-weight group, suggesting a trend in this group to protection from the reaction (p = 0.0906). The study found no association between nutritional status and leprosy reaction.


A hanseníase pode apresentar processos inflamatórios agudos/subagudos (reações hansênicas). Os objetivos foram caracterizar os estados reacionais de pacientes de Unidades de Saúde da Grande Vitória (Espírito Santo, Brasil) e associá-los aos fatores sociodemográficos e a variáveis clínicas/nutricionais. Estudo longitudinal, de monitoramento de portadores de hanseníase acompanhados até o aparecimento da reação hansênica ou até 6 meses iniciais da poliquimioterapia, de janeiro a dezembro de 2009. Participaram 151 pacientes, sendo 78 (51,7 por cento) femininos; 48 (31,8 por cento) estudaram de cinco a oito anos; 93 (61,6 por cento) trabalhavam e ganhavam de um a três salários mínimos; 55 (36,4 por cento) apresentaram reação hansênica, sem associação estatística às características socioeconômicas nem ao estado nutricional. Porém, a ausência de reação foi maior no grupo baixo peso, sugerindo neste grupo tendência na proteção da reação (p = 0,0906). No estudo não houve associação do estado nutricional com a reação hansênica.


Assuntos
Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Hanseníase/epidemiologia , Estado Nutricional/fisiologia , Atenção Primária à Saúde/estatística & dados numéricos , Distribuição por Idade , Índice de Massa Corporal , Tamanho Corporal , Brasil/epidemiologia , Seguimentos , Hanseníase/diagnóstico , Distribuição por Sexo , Fatores Socioeconômicos
14.
Hansen. int ; 37(2): 69-74, 2012.
Artigo em Português | SES-SP, LILACS, SES-SP, SESSP-ILSLPROD, SES-SP, SESSP-ILSLACERVO, SES-SP | ID: biblio-1063242

RESUMO

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.


Assuntos
Hanseníase , Ciências da Nutrição , Promoção da Saúde , Comportamento Alimentar , Estado Nutricional
15.
Rev Soc Bras Med Trop ; 44(2): 228-31, 2011.
Artigo em Português | MEDLINE | ID: mdl-21503549

RESUMO

INTRODUCTION: The present study investigated leprosy in relation to the clinical, sociodemographic, nutritional and dietary profiles of patients diagnosed at primary healthcare units in the suburbs of Greater Vitória, State of Espírito Santo, Brazil, from January to December 2009. METHODS: The study involved 152 male and female patients initiating polychemotherapy treatment. The collected data included sociodemographic, anthropometric, biochemical and dietary aspects derived from a questionnaire of eating frequency (QEF) that was validated and adapted for Brazilian culture. Body mass index (BMI) was calculated to evaluate patient nutritional status. RESULTS: The study showed that: 79 (52%) of the participants were women, average age was 40.4 years-old (± 16.9); 81 (53.3%) were employed; the mean number of years of schooling was 7.1 (± 4.5). Concerning the disease, 79 (52%) of the participants were multibacillary and 73 (48%) paucibacillary. The bacilloscopy index was negative in 125 (82.2%) patients. Excess weight was identified in 11.8% and 5.3% were underweight. Rice and beans were mentioned frequently, 87.3% and 88.7%, respectively. CONCLUSIONS: The study showed that simple actions, initiated during primary healthcare, can help to improve the treatment of patients with the leprosy.


Assuntos
Índice de Massa Corporal , Ingestão de Energia , Comportamento Alimentar , Hanseníase , Estado Nutricional , Adolescente , Adulto , Brasil , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
16.
Rev. Soc. Bras. Med. Trop ; 44(2): 228-231, Mar.-Apr. 2011. graf, tab
Artigo em Português | LILACS | ID: lil-586117

RESUMO

INTRODUÇÃO: O presente estudo investigou a hanseníase quanto à apresentação clínica, perfil sociodemográfico, nutricional e alimentar de pacientes diagnosticados nas Unidades de Saúde dos municípios da Grande Vitória, Espírito Santo, Brasil, no período de janeiro a dezembro de 2009. MÉTODOS: Foram estudados 152 pacientes de ambos os sexos, em início de tratamento poliquimioterápico. Foram coletados dados sociodemográficos, antropométricos, bioquímicos e de alimentação a partir de um questionário de frequência alimentar (QFA) validado e adaptado. Foi calculado o índice de massa corporal (IMC) para avaliação do estado nutricional. RESULTADOS: O estudo mostrou que: 79 (52 por cento) dos participantes eram do sexo feminino, a média de idade foi de 40,4 anos (± 16,9); 81 (53,3 por cento) possuíam vínculo empregatício; a média de anos de estudo foi de 7,1 (± 4,5). Em relação à doença, 79 (52 por cento) eram multibacilares e 73 (48 por cento) paucibacilares. O índice baciloscópico foi negativo em 125 (82,2 por cento) pacientes. O excesso de peso foi identifcado em 11,8 por cento e 5,3 por cento apresentaram baixo peso. O arroz e o feijão foram os alimentos relatados com maior frequência de consumo, 87,3 por cento e 88,7 por cento respectivamente. CONCLUSÕES: O estudo demonstrou que ações simples, iniciadas na atenção primária à saúde, podem auxiliar na melhoria do acompanhamento a portadores de hanseníase.


INTRODUCTION: The present study investigated leprosy in relation to the clinical, sociodemographic, nutritional and dietary profiles of patients diagnosed at primary healthcare units in the suburbs of Greater Vitória, State of Espírito Santo, Brazil, from January to December 2009. METHODS: The study involved 152 male and female patients initiating polychemotherapy treatment. The collected data included sociodemographic, anthropometric, biochemical and dietary aspects derived from a questionnaire of eating frequency (QEF) that was validated and adapted for Brazilian culture. Body mass index (BMI) was calculated to evaluate patient nutritional status. RESULTS: The study showed that: 79 (52 percent) of the participants were women, average age was 40.4 years-old (±16.9); 81 (53.3 percent) were employed; the mean number of years of schooling was 7.1 (±4.5). Concerning the disease, 79 (52 percent) of the participants were multibacillary and 73 (48 percent) paucibacillary. The bacilloscopy index was negative in 125 (82.2 percent) patients. Excess weight was identified in 11.8 percent and 5.3 percent were underweight. Rice and beans were mentioned frequently, 87.3 percent and 88.7 percent, respectively. CONCLUSIONS: The study showed that simple actions, initiated during primary healthcare, can help to improve the treatment of patients with the leprosy.


Assuntos
Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Adulto Jovem , Índice de Massa Corporal , Ingestão de Energia , Comportamento Alimentar , Hanseníase , Estado Nutricional , Brasil , Estudos Transversais , Fatores Socioeconômicos , Inquéritos e Questionários
17.
Hansen. int ; 36(2): 43-51, 2011. tab
Artigo em Português | SES-SP, LILACS, SES-SP, SESSP-ILSLPROD, SES-SP, SESSP-ILSLACERVO, SES-SP | ID: lil-789369

RESUMO

OBJETIVO: Conhecer o estado nutricional e percepção alimentar dos moradores com seqüelas de hanseníase. MÉTODOS: Estudo transversal, descritivo e analítico A população avaliada constou de 40 ex hansenianos institucionalizados. Para classificação do estado nutricional utilizou-se o Índice de Massa Corporal para adulto segundo OMS, 1995 e 1997 e para avaliação do consumo alimentar (calorias e proteínas) o registro alimentar de dois dias. Para percepção alimentar foi aplicado um questionário com 15 moradores que mantinham contato produtivo. Utilizou-se o software SPSS for Windows® versão 17.0.RESULTADOS: Três (7,5%) moradores apresentaram diagnóstico nutricional de magreza grau I; 4 (10%) grau II; 2 (5%) grau III; 23 (57,5%) de eutrofia; 6 (15%) de pré obesidade e 2 (5%) com diagnóstico nutricional de obesidade grau I. A soma dos moradores (25) com ad-equação calórica acima de 110% e abaixo de 90% foi superior ao número de moradores (15) com adequação calórica de 90 a 110%.O percentual médio de adequação protéica foi 131,2% . Com relação à percepção alimentar observou-se que 4(26,7%) têm percepção que não alimentam bem; 13(86,7%) que a alimentação é suficiente; 8(53,3%) gostam da alimentação oferecida na instituição; 9 (60%) alimentam exclusivamente das refeições oferecidas pela instituição; 9(60%) não gostam de mastigar os alimentos; 6(40,0%) gostam de ficar sozinhos durante as refeições. Os resultados mostraram uma situação preocupante, de risco nutricional. CONCLUSÕES: A associação entre as percepções merece ser valorizada pela equipe de saúde e responsáveis pela alimentação, que poderia gerar maior aceitação ao ali-mento oferecido. Torna-se imprescindível uma assistência voltada para minimizar as marcas, o sofrimento e a rejeição deixada pelo estigma social associado à hanseníase.


OBJECTIVE: Knowing the nutritional status and eating perception of residents with leprosy sequel. METHODS: The evaluated population consisted of 40 former leprosy residents . To determine the nutritional status the BMI (Body Mass Index) for adults was used according to WHO (Wolrd Health Organization) , 1995 and 1997 for assessment of food intake (protein and calories) the eating record of 2 days. To determine the eating perception a questionnaire was applied with 15 residents that were keeping productive contact. Data were tabulated and analyzed using Software SPSS for Windows® version 17.0.RESULTS: 3 (7,5%) residents presented nutritional diagnosis of thinness level I ; 4 (10%) thinness level II; 2 (5%) thinness level III; 23 (57,5%) eutrophic; 6 (15%) pre obesity; and 2 (5%) residents with nutritional diagnosis of obesity level I . It was observed that the sum of resindents (25) with caloric adequacy over 110% and below 90% was superior than the number of residents (15) with caloric adequacy from 90 to 110% . The average percentage of proteic adequacy of 131,2 % . Regarding eating perception it was observed that 4(26,7%) have perception that they do not eat well; 13(86,7%) answered that their diet is enough; 8(53,3%) like the food offered in the institution; 9 (60%) eat exclusively the meals offered in the institution; 9(60%) not like to chew the food; 6(40,0%) like to be alone during meals.CONCLUSION: The results showed a worrying situation of nutritional risk. The association among the perceptions deserve to be valued by the health team and responsible for feeding. This knowledge could generate greater acceptance to the food offered. It is indispensable assistance aimed to minimize the marks, suffering and rejection left by the social stigma associated with leprosy.


Assuntos
Humanos , Masculino , Feminino , Idoso , Estado Nutricional , Hanseníase/complicações , Avaliação Nutricional , Hospitais de Dermatologia Sanitária de Patologia Tropical , Comportamento Alimentar , Saúde do Idoso Institucionalizado , Sistema Único de Saúde
18.
Hansen. int ; 36(2): 53-61, 2011. tab
Artigo em Português | SES-SP, LILACS, SES-SP, SESSP-ILSLPROD, SES-SP, SESSP-ILSLACERVO, SES-SP | ID: lil-789370

RESUMO

A Hanseníase é uma doença sistêmica, infectocontagiosa, de evolução crônica. Seu tratamento é realizado por meio de poliquimioterapia que pode desencadear algumas alterações nutricionais. Sendo assim, este trabalho teve como objetivo avaliar o estado nutricional e o consumo alimentar de pacientes com Hanseníase em acompanhamento no Ambulatório de Dermatologia Sanitária. Estudo de delineamento transversal, no qual realizou avaliação antropométrica, laboratorial e dietética. A amostra final foi de 39 pacientes, de ambos os sexos, com concentração de indivíduos na faixa etária a avaliação foi realizada apenas após o início do trata-entre os 40-50 anos, predomínio do ensino fundamen-tal incompleto e baixa renda familiar. A população se caracterizou pelo sedentarismo, sobrepeso, ocorrência de doenças crônicas não transmissíveis, insegurança alimentar e nutricional, consumo muito elevado de gorduras e inadequação de micronutrientes essenciais para a prevenção de doenças. Os resultados mostraram a necessidade da inserção do nutricionista na equipe multiprofissional, a fim de promover alimentação ade-quada e a prevenção de comorbidades, garantindo a promoção à saúde e a segurança alimentar. No entanto, não foi possível associar esses distúrbios nutricionais ao diagnóstico/tratamento da Hanseníase, uma vez que a avaliação foi realizada apenas após o início do tratamento da doença.


Leprosy is a systemic, infectious disease with a chronic course. It can be treated by drug therapy combination that may induce nutritional changes. Thus, this study aimed to assess the nutritional status and dietary in-take of leprosy patients under care at the Dermatology Clinic Health. Cross-sectional study, which was held on anthropometric, dietary and laboratory evaluation. The final sample of 39 patients of both sexes, presented a concentration of individuals aged between 40-50 years, prevalence of incomplete primary education and low family income. The population was characterized by sedentary, overweight, occurrence of chronic non-com-municable diseases, food and nutrition insecurity, high consumption of fats and inadequacy of micronutrients essentials for disease prevention. The results showed the necessity of inserting a nutritionist in the multidisci-plinary team in order to promote proper nutrition and the prevention of comorbid conditions, ensuring the promotion of health and food safety. However, it could not associate these nutritional disorders to the diagno-sis/treatment of leprosy, since the evaluation was per-formed only after the start of the treatment of disease.


Assuntos
Humanos , Masculino , Feminino , Ingestão de Alimentos , Estado Nutricional , Hanseníase , Educação Alimentar e Nutricional , Hospitais de Dermatologia Sanitária de Patologia Tropical , Instituições de Assistência Ambulatorial , Nutricionistas , Sistema Único de Saúde
19.
AIDS ; 23(8): 961-969, 2009 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-19287300

RESUMO

OBJECTIVE: To evaluate an enzyme-linked immunospot assay (ELISPOT) for the diagnosis of tuberculosis (TB) in HIV-infected children with suspected TB and to compare the performance of ELISPOT with the tuberculin skin test (TST). METHODS: Interferon-gamma responses to Mycobacterium tuberculosis-specific antigens were measured by ELISPOT in HIV-infected children with suspected TB. HIV-infected and HIV-uninfected children without TB were taken for comparison. RESULTS: Results were available for 188 children, of whom 139 (74%) were HIV-infected. Of these, 22 were classified as having definite TB: 24 probable TB, 14 possible TB and 128 not having TB. The median (range) age of patients was 20 (10-54.1) months. Median interferon-gamma responses to early-secreted antigenic target-6 and culture filtrate protein-10 were higher in children with definite or probable TB compared with children without TB (P < 0.002). In HIV-infected children with an interpretable ELISPOT result, the ELISPOT was positive in 14/21 (66%) with definite TB. A significantly higher proportion of HIV-infected children with definite or probable TB had a positive ELISPOT compared with a positive TST [25/39 (64%) vs. 10/34 (29%), P = 0.005]. In contrast to TST, results from ELISPOT were not affected by young age or severe immunosuppression. In HIV-infected children without active TB disease, 27% had a positive ELISPOT, suggesting latent TB infection. CONCLUSION: ELISPOT is more sensitive than TST for the detection of active TB in HIV-infected children. However, the sensitivity of current ELISPOT assays is not sufficiently high to be used as a rule out test for TB.


Assuntos
Infecções por HIV/imunologia , Hospedeiro Imunocomprometido/imunologia , Mycobacterium tuberculosis/imunologia , Tuberculose Pulmonar/diagnóstico , Fatores Etários , Antígenos de Bactérias , Proteínas de Bactérias , Pré-Escolar , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Infecções por HIV/complicações , Humanos , Lactente , Interferon gama/sangue , Tuberculose Latente/complicações , Tuberculose Latente/diagnóstico , Tuberculose Latente/imunologia , Masculino , Estado Nutricional , Sensibilidade e Especificidade , África do Sul , Teste Tuberculínico/métodos , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/imunologia
20.
São Paulo; s.n; 2006. 138 p. tab, graf.
Tese em Português | LILACS | ID: lil-443528

RESUMO

Introdução: A hanseníase é uma doença infecto-contagiosa, de evolução lenta, que se manifesta por meio de lesões na pele e nos nervos periféricos, sendo importante caracterizar o estado nutricional dos pacientes. Objetivo: Avaliar o estado nutricional de indivíduos adultos com hanseníase. Métodos: Trata-se de um estudo epidemiológico observacional do tipo transversal, com coleta de dados primários que foi desenvolvido no Hospital das Clínicas da FMUSP, Centro de Dermatologia Sanitária em São Paulo e Instituto Lauro de Souza Lima em Bauru. Para avaliar o consumo alimentar foi adotado o inquérito Rec 24h e um questionário para caracterização das variáveis sócio-demográficas, clínicas, antropométricas e dos hábitos e práticas alimentares. Resultados: A população nos três locais foi composta por 91 pacientes, com predominância do gênero masculino e idade entre 23 e 79 anos. A maior concentração ocorreu na faixa de 40 a 59 anos que representou 43 por cento dos pacientes. Houve predomínio do estado civil casado. A maior parte da população (41,8 por cento) constituiu-se de trabalhadores ativos e 10 por cento encontrava-se afastada de suas atividades, 70 por cento, possuíam o nível fundamental incompleto e 22 por cento eram analfabetos. Os indivíduos (80,3 por cento) recebiam até 2 salários mínimos. A maioria da população (61,5 por cento) não praticava atividade física. Com relação à prática alimentar 71,4 por cento realizavam entre 3 e 4 refeições diárias. Observou-se 13,1 por cento de obesidade (classes 1 e 2) 3,2 por cento de baixo peso. Após o diagnóstico da doença 16,5 por cento referiram ter deixado de comer carne de pato, porco, peixe, linguiça e ovos, 12,1 por cento referiram acreditar que a alimentação provocava hanseníase e 30,8 por cento que a alimentação poderiam piorar a hanseníase. Conclusões: A população de estudo apresentou-se com baixa renda, baixa escolaridade e predomínio de pré-obesidade. Os pacientes referiram ter mudado a alimentação após o diag...


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Ingestão de Alimentos , Comportamento Alimentar , Hanseníase/epidemiologia , Avaliação Nutricional , Estado Nutricional , Antropometria , Estudos Transversais
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