Os contatos de portadores de Hanseníase em Paracatu (MG): perfil, conhecimentos e percepções / The leprosy bearers' contacts in Paracatu (MG), profile, understandings and perceptions

A hanseníase representa ainda um grave problema de saúde pública no Brasil e, sobretudo, em Paracatu-MG(detecção de 17,9/100.000 hab. em 2010). Uma parte importante dos contatos de crianças previamente tratadas não havia comparecido ao serviço de saúde para realização do exame dermato neurológico. Objetivos: conhecer o perfil socioeconômico dos contatos de escolares tratados de hanseníase em Paracatu (MG), de 2004 a 2006, identificar o conhecimento sobre a doença, a percepção sobre os serviços de saúde do município e identificar os motivos do não comparecimento para a realização do exame dermato neurológico preconizado. Foi desenvolvido um roteiro de entrevista semi estruturada, aplicado em visitas domiciliárias, no ano de 2009, a 46 sujeitos de 33 famílias. Resultados: Do total de 46 contatos pesquisados, 61% eram homens e 24% encontram-se entre a faixa etária de 21 a 28 anos; 33% eram os pais das crianças tratadas, 54% analfabetos funcionais, com renda familiar de 1 a 2 salários mínimos. Entre os entrevistados, 78% residiam em bairros periféricos pobres. O principal motivo referido por 38% dos contatos para a não realização do exame dermato neurológico foi falta de tempo devido ao horário trabalho. O risco de adquirir a doença era desconhecido por 50,0% dos entrevistados, que sugeriram ampliação dos horários de atendimento, visitas domiciliárias da equipe de saúde com informações e divulgações da doença como melhorias ao acesso aos serviços de saúde. Conclusão: a reorientação dos serviços de saúde pode ampliar as ações de promoção de saúde, de prevenção da doença e adesão ao tratamento da hanseníase.

Leprosy is a serious public health problem in Brazil and especially in the county of Paracatu (MG), a site of priority for the disease control according to the National Program of Leprosy Control due to a high detection rate (17.9%/ 100,000 inhabitants – detection rate in 2008). A significant part of intra domiciliary contacts of the school children treated for leprosy previously (2004 to 2006) were not submitted to the dermato neurological examination. Aims: Identify leprosy intra domiciliary contacts socio economic profile, their awareness about the disease, their perceptions about local health services, and the reasons of not being exanimate. We have developed a semi-structured interview, applied in home visits for 46 subjects from 33 families in Paracatu (MG), performed during 2009. Results: Among the 46 intra domiciliary contacts, 61.0% were male, 24.0% aged from 21 to 28 years, 33.0% were fathers of a treated child, 54.0% functionally illiterates, with a low familiar income; 78.0% were residents of periphery neigh borhood, with low socio economic conditions and insufficient coverage of sanitary infrastructure. The main reason given for not being submitted to the dermato neurologic examination, by 38.0% of the contacts, was due to work period. About 50.0% of the interviewed referred not know about the risk of acquiring the disease. They suggested an enlargement of the timetables for health services and domiciliary visits, information about the disease, as well as the improvement of health services access. Conclusion: health services reorientation can enhance health promotion actions, disease prevention and adhesion to leprosy treatment.

The use of ML Flow test in school children diagnosed with leprosy in the district of Paracatu, Minas Gerais.

The detection rate of leprosy in the district of Paracatu is high in the age group under 15 years-old, including about 6.8/10,000 inhabitants in 2003, and classified as hyperendemic. The study aimed to analyze the application of the PGL-1 (ML Flow) serological test in 56 of 68 school-age patients of the public school system, diagnosed with leprosy through active case finding in Paracatu, Minas Gerais State (2004 to 2006), with 71% classified as paucibacillary. Of these, 85.2% lived in urban areas, 55.8% were female and the disease was predominant in the 10 to 14 year-old age group (95%CI: 0.49-0.89; chi(2)=7.373), with 15 (26.7%) presenting a positive ML Flow result. Five patients showed grade 1 disabilities in the borderline clinical form (40% ML Flow positive). The percentage of leprosy cases among household contacts was 46.4%, 44.9% presenting positive ML Flow test results. The study suggests incorporating the ML Flow test into the health services, since it assists in the operational classification of the disease and in the control of household contacts with positive test results, aimed at early detection of suspected leprosy cases.

Uso do teste ML Flow em escolares diagnosticados com hanseníase no município de Paracatu, Minas Gerais / The use of ML Flow test in school children diagnosed with leprosy in the district of Paracatu, Minas Gerais

A detecção da hanseníase no município de Paracatu é elevada em menores de quinze anos, abrangendo cerca de 6,8/10.000 hab. em 2003 e é classificada como hiperendêmica. O estudo objetiva analisar a aplicação do teste sorológico do PGL-1 (ML Flow) em 56 de 68 pacientes escolares da rede pública, diagnosticados com hanseníase através da busca ativa de casos no município de Paracatu – MG (2004 a 2006), sendo 71%, paucibacilares. Cerca de 85,2% dos pacientes residiam na área urbana, 55,8% eram do sexo feminino e a doença predominava no grupo de 10 a 14 anos (IC95%:0,49-0,89%) e χ2=7,376, sendo que 15 (26,7%) com resultado do ML Flow positivo. Cinco pacientes tinham incapacidades do Grau 1, da forma clínica Dimorfa (40% ML Flow positivo). O percentual de casos de hanseníase entre os contatos intradomiciliares foi de 46,4%, sendo que 44,9% deles com resultado do teste do ML Flow positivo. O estudo sugere incorporar o teste ML Flow nos serviços de saúde, uma vez que o mesmo auxilia na classificação operacional da doença, controle de contatos intradomiciliares com resultado do teste positivo, visando à detecção precoce dos casos suspeitos de hanseníase.

The detection rate of leprosy in the district of Paracatu is high in the age group under 15 years-old, including about 6.8/10,000 inhabitants in 2003, and classified as hyperendemic. The study aimed to analyze the application of the PGL-1 (ML Flow) serological test in 56 of 68 school-age patients of the public school system, diagnosed with leprosy through active case finding in Paracatu, Minas Gerais State (2004 to 2006), with 71% classified as paucibacillary. Of these, 85.2% lived in urban areas, 55.8% were female and the disease was predominant in the 10 to 14 year-old age group (95%CI: 0.49-0.89; c2=7.373), with 15 (26.7%) presenting a positive ML Flow result. Five patients showed grade 1 disabilities in the borderline clinical form (40% ML Flow positive). The percentage of leprosy cases among household contacts was 46.4%, 44.9% presenting positive ML Flow test results. The study suggests incorporating the ML Flow test into the health services, since it assists in the operational classification of the disease and in the control of household contacts with positive test results, aimed at early detection of suspected leprosy cases.