Importância dos focos lepromatosos no contrôle domiciliar da endemia de lepra - prevenção da lepromatose pela cura da lepra indeterminada

ABSTRACT

The importance of lepromatous foci for the domestic control of endemic lepra the prevention of leprosy by the cure of indeterminate lepra. Starning from the traditional concept established by Armauer Hansen in 1886 that lepra is a disease spreal through contagion within the family, the author suggests a prophylaxis system in accordance with irrefutable epidemiologic arguments and with an ecologic basis in the field of preventive medicine, to work as follows a) periodic inspection of domestic foci by mobile Sanatary Units. b)Intensive treatment of the indeterminate group cases, so as to break the cycle of contagion and avoid their development into the lepromatous type, the majority of which evolve from the indeterminate type, the most frequent among Lepra incipiens. c) Higher efficiency and more facilities for sulfone therapy is diagnosed in its initial form. avoiding highly infective open lesions through intensive treatment. d) Extinction of compulsory isolation which, besides being extremely expensive for the campaing, brings about the hiding of foci; to assist advanced cases of the disease, the existing sanitaria should be maintained with an open door regime, the only condition compatible with selective isolation advocated by the VII International Lepra Congress (Tokyo - 1958). e) Transformation of preventories into polyvalent educational and assistential institutions for needy minors, so as to protect descendants of Lepra patients from the stigma of millenary tradition. f) Integration of lepra prophylaxy within the Public Health Service, to be coordinated as a specific unit in polyvalent organizations with sanitary, assistential and scientific aims, of official, state, or private institutions; thus, a close collaboration between clinicians, pathologists, and sanitarists specialized in leprology and the technical personnel of the Public Health Organization is obtained. In consequence, specific standards are raised and stigmas and anathemas, among which pop...