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1.
Arq. ciências saúde UNIPAR ; 26(3): 569-579, set-dez. 2022.
Artigo em Português | LILACS | ID: biblio-1399248

RESUMO

hanseníase no Brasil ainda apresenta como um problema de saúde pública. A posição epidemiológica da doença no país é considerada diversificada devido ao alto coeficiente e variação de prevalência nas diversas regiões do país. O objetivo desse estudo é conhecer o perfil epidemiológico da população acometida pela hanseníase na cidade de General Carneiro, no interior do Mato Grosso, durante os anos de 2006 e 2021. A coleta de dados foi realizada nos meses de julho e agosto do ano de 2021. Trata-se de uma pesquisa retrospectiva, documental do tipo descritiva, com abordagem quantitativa. No período em estudo notificou-se 50 casos, sendo 62% do sexo masculino, com faixa etária entre 48 a 69 anos de idade, de cor branca, com predominância da forma dimorfa. Os resultados demonstram que a cidade de General Carneiro, está com o número de casos de hanseníase na média do preconizado pela Organização Mundial de Saúde e também, inferior à média brasileira.


Leprosy in Brazil still presents as a public health problem. The epidemiological position of the disease in the country is considered diversified due to the high coefficient and variation in prevalence in different regions of the country. The aim of this study is to know the epidemiological profile of the population affected by leprosy in the city of General Carneiro, in the interior of Mato Grosso, during the years 2006 and 2021. Data collection was carried out in July and August of 2021 This is a retrospective, descriptive documentary research with a quantitative approach. During the study period, 50 cases were reported, 62% male, aged between 48 and 69 years old, white, with a predominance of the borderline form. The results show that the city of General Carneiro has the number of cases of leprosy in the average recommended by the World Health Organization and also below the Brazilian average.


La lepra en Brasil sigue siendo un problema de salud pública. La posición epidemiológica de la enfermedad en el país se considera diversificada debido al alto coeficiente y a la variación de la prevalencia en diferentes regiones del país. El objetivo de este estudio es conocer el perfil epidemiológico de la población afectada por la lepra en la ciudad de General Carneiro, en el interior de Mato Grosso, durante los años 2006 y 2021. La recogida de datos se realizó en julio y agosto del año 2021. Se trata de una investigación retrospectiva, documental y descriptiva, con un enfoque cuantitativo. En el período de estudio se notificaron 50 casos, siendo el 62% de sexo masculino, con una edad entre 48 y 69 años, de color blanco, con predominio de la forma dimorfa. Los resultados muestran que la ciudad de General Carneiro, está con el número de casos de lepra en la media recomendada por la Organización Mundial de la Salud y también por debajo de la media brasileña.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Perfil de Saúde , Hanseníase/diagnóstico , Hanseníase/etiologia , Hanseníase/epidemiologia , Pacientes/estatística & dados numéricos , Organização Mundial da Saúde/organização & administração , Vigilância da População , Saúde Pública , Prevalência , Estudos Retrospectivos , Estudos Populacionais em Saúde Pública
2.
PLoS Negl Trop Dis ; 16(10): e0010799, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36264976

RESUMO

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.


Assuntos
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
3.
BMJ Case Rep ; 15(10)2022 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-36192029

RESUMO

Leprosy was eliminated globally in 2000, but it continues to be endemic in developing countries like India, Brazil and Indonesia, with a prevalence of 0.57/10 000 persons in India (2020). At the end of the year 2020, the prevalence was 129 389, and oral manifestation of the leprosy is luncommon. We hereby report a case of a female patient in her late 30s who presented with palatal perforation. Following a thorough history taking and full body clinical examination, we arrived at a diagnosis of leprosy, and prompt treatment was initiated. Knowledge of cases like this becomes important as the oral lesion is said to form an essential source of leprosy dissemination in the community, and awareness about them becomes crucial, demanding immediate attention.


Assuntos
Hanseníase Dimorfa , Hanseníase Virchowiana , Hanseníase Multibacilar , Hanseníase , Feminino , Humanos , Índia/epidemiologia , Hanseníase/diagnóstico , Hanseníase Dimorfa/epidemiologia , Hanseníase Dimorfa/patologia , Hanseníase Virchowiana/complicações , Hanseníase Virchowiana/diagnóstico , Hanseníase Virchowiana/tratamento farmacológico , Prevalência
4.
Curr Microbiol ; 79(11): 345, 2022 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-36209340

RESUMO

Tuberculosis (TB) is a major zoonotic disease of public health importance worldwide. Its burden is more in developing countries due to inadequate surveillance, co-infection with HIV/AIDS and poor social amenities; hence consumption of unpasteurized milk, contaminated meat and inhalation of infected droplets from animals or patients with active TB are the major risk practices. A survey was conducted on TB prevalence from 2013 to 2014 while patients records from TB and Leprosy units of hospitals in the three Agricultural zones (Ogoja, Ikom and Calabar) of Cross River State, Nigeria were assessed from 2000 to 2010. Out of 1,170 sampled patients, 8 (0.7%) were positive, of which 6 and 2 isolates were identified as M. tuberculosis and M. bovis, respectively. Out of 52,558 studied patients files, 235 (0.4%) were positive with varied annual prevalence; the highest (1.0%) and lowest (0.2%) in 2009 and 2011, respectively. The prevalence was higher in dry (0.9% and 0.5%) than the rainy season (0.5% and 0.4%), in females (0.9% and 0.5%) than the males (0.4% and 0.4%) in the survey and retrospective studies, respectively. The age distribution of TB among the patients were; (0% and 0.3%), (0.4% and 0.4%), (0.7% and 0.4%) and (1.5% and 0.7%) for those (≤ 18), (19-40), (41-60) and (> 60) yrs old in the survey and retrospective study, respectively. TB is prevalent in human patients in Cross River State hence, the need for sustainable campaign, continuous surveillance and private/ public health partnership in accurate and early diagnosis, treatment and one health approach to its control.


Assuntos
Infecções por HIV , Mycobacterium tuberculosis , Saúde Única , Tuberculose , Animais , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Nigéria/epidemiologia , Prevalência , Estudos Retrospectivos , Tuberculose/epidemiologia
5.
Porto Alegre; Editora Rede Unida;Organização Pan-Americana da Saúde; 20220906. 212 p.
Monografia em Português | LILACS | ID: biblio-1397766

RESUMO

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.


Assuntos
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
6.
Ann Clin Microbiol Antimicrob ; 21(1): 40, 2022 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-36071525

RESUMO

BACKGROUND: Leprosy is a chronic infectious disease caused by Mycobacterium leprae or Mycobacterium lepromatosis that is mainly transmitted through droplets from the nose and mouth of untreated patients. Owing to the lack of specific serological markers and clinical manifestations, leprosy can be easily confused with other skin lesion-related diseases and is difficult to distinguish. CASE PRESENTATION: This study introduces and summarises the diagnosis and treatment process of a case of leprosy misdiagnosed as erythema multiforme for a long time. A 43-year-old female was admitted to our hospital because of "repeated fever with superficial lymphadenopathy and systemic rash in May". The diagnosis of the patient was based on the two main clinical characteristics of superficial lymphadenopathy and systemic pleomorphic erythema by using a combination of multiple samples of lymph nodes and skin, routine pathological examination, immunohistochemistry, acid-fast, silver hexamine, periodic acid-Schiff (PAS) staining, and second-generation gene sequencing of fresh biopsy tissue. The patient was treated with dapsone, rifampicin, and clofazimine at the Institute of Dermatology and Venereal Diseases. After treatment for 1 year, her temperature returned to normal, the area of facial erythema decreased, and the volume of axillary lymph nodes had gradually reduced. CONCLUSIONS: In conclusion, special pathological staining and second-generation gene sequencing show promising advantages in distinguishing leprosy from other skin lesion-related diseases.


Assuntos
Eritema Multiforme , Hanseníase , Linfadenopatia , Adulto , Erros de Diagnóstico , Eritema , Eritema Multiforme/diagnóstico , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Hanseníase/diagnóstico , Linfadenopatia/diagnóstico
7.
PLoS One ; 17(9): e0274678, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36149867

RESUMO

INTRODUCTION: Moringa stenopetala Bak. Cuf. is a native plant of Ethiopia with important nutraceutical applications. However, little is known about its nutritional, ethno-pharmaceutical and therapeutic properties. Hence, the present study sought to assess the nutraceutical applications of M. stenopetala among traditional healers in southern Ethiopia. METHODS: A community-based cross-sectional study was conducted on 50 selected administrative units in Gamo Gofa, Segen areas and south Omo zones of southern Ethiopia from May to June 2020. Data were gathered using a semi-structured interview, field observation, and group discussion. Both quantitative and qualitative data were analysed using Excel 2019 and open code version 4.03, respectively. The results were presented using descriptive statistics, with the fidelity level (FL)% used to distinguish the preferential use of various plant parts. RESULTS: A total of 120 individuals participated in the study, and the majority of them, 89 (74.2%), were male and farmers by occupation. Eight four (70%) of them were residents of the Gamo Gofa Zone. The fidelity level revealed that the leaf and root were the most commonly used parts for nutraceutical purposes. Remarkably, M. stenopetala is used to treat human ailments such as leprosy and kidney and liver infections via various modes of utilisation and administration. As a result, the most common methods of utilising plant products are chewing or consuming crushed plant parts, and the oral route is the much-preferred method of application. On the other hand, the larvae of Moringa moth Nurda blitealis, are a defoliating insect during the rainy season and have been identified as a limiting factor for its production. CONCLUSIONS: The nutraceutical aspects of M. stenopetala are extremely important to the rural community in southern Ethiopia. However, the defoliating moth larvae threaten its growth and biomass production, necessitating the need to manage and improve the plant's productivity and sustainable use. Additionally, conducting experimental studies to validate the plant's pharmacological potential correspond to a milestone in drug discovery.


Assuntos
Moringa , Estudos Transversais , Etiópia , Feminino , Humanos , Folhas de Planta
8.
Food Res Int ; 160: 111735, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36076465

RESUMO

Lentilactobacillus parabuchneri is the main bacteria responsible for the accumulation of histamine in cheese. The goal of this study was to assess the efficiency of potential histamine-degrading microbial strains or, alternatively, the action of the diamine oxidase (DAO) enzyme in the reduction of histamine accumulation along the ripening process in cheese. A total of 8 cheese variants of cow milk cheese were manufactured, all of them containing L. parabuchneri Deutsche Sammlung von Mikroorganismen 5987 (except for the negative control cheese variant) along with histamine-degrading strains (Lacticaseibacillus casei 4a and 18b; Lactobacillus delbrueckiisubsp. bulgaricus Colección Española de Cultivos Tipo (CECT) 4005 and Streptococcus salivariussubsp.thermophilus CECT 7207; two commercial yogurt starter cultures; or Debaryomyces hansenii), or DAO enzyme, tested in each cheese variant. Histamine was quantified along 100 days of cheese ripening. All the degrading measures tested significantly reduced the concentration of histamine. The highest degree of degradation was observed in the cheese variant containing D. hansenii, where the histamine content decreased up to 45.32 %. Cheese variants with L. casei, or L. bulgaricus and S. thermophilus strains, also decreased in terms of histamine content by 43.05 % and 42.31 %, respectively. No significant physicochemical changes (weight, pH, water activity, color, or texture) were observed as a consequence of the addition of potential histamine-degrading adjunct cultures or DAO in cheeses. However, the addition of histamine-degrading microorganisms was associated with a particular, not unpleasant aroma. Altogether, these results suggest that the use of certain histamine-degrading microorganisms could be proposed as a suitable measure in order to decrease the amount of histamine accumulated in cheeses.


Assuntos
Amina Oxidase (contendo Cobre) , Queijo , Lactobacillus casei , Animais , Bovinos , Queijo/análise , Feminino , Microbiologia de Alimentos , Histamina , Streptococcus thermophilus
9.
PLoS Negl Trop Dis ; 16(9): e0010695, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36094952

RESUMO

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.


Assuntos
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
10.
BMC Health Serv Res ; 22(1): 1074, 2022 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-35996175

RESUMO

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.


Assuntos
Soropositividade para HIV , Tuberculose , Adolescente , Confiabilidade dos Dados , Feminino , Humanos , Masculino , Recidiva , Estudos Retrospectivos , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Zâmbia/epidemiologia
11.
Afr Health Sci ; 22(1): 611-618, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36032431

RESUMO

Background and Aim: Handicapped children cause psychological problems for mothers. As mothers' actual well-being is so important in the family and society, the aim of this research was to predict the role of psychological toughness and adaptability on the actual well-being of mothers with handicapped children. Materials and Methods: The research was descriptive correlational study with volunteer mothers of handicapped children (n=150). Data collection tools were: Ahwaz Kiamarsi et al. (1998) psychological toughness questionnaire, Connor and Davidson adaptability scale (2003), Lyubomerisky and Leper actual well-being scale (1999) and Diener life satisfaction scale (2009). Pearson correlation coefficient and multiple linear regression analysis were used to analyze the data using SPSS 21 version. Results: The results showed that psychological toughness and its components (commitment, control, struggle) have a significant positive relationship with the actual well-being of mothers with handicapped children and its dimensions (actual well-being and life satisfaction) and is able to predict their well-being. Discussion: Therefore, it can be said that by promoting adaptability, mothers with handicapped children can resist and overcome stressors as well as factors that cause many psychological problems. By reducing psycho-emotional problems in mothers, mental well-being and life satisfaction are improved. Conclusion: The actual well-being of mothers with handicapped children can be predicted by their psychological toughness and adaptability.


Assuntos
Crianças com Deficiência , Mães , Criança , Feminino , Humanos , Inquéritos e Questionários
12.
PLoS Negl Trop Dis ; 16(8): e0010646, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35984857

RESUMO

BACKGROUND: Leprosy continues to be a health problem in Indonesia, with incidence reaching over 10,000 new cases by 2021. Leprosy-related disabilities cause limitation of patients' activity and participation in social activities. To date, no studies have been conducted in Indonesia which investigates disability in terms of bodily function, structure impairment, limitations in performing daily activities, and restrictions in participation in social activities in leprosy patients. This study is aimed to determine the demographic and clinical characteristics that might affect functional activity limitations of leprosy patients in endemic areas in Indonesia. METHODS AND FINDINGS: A cross-sectional study was conducted on 267 retrospectively-diagnosed cases of leprosy. The Screening of Activity Limitation and Safety Awareness (SALSA) scale was used to measure functional activity limitation, which comprises five domains: vision, mobility, self-care, work with hands, and dexterity. Differences among variables were evaluated using Kruskal-Wallis and Mann-Whitney test. The mean age of participants was 51.89±13.66 years, the majority of which were men (62.5%), uneducated (48.3%), and classified as type 2 in the World Health Organization (WHO) disability grading for hands and feet (66.3% and 68.2%, respectively). Assessment using the SALSA Scale showed 28.5% of subjects were without limitation, 43.8% with mild limitation, 13.5% with moderate limitation, 9.4% with severe limitation, and 4.9% with extreme limitation. Significant differences in the total SALSA Scale were found between age groups (p = 0.014), educational level (p = 0.005), occupation (p<0.001), and WHO disability grades (p<0.001). Multivariate analysis showed that the most significant factor influencing the total score of SALSA was disability grading for feet (score = 0.31, p <0.001) followed by occupational status, disability grading for eyes, and age. Limitation of functional activity was significantly correlated to becoming unemployed with the odds 2.59. CONCLUSION: People affected by leprosy are prone to have functional activity limitation, especially the elderly, uneducated, unemployed and those with multiple disabilities. If they can overcome their barriers in functional activities, they will have better occupational opportunities.


Assuntos
Avaliação da Deficiência , Hanseníase , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Indonésia/epidemiologia , Hanseníase/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
13.
BMJ Open ; 12(7): e058397, 2022 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-35851027

RESUMO

INTRODUCTION: Malaria is one of the major public health problems in sub-Saharan Africa. It contributes significantly to maternal and fetal morbidity and mortality in affected countries. This study aims to evaluate the impact of enhanced case detection using molecular testing called loop-mediated isothermal amplification (LAMP) on birth outcomes in a prospective study design. METHODS AND ANALYSIS: A pragmatic randomised diagnostic outcomes trial will be conducted in several health institutes in different Ethiopian regions. Women (n=2583) in their first and second trimesters of pregnancy will be included in the study and individually randomised to the standard of care or enhanced case detection arms, and followed until delivery. Enrolment will encompass the malaria peak transmission seasons. In the standard of care arm, a venous blood sample will be collected for malaria diagnosis only in symptomatic patients. In contrast, in the intervention arm, mothers will be tested by a commercially available Conformité Européene (CE)-approved LAMP malaria test, microscopy and rapid diagnostic test for malaria regardless of their symptoms at each antenatal care visit. The primary outcome of the study is to measure birth weight. ETHICS AND DISSEMINATION: The study was approved by the following ethical research boards: Armauer Hansen Research Institute/ALERT Ethics Review Committee (FORM AF-10-015.1, Protocol number PO/05/20), the Ethiopia Ministry of Science and Higher Education National Research Ethics Review Committee (approval SRA/11.7/7115/20), the Ethiopia Food and Drug Administration (approval 02/25/33/I), UCalgary Conjoint Health Research Ethics Board (REB21-0234). The study results will be shared with the institutions and stakeholders such as the Ethiopia Ministry of Health, the Foundation for Innovative Diagnostics, WHO's Multilateral initiative on Malaria - Tropical Diseases Research (TDR-MIM), Roll Back Malaria and the Malaria in Pregnancy Consortium. The study results will also be published in peer-reviewed journals and presented at international conferences. TRIAL REGISTRATION NUMBER: NCT03754322.


Assuntos
Malária , Programas de Rastreamento , Complicações Parasitárias na Gravidez , Feminino , Humanos , Malária/diagnóstico , Malária/terapia , Programas de Rastreamento/métodos , Técnicas de Diagnóstico Molecular , Técnicas de Amplificação de Ácido Nucleico , Ensaios Clínicos Pragmáticos como Assunto , Gravidez , Complicações Parasitárias na Gravidez/diagnóstico , Complicações Parasitárias na Gravidez/terapia , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Tecnologia
14.
Int J Dermatol ; 61(12): 1506-1510, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35775153

RESUMO

BACKGROUND: The implications of COVID-19 co-infection in patients under treatment for Hansen's disease (HD, leprosy) remain uncertain. We aimed to describe clinical characteristics, treatments, and outcomes in patients with HD and COVID-19 in Brazil. METHODS: Cross-sectional study recruiting adult HD patients with PCR-confirmed COVID-19 from five HD treatment centers in Brazil between March 1, 2020, and March 31, 2021. At the time of this study, no patient had received COVID-19 vaccine. RESULTS: Of 1377 patients under treatment for HD, 70 (5.1%) were diagnosed with COVID-19. Of these, 41 (58.6%) had PCR-confirmed COVID-19, comprising 19 men and 22 women, aged 24-67 (median 45) years. HD was multibacillary in 39/41 patients. Eight patients ceased WHO Multi-Drug Therapy for HD, three for lack of drugs, two because of COVID-19, and three for other reasons. Of the 33 who continued treatment, 26 were on the standard regimen and seven an alternative regimen. Seventeen patients were receiving oral prednisone, including nine patients with type 1 reaction, four with type 2 reaction, three with neuritis, and one with rheumatologic disease. Twelve patients were hospitalized for COVID-19, and six patients died, of whom three had hypertension and one also had type 2 diabetes and obesity. CONCLUSIONS: COVID-19 and Hansen's disease co-infection did not appear to change the clinical picture of either disease in this cross-sectional study. The wider impact of the pandemic on persons affected by HD requires follow-up and monitoring.


Assuntos
COVID-19 , Coinfecção , Diabetes Mellitus Tipo 2 , Hanseníase , Adulto , Masculino , Humanos , Feminino , Estudos Transversais , COVID-19/epidemiologia , Coinfecção/epidemiologia , Brasil/epidemiologia , Vacinas contra COVID-19 , Hanseníase/complicações , Hanseníase/diagnóstico , Hanseníase/tratamento farmacológico
15.
Indian J Pharmacol ; 54(3): 177-182, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35848688

RESUMO

OBJECTIVE: The objective of the study was to assess the efficacy and safety profiles of combined treatment of prednisolone with thalidomide (Gr-A) and prednisolone with clofazimine (Gr. B) in patients with erythema nodosum leprosum (ENL) or type 2 lepra reactions. MATERIALS AND METHODS: Efficacy of both regimens was assessed on the basis of clinical recovery of recurrent ENL measured by reaction severity score (RSS), Visual Analog Scale (VAS), and recurrence of type 2 lepra reaction. The causality assessment of adverse drug reactions was done using the WHO UMC causality assessment scale. RESULTS: The average age of patients with recurrent ENL was 42.8 years (male) and 51.8yrs (female) and had mean duration of leprosy and recurrent ENL 2.4 years and 2.09 years, respectively. 80% of nonrecurrence was observed in Gr-A versus 66% in Gr-B. Significant (P < 0.05) lower RSS and VAS was found in both the treatment groups as compared to pretreatment value. The reduction in RSS and VAS was statistically significant (P < 0.05) in Gr-A compared to Gr-B treatment. CONCLUSION: Thalidomide combination with steroid was found to be more efficacious than clofazimine combination with steroid in the treatment of ENL both the treatment regimens showed few tolerable side effects. Improved strategies for the treatment and management of these reactions need to be developed.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Eritema Nodoso , Hanseníase Virchowiana , Adulto , Clofazimina/uso terapêutico , Eritema Nodoso/tratamento farmacológico , Feminino , Humanos , Hansenostáticos/efeitos adversos , Hanseníase Virchowiana/tratamento farmacológico , Masculino , Prednisolona/uso terapêutico , Talidomida/efeitos adversos
16.
Mycopathologia ; 187(4): 363-374, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35764905

RESUMO

Chromoblastomycosis and leprosy are chronic diseases with high prevalence in tropical and subtropical regions. Brazil is one of the countries with the highest incidence and prevalence for both diseases, however, reports of co-infections are scarce. The aim of this study was to describe three cases of chromoblastomycosis-leprosy co-infection in patients from Mato Grosso state, Brazil. A review of chromoblastomycosis-leprosy co-infection was performed of English, Portuguese and Spanish publications in LILACS, SciELO, PubMed and Web of Science databases using the descriptors (chromoblastomycosis OR cromoblastomicose OR cromoblastomicosis) AND (leprosy OR hanseníase OR lepra), without time period delimitation. Nineteen cases were included, 16 cases were published in 11 articles, plus the three cases reported in the current study. Most reported coninfection cases came from Brazil. Majority of the patients were male with a mean age of 52.2 years. Farmer was the main occupational activity reported. In 12 patients, the clinical signs and symptoms of leprosy started first. No contacts with patients affected by leprosy, armadillos or history of injuries at the anatomical site of chromoblastomycosis lesions were reported. Five leprosy patients who received steroid treatment for leprosy reactions or neuropathies, were diagnosed with chromoblastomycosis during immunosuppressive therapy. Four cases (21.1%) were reported among the elderly patients. Co-infections in patients with chromoblastomycosis or leprosy are uncommon, but the possibility should always be considered, especially if the patient is undergoing immunosuppressive treatment or is elder.


Assuntos
Cromoblastomicose , Coinfecção , Hanseníase , Idoso , Brasil/epidemiologia , Cromoblastomicose/diagnóstico , Cromoblastomicose/tratamento farmacológico , Cromoblastomicose/epidemiologia , Coinfecção/diagnóstico , Coinfecção/epidemiologia , Feminino , Humanos , Incidência , Hanseníase/epidemiologia , Masculino , Pessoa de Meia-Idade
17.
PLoS One ; 17(6): e0265416, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35737690

RESUMO

To give an insight into the different manifestations of leprosy and their biological consequences in the Avar Age of the Hungarian Duna-Tisza Interfluve, two cases from the 7th-century-CE osteoarchaeological series of Kiskundorozsma-Daruhalom-dulo II (Hungary; n = 94) were investigated. Based on the macromorphology of the bony changes indicative of Hansen's disease, KD271 (a middle-aged male) and KD520 (a middle-aged female) represent the two extremes of leprosy. KD271 appears to have an advanced-stage, long-standing near-lepromatous or lepromatous form of the disease, affecting not only the rhinomaxillary region but also both upper and lower limbs. This has led to severe deformation and disfigurement of the involved anatomical areas of the skeleton, resulting in his inability to perform the basic activities of daily living, such as eating, drinking, grasping, standing or walking. The skeleton of KD520 shows no rhinomaxillary lesions and indicates the other extreme of leprosy, a near-tuberculoid or tuberculoid form of the disease. As in KD271, Hansen's disease has resulted in disfigurement and disability of both of the lower limbs of KD520; and thus, the middle-aged female would have experienced difficulties in standing, walking, and conducting occupational physical activities. KD271 and KD520 are amongst the very few published cases with leprosy from the Avar Age of the Hungarian Duna-Tisza Interfluve, and the only examples with detailed macromorphological description and differential diagnoses of the observed leprous bony changes. The cases of these two severely disabled individuals, especially of KD271 -who would have required regular and substantial care from others to survive-imply that in the Avar Age community of Kiskundorozsma-Daruhalom-dulo II there was a willingness to care for people in need.


Assuntos
Atividades Cotidianas , Hanseníase , Benzodiazepinas , Diagnóstico Diferencial , Feminino , Humanos , Hungria , Hanseníase/diagnóstico , Masculino , Pessoa de Meia-Idade , Enxofre
19.
Pathog Glob Health ; 116(8): 467-476, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35510339

RESUMO

The objectives of this study were to explore global epidemiological characteristics of leprosy, and to provide reference for the construction of prevention strategies for leprosy. Computer retrieval of the study on the epidemiology of leprosy from 2010 to 2020 in Web of Science, PubMed, and SCOPUS databases were summarized. The included studies were assessed for the quality of the AHRQ; the proportions of the study indices were meta-analyzed with Stata 16.0. A random effects model was adopted to merge categories, including sex, type, grade 2 deformity (G2D) and age group for meta-analysis. The subgroup analysis used region as a stratification factor to analyze whether there were differences in the indicators. The meta-analysis included 30 studies totaling 11,353 cases. The global pooled proportion of male to female subjects with leprosy was 63% (95% CI 59%, 66%) to 37% (95% CI 34%, 41%), respectively. The pooled multibacillary proportion and paucibacillary proportion were 69% (95% CI 62%, 76%) and 31% (95% CI 24%, 38%), respectively. The pooled grade 2 deformity (G2D) proportion was 22% (95% CI 15%, 30%). Among age groups, the pooled children proportion was 11% (95% CI 8%, 13%), and the pooled adult proportion was 89% (95% CI 87%, 92%). The subgroup analysis indicated that epidemiological indicators varied from country to country. This study suggested that disparities existed between sex, type, grade 2 deformity (G2D) and age group characteristics of leprosy from country to country.


Assuntos
Hanseníase , Adulto , Criança , Masculino , Humanos , Feminino , Hanseníase/epidemiologia , Hanseníase/prevenção & controle
20.
Radiol Clin North Am ; 60(3): 399-408, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35534127

RESUMO

Mycobacterial species other than Mycobacterium tuberculosis and Mycobacterium leprae constitute nontuberculous mycobacteria (NTM). NTM infections are on the rise, particularly in the Western world. They cause a wide range of pulmonary and systemic manifestations. The 2 most common types are as follows: classical cavitary type, seen with preexisting lung disease, and the nonclassical bronchiectatic type, seen in elderly women without preexisting lung disease. Disseminated infections by the hematogenous route are common in immunocompromised patients including those with HIV. Imaging plays a key role in the diagnosis and monitoring of NTM infection.


Assuntos
Bronquiectasia , Pneumopatias , Infecções por Mycobacterium não Tuberculosas , Idoso , Bronquiectasia/diagnóstico , Feminino , Humanos , Infecções por Mycobacterium não Tuberculosas/diagnóstico por imagem , Infecções por Mycobacterium não Tuberculosas/microbiologia , Complexo Mycobacterium avium , Micobactérias não Tuberculosas
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