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1.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-LISBR1.1-47395

RESUMEN

Relatório Ações de Controle - Hanseníase 2010, gerado pelo Centro de Vigilância Epidemiológica da Secretaria de Estado da Saúde de São Paulo do XXII Encontro Estadual de Avaliação das Ações de Controle da Hanseníase em 25 e 26 de maio de 2010


Asunto(s)
Lepra , Monitoreo Epidemiológico , Lepra/prevención & control
2.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-LISBR1.1-47396

RESUMEN

A atual estratégia global de combate à hanseníase se baseia em estratégias quinquenais anteriores. A estratégia de esforço final para a eliminação da hanseníase (2000-2005) se concentrou na PQT e na detecção passiva de casos. A estratégia global para aliviar a carga da hanseníase e manter as atividades de controle da hanseníase (2006-2010) consolidou os princípios de detecção oportuna e quimioterapia efetiva no contexto de serviços integrados de combate à hanseníase. A estratégia global aprimorada para redução adicional da carga da hanseníase (2011-2015) aperfeiçoou ações conjuntas e aprimorou esforços globais para abordar os desafios enfrentados no controle da hanseníase com uma ênfase na detecção precoce para reduzir incapacidades decorrentes da hanseníase. Ainda assim, a estratégia atual é inovadora, pois propicia, além de um componente médico sólido, maior visibilidade e peso aos aspectos humanos e sociais que afetam o controle da hanseníase. A redução de estigmas e a promoção da inclusividade reforçarão o diagnóstico melhor e antecipado. Entre as condutas inovadoras estão a ênfase em crianças, mulheres e outras populações vulneráveis, o fortalecimento dos sistemas de referência, a detecção sistemática de contatos domésticos, o monitoramento da resistência aos medicamentos, o esforço para simplificar a conduta terapêutica e a avaliação do papel da profilaxia pós exposição. Está integrada a agendas mais amplas de saúde e desenvolvimento, inclusive a cobertura universal de saúde e os objetivos de desenvolvimento sustentável.


Asunto(s)
Lepra , Lepra/prevención & control , Erradicación de la Enfermedad , Estrategias Mundiales
3.
Rev Bras Epidemiol ; 23: e200019, 2020.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-32159629

RESUMEN

OBJECTIVE: To characterize spatiotemporal patterns of operational indicators for leprosy control in the state of Bahia from 2001 to 2014. METHODS: This is a population-based ecological study, with spatial distribution and autocorrelation of operational indicators for leprosy control. RESULTS: From 2001 to 2007, 42.7% (n=178) of the municipalities presented a cure rate lower than 75%, increasing to 61.4% (n =291) from 2009 to 2014. Between 2001 and 2007, 32.5% (n=54) of the municipalities reported more than 10% of the total number of relapses in the state, increasing to 36.9% (n=75) between 2008 and 2014. From 2001 to 2014, 38% (n=159) of the municipalities presented an assessment index of disability grading at the time of diagnosis within the regular performance parameter. Between 2009 and 2014, the number of municipalities with a high incidence of grade 2 disability (G2D) at the time of diagnosis increased, reaching 55.3% (n=230) of the municipalities. Most municipalities in the state of Bahia showed poor performance in the implementation of planned actions for leprosy control, with little change or relative worsening in the patterns of operational indicators throughout the historical series. CONCLUSION: The operational context in Bahia indicates significant institutional vulnerability, leading to the need for expansion and qualification of the surveillance and health care network in the different regions and conditions analyzed in the public health system (Sistema Único de Saúde - SUS).


Asunto(s)
Personas con Discapacidad , Enfermedades Endémicas/estadística & datos numéricos , Lepra/prevención & control , Brasil/epidemiología , Ciudades , Estudios de Cohortes , Evaluación de la Discapacidad , Humanos , Incidencia , Lepra/epidemiología , Vigilancia de la Población , Características de la Residencia , Factores de Riesgo , Análisis Espacio-Temporal
4.
Rev Soc Bras Med Trop ; 53: e20190507, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32187344

RESUMEN

INTRODUCTION: Intra-domiciliary contacts are a group with the highest risk of developing leprosy. METHODS: A cross-sectional study of intra-domiciliary contacts of new leprosy cases was conducted. A descriptive analysis of the variables was performed. RESULTS: Among 190 contacts, 63% were invited to visit the health unit, and 54.2% received the BCG vaccine. The prevalence of leprosy among the contacts was 4.7%. CONCLUSIONS: The occurrence of leprosy among the contacts was high and similar to that found previously. There were failures in surveillance actions carried out by health units. Never-before treated cases were found.


Asunto(s)
Vacuna BCG/administración & dosificación , Trazado de Contacto/estadística & datos numéricos , Lepra/epidemiología , Adulto , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Lepra/prevención & control , Masculino , Persona de Mediana Edad , Vigilancia de la Población , Prevalencia , Factores Socioeconómicos , Adulto Joven
5.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud, LIS-bvsms | ID: lis-LISBR1.1-46983

RESUMEN

Considerada a enfermidade mais antiga da humanidade, a hanseníase tem cura, mas ainda hoje representa um problema de saúde pública no Brasil. Doença tropical negligenciada, infectocontagiosa de evolução crônica, se manifesta principalmente por meio de lesões na pele e sintomas neurológicos como dormências e diminuição de força nas mãos e nos pés.


Asunto(s)
Lepra/prevención & control , Enfermedades Transmisibles , Lepra
6.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería, HANSEN | ID: biblio-1051323

RESUMEN

Objetivo: Analisar a percepção de pacientes com hanseníase sobre suas Necessidades Humanas Básicas alteradas. Método: Pesquisa qualitativa e descritiva, realizada com dez pacientes inscritos no Programa Nacional de Controle da Hanseníase em uma Unidade Básica de Saúde em Belém-PA. Dados coletados de agosto a setembro de 2017, por meio de entrevista semiestruturadas e prontuários dos participantes. Os dados foram organizados e analisados na perspectiva da análise de conteúdo. A pesquisa foi aprovada, sob o nº 2.148.415/23.06.2017, pelo Comitê de Ética da Escola de Enfermagem Magalhães Barata. Resultados: foram detectadas cinco necessidades alteradas: necessidades fisiológicas, de segurança, de amor e/ou sociais, de estima e de autorrealização. Evidenciou-se que a percepção das necessidades alteradas estimula ações de autocuidado, com vistas a sua satisfação. Conclusão: O enfermeiro deve prestar cuidados humanizados ao paciente com hanseníase, motivando-os para a autonomia e para o autocuidado, contribuindo para a melhoria da qualidade de vida


Objective: To analyze Hansen's disease patients' perception on their altered fundamental human needs. Method: Qualitative descriptive research, conducted with ten patients who were registered in the National Hansen's Disease Control Program at a Health Unit, in Belém-PA. The data was collected from August to September, 2017, through semi structured interviews and patients' medical reports. The data was organized and analyzed from the perspective of content analysis. The research was approved under the nº 2.148.415/23.06.2017 through the zip code of the Magalhães Barata Nursing School. Results: Five altered needs were identified: physiological, security, of love and/or social, esteem and self-actualizing needs. It was noticeable that the perception of the altered stimulates self-care actions, aiming its satisfaction. Conclusion: The nurse should provide humanized care to Hansen's disease patients, motivating them in order to achieve autonomy and self-care, contributing to an improvement in their quality of life


Objetivos: Analizar la percepción de los pacientes con hanseníasis sobre sus necesidades humanas fundamentales cambiadas. Método: Investigación descriptiva cualitativa, realizada con diez pacientes inscritos en el Programa Nacional de Control de la Hanseníasis en una Unidad Básica de Salud en Belém-PA. Los datos fueron recolectados desde agosto hasta septiembre de 2017, por medio de entrevistas semiestructuradas e historial clínico de los participantes. Los datos fueron organizados y analizados en la perspectiva del análisis de contenido. La investigación fue aprobada bajo el número 2.148.415/23.06.2017 a través del código postal de la Escuela de Enfermería Magalhães Barata. Resultados: Fueron detectadas cinco necesidades cambiadas: necesidades fisiológicas, de seguridad, de amor y/o sociales, de estima y de autorrealización. Fue evidenciado que la percepción de las cambiadas estimula acciones de autocuidado con el objetivo de alcanzar su satisfacción. Conclusión: El enfermero debe ofrecer cuidados humanizados a los pacientes con hanseníasis, motivándolos a todos para la autonomía y para el autocuidado, contribuyendo para la mejoría en la cualidad de vida


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Autocuidado/psicología , Lepra/prevención & control , Lepra/terapia , Calidad de Vida , Educación en Salud , Investigación Cualitativa
7.
BMC Infect Dis ; 19(1): 1033, 2019 Dec 05.
Artículo en Inglés | MEDLINE | ID: mdl-31805862

RESUMEN

BACKGROUND: Leprosy is an ancient infectious disease with a global annual incidence that has plateaued above 200,000 new cases since over a decade. New strategies are required to overcome this stalemate. Post-exposure prophylaxis (PEP) with a single dose of Rifampicin (SDR) has conditionally been recommended by the World Health Organization (WHO), based on a randomized-controlled-trial in Bangladesh. More evidence is required. The Post ExpOsure Prophylaxis for Leprosy (PEOPLE) trial will assess effectiveness of different modalities of PEP on the Comoros and Madagascar. METHODS: PEOPLE is a cluster-randomized trial with villages selected on previous leprosy-incidence and randomly allocated to four arms. Four annual door-to-door surveys will be performed in all arms. All consenting permanent residents will be screened for leprosy. Leprosy patients will be treated according to international guidelines and eligible contacts will be provided with SDR-PEP. Arm-1 is the comparator in which no PEP will be provided. In arms 2, 3 and 4, SDR-PEP will be provided at double the regular dose (20 mg/kg) to eligible contacts aged two years and above. In arm 2 all household-members of incident leprosy patients are eligible. In arm 3 not only household-members but also neighbourhood contacts living within 100-m of an incident case are eligible. In arm 4 such neighbourhood contacts are only eligible if they test positive to anti-PGL-I, a serological marker. Incidence rate ratios calculated between the comparator arm 1 and each of the intervention arms will constitute the primary outcome. DISCUSSION: Different trials on PEP have yielded varying results. The pivotal COLEP trial in Bangladesh showed a 57% reduction in incidence over a two-year period post-intervention without any rebound in the following years. A study in a high-incidence setting in Indonesia showed no effect of PEP provided to close contacts but a major effect of PEP provided as a blanket measure to an entire island population. High background incidence could be the reason of the lack of effect of PEP provided to individual contacts. The PEOPLE trial will assess effectiveness of PEP in a high incidence setting and will compare three different approaches, to identify who benefits most from PEP. TRIAL REGISTRATION: Clinicaltrials.Gov. NCT03662022. Initial Protocol Version 1.2, 27-Aug-2018.


Asunto(s)
Leprostáticos/uso terapéutico , Lepra/prevención & control , Profilaxis Posexposición/métodos , Rifampin/uso terapéutico , Preescolar , Comoras/epidemiología , Composición Familiar , Femenino , Humanos , Incidencia , Leprostáticos/administración & dosificación , Lepra/epidemiología , Madagascar/epidemiología , Masculino , Ensayos Clínicos Controlados Aleatorios como Asunto , Rifampin/administración & dosificación
8.
Fontilles, Rev. leprol ; 32(3): 153-153, sept.-dic. 2019.
Artículo en Español | IBECS | ID: ibc-189961

RESUMEN

No disponible


Asunto(s)
Humanos , Lepra/prevención & control , Objetivos , Congresos como Asunto
9.
PLoS Negl Trop Dis ; 13(10): e0007713, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31603913

RESUMEN

Few investigations to date have analyzed the epidemiology of Hansen's disease (leprosy) in the United States, and in particular, if birth location is related to multibacillary versus paucibacillary leprosy. We collected data on 123 patients diagnosed with leprosy in Georgia from the National Hansen's Disease Program from 1923-January 2018. A logistic regression model was built to examine the relationship between country of origin (U.S.-born or immigrant) and the type of leprosy. While the model showed no significant relationship between country of origin and type of leprosy, being Asian or Pacific Islander was associated with a higher odds of multibacillary disease (aOR = 5.71; 95% CI: 1.25-26.29). Furthermore, since the early 1900s, we found an increasing trend of leprosy reports in Georgia among both domestic born and immigrant residents, despite the overall decrease in cases in the United States during the same time period. More research is therefore necessary to further evaluate risk for multibacillary leprosy in certain populations and to create targeted interventions and prevention strategies.


Asunto(s)
Lepra/epidemiología , Lepra/historia , Emigrantes e Inmigrantes , Grupos Étnicos , Femenino , Georgia/epidemiología , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Lepra/prevención & control , Lepra Multibacilar/epidemiología , Lepra Multibacilar/historia , Lepra Multibacilar/prevención & control , Lepra Paucibacilar/epidemiología , Lepra Paucibacilar/historia , Lepra Paucibacilar/prevención & control , Masculino , Estados Unidos
10.
Int J Infect Dis ; 88: 65-72, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31499206

RESUMEN

OBJECTIVE: To assess the effectiveness of single-dose rifampicin (SDR) after bacillus Calmette-Guérin (BCG) vaccination in preventing leprosy in contacts. METHODS: This was a single-centre, cluster-randomized controlled trial at a leprosy control programme in northwest Bangladesh. Participants were the 14988 contacts of 1552 new leprosy patients who were randomized into the SDR-arm (n=7379) and the SDR+arm (n=7609). In the intervention group, BCG vaccination was followed by SDR 8-12 weeks later. In the control group, BCG vaccination only was given. Follow-up was performed at 1year and 2 years after intake. The main outcome measure was the occurrence of leprosy. RESULTS: The incidence rate per 10000 person-years at risk was 44 in the SDR-arm and 31 in the SDR+arm at 1year; the incidence rate was 34 in the SDR-arm and 41 in the SDR+arm at 2 years. There was a statistically non-significant (p=0.148; 42%) reduction for paucibacillary (PB) leprosy in the SDR+ arm at 1 year. Of all new cases, 33.6% appeared within 8-12 weeks after BCG vaccination. CONCLUSIONS: In the first year, SDR after BCG vaccination reduced the incidence of PB leprosy among contacts by 42%. This was a statistically non-significant reduction due to the limited number of cases after SDR was administered. To what extent SDR suppresses excess leprosy cases after BCG vaccination is difficult to establish because many cases appeared before the SDR intervention. TRIAL REGISTRATION: Netherlands Trial Register: NTR3087.


Asunto(s)
Vacuna BCG/administración & dosificación , Leprostáticos/administración & dosificación , Lepra/prevención & control , Rifampin/administración & dosificación , Adolescente , Adulto , Bangladesh , Niño , Preescolar , Femenino , Humanos , Incidencia , Lepra/diagnóstico , Lepra/tratamiento farmacológico , Lepra/microbiología , Masculino , Persona de Mediana Edad , Mycobacterium leprae/efectos de los fármacos , Mycobacterium leprae/fisiología , Vacunación , Adulto Joven
11.
PLoS Negl Trop Dis ; 13(9): e0007646, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31539374

RESUMEN

BACKGROUND: The country of Kiribati is a small Pacific island nation which had a new case detection rate of 191 per 100,000 in 2016, and is one of the few countries yet to reach the WHO leprosy elimination goal. Chemoprophylaxis of household contacts of new cases, or to the whole population in a highly endemic areas have been found to be effective in reducing new case rates. This study investigated the potential impact of different chemoprophylaxis strategies on future cases in South Tarawa, the main population centre of Kiribati. METHODOLOGY: The microsimulation model SIMCOLEP was calibrated to simulate the South Tarawa population and past leprosy control activities, and replicate annual new cases from 1989 to 2016. The impact of six different strategies for delivering one round of single dose rifampicin (SDR) chemoprophylaxis to household contacts of new cases and/or one or three rounds of SDR to the whole population was modelled from 2017 to 2030. PRINCIPAL FINDINGS: Our model predicted that continuing the existing control program of high levels of public awareness, passive case detection, and treatment with multidrug treatment would lead to a substantial reduction in cases but this was less effective than all modelled intervention scenarios. Mass chemoprophylaxis led to a faster initial decline in cases than household contact chemoprophylaxis alone, however the decline under the latter was sustained for longer. The greatest cumulative impact was for household contact chemoprophylaxis with three rounds of mass chemoprophylaxis at one-year intervals. CONCLUSIONS: The results suggest that control of leprosy would be achieved most rapidly with a combination of intensive population-based and household chemoprophylaxis. These findings may be generalisable to other countries where crowding places social contacts as well as household contacts of cases at risk of developing leprosy.


Asunto(s)
Lepra/prevención & control , Adolescente , Adulto , Quimioprevención , Niño , Trazado de Contacto , Composición Familiar , Femenino , Humanos , Leprostáticos/administración & dosificación , Lepra/epidemiología , Masculino , Micronesia/epidemiología , Modelos Teóricos , Rifampin/administración & dosificación , Rifampin/uso terapéutico , Adulto Joven
12.
J Dermatol ; 46(10): 853-858, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31432529

RESUMEN

In patients with lepromatous leprosy, Mycobacterium leprae is often observed inside the human microvascular endothelial cells (HMVEC) surrounding Schwann cells (SC) at the site of lesions in the peripheral nerves. Based on this observation, it is considered that the nasal mucous may be the invasion pathway for M. leprae and HMVEC serve as an important reservoir for the bacteria before they invade SC. In light of previous research which revealed that Mce1A protein mediates bacterial invasion into nasal epithelial cells and HMVEC, we conducted a study to determine whether the invasion of M. leprae into HMVEC can be suppressed by blocking the Mce1A protein. In this study, we analyzed bacterial invasive activity by adding recombinant Escherichia coli, which express the active region (InvX:72 a.a.) of Mce1A protein on their external membrane, into cultured HMVEC, using the adhesin involved in the diffuse adherence mechanism. The number of bacteria that invaded into the cells was then measured by a colony counting method. The active region of Mce1A was divided into four sections, and hyperimmune antisera was prepared for each section for analyzing the inhibitory effect against invasion. The invasive activity was suppressed by antibodies against InvX regions 1-24 a.a., 25-46 a.a. and 58-72 a.a. This suggests that the InvX regions 1-24 a.a., 25-46 a.a. and 58-72 a.a. of Mce1A protein play an important role in the invasion of M. leprae into HMVEC and that it may be possible to suppress entry of M. leprae in HMVEC with antibodies against these regions.


Asunto(s)
Anticuerpos Antibacterianos/inmunología , Proteínas Bacterianas/inmunología , Células Endoteliales/microbiología , Lepra/inmunología , Mycobacterium leprae/inmunología , Animales , Anticuerpos Antibacterianos/aislamiento & purificación , Proteínas Bacterianas/genética , Línea Celular , Recuento de Colonia Microbiana , Humanos , Sueros Inmunes/inmunología , Sueros Inmunes/aislamiento & purificación , Lepra/microbiología , Lepra/prevención & control , Mycobacterium leprae/patogenicidad , Conejos , Proteínas Recombinantes/genética , Proteínas Recombinantes/inmunología
13.
Rev Saude Publica ; 53: 61, 2019 Aug 01.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31390430

RESUMEN

OBJECTIVE: To analyze the temporal trend of leprosy indicators in a hyperendemic state of Brazil, from 2001-2015. METHODS: This is a time-series study of leprosy indicators in the state of Maranhão, Northeastern region of Brazil. The study used data from the Brazilian National System of Reportable Diseases, for the period between 2001 and 2015. The following indicators were evaluated: (i) detection coefficient in the general population; (ii) detection coefficient in people under 15 years old; (iii) rate of cases with grade 2 physical disability in the diagnosis; (iv) rate of examined contacts, and (v) proportion of healing . The Prais-Winsten regression model was used for trend analysis. Analyses were performed for the state and by each health region. RESULTS: 77,697 leprosy cases were analyzed in the general population and 7,599 in individuals under 15 years old. The detection coefficient in the general population ranged from 80.7/100 thousand inhabitants in 2001 to 51.2/100 thousand inhabitants in 2015. The coefficient in the general population presented a downward trend (annual percentage variation [APV] = -2.98; 95%CI -4.15- -1.79). For the population under 15 years old, the rate was 24.9/100 thousand inhabitants in 2001, and 19.9/100 thousand inhabitants in 2015, with downward trend (APV = -3.07; 95%CI -4.95- -1.15). It was observed upward trend in rate of contacts examined (APV = 2.35; 95%CI 0.58-4.15) and rate of cases with grade 2 disability (APV = 2.19; 95%CI 0.23-4.19). Stationary trend was observed in the proportion of healing (APV = -0.10; 95%CI -0.50-0.30). Regional differences were found in the performance of the indicators. CONCLUSIONS: A downward trend for the detection coefficients in the general population and in individuals under 15 years old was found in Maranhão. Despite this result, the rates are still very high, demanding efforts from all spheres of public administration and health professionals to reduce the burden of the disease in the state.


Asunto(s)
Enfermedades Endémicas/estadística & datos numéricos , Indicadores de Salud , Lepra/epidemiología , Enfermedades Desatendidas/epidemiología , Adolescente , Adulto , Anciano , Brasil/epidemiología , Femenino , Geografía , Humanos , Lepra/diagnóstico , Lepra/prevención & control , Lepra/transmisión , Modelos Lineales , Masculino , Persona de Mediana Edad , Vigilancia de la Población , Factores de Tiempo , Adulto Joven
14.
Fontilles, Rev. leprol ; 32(2): 87-104, mayo-ago. 2019. tab
Artículo en Español | IBECS | ID: ibc-187212

RESUMEN

Se realizó una investigación observacional descriptiva prospectiva con el objetivo de determinar la eficacia del uso de la rifampicina como tratamiento profiláctico en los contactos de primer orden de los casos de lepra en el municipio Camagüey, durante los años 2000 al 2010. Predomino el grupo de 40 a 49 años, sin diferencias significativas en cuanto al sexo. En más de la mitad de los contactos el per cápita familiar fue malo y tenían hacinamiento. La madre resultó ser la fuente de infección más probable, con más de 10 años de convivencia con los contactos en la mayoría de los casos. Un mínimo por ciento de los contactos desarrolló lepra, con serología UMELISA HANSEN reactiva y examen dermato-neurológico con lesiones sugestivas de la enfermedad y uno solo con baciloscopia positiva. Los enfermos presentaron lepra paucibacilar, dentro de esta, la indeterminada. Se concluyó que la quimioprofilaxis con rifampicina en dosis única no fue totalmente efectiva


A prospective, descriptive, observational investigation was carried out with the aim of determining the effectiveness of the use of the rifampicin as a preventive treatment in household contacts of leprosy in Camagüey city, from 2000 to 2010. The majority of the contacts were in the age group from 40 to 49 years, without significant gender differences. In more than half of the contacts, the family income rate was poor and they lived in harsh conditions. In the majority of cases, the mother turned out to be the source of infection. A very small percent of the contacts developed leprosy, with positive ELISA serology and dermal - neurological examination with suggestive lesions of the illness and only one case with positive skin smear. The affected individuals presented indeterminate leprosy a form of paucibacillary leprosy. The study concluded that Chemoprophylaxis with only one dose of rifampicin was not totally effective


Asunto(s)
Humanos , Masculino , Femenino , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Trazado de Contacto/estadística & datos numéricos , Leprostáticos/uso terapéutico , Rifampin/uso terapéutico , Lepra/transmisión , Factores Socioeconómicos , Profilaxis Posexposición , Estudios Prospectivos , Lepra/prevención & control , Cuba
15.
Rev Gaucha Enferm ; 40: e20180258, 2019 Jun 06.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31188975

RESUMEN

OBJECTIVE: To analyze contextual relations of health care in the discharge of leprosy. METHOD: An analytical, reflexive study based on the theoretical framework of context analysis, elaborated through an integrative review of literature in the databases SCOPUS, PUBMED, LILACS, SCIELO and BDENF, with uncontrolled descriptors Leprosy and Patient Discharge, obtaining 14 publications. RESULTS: The immediate context addresses health care at discharge in leprosy; the specific context treats leprosy as a public health problem; the symbolic conceptions and marks involving leprosy are encompassed by the general context; and in the metacontext are described the health programs and policies that subsidize the care of leprosy patients. CONCLUSION: The contextual elements emphasize the need to guarantee universal coverage of cases of leprosy, from diagnosis to the post-discharge, reinforcing leprosy as a public health problem. Despite the limitations of the bibliographic studies, these have relevance for the health area.


Asunto(s)
Prestación de Atención de Salud , Lepra/tratamiento farmacológico , Alta del Paciente , Salud Pública , Brasil , Diagnóstico Tardío , Promoción de la Salud , Humanos , Leprostáticos/uso terapéutico , Lepra/diagnóstico , Lepra/prevención & control
17.
PLoS Negl Trop Dis ; 13(4): e0007302, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30951526

RESUMEN

BACKGROUND: With the introduction of new interventions to prevent leprosy, such as post-exposure prophylaxis (PEP) given to contacts of leprosy patients, it is necessary to update our understanding of knowledge and perception of leprosy among the populations where these interventions will be introduced, in order to tailor communication optimally to the current situation. This study is a baseline study of the PEP++ project and aimed to assess the knowledge, attitudes and practices regarding leprosy in Fatehpur, India. METHODOLOGY: The study used a community-based cross-sectional design with a mixed-methods approach. We assessed knowledge, attitudes, and practices with the KAP measure, and stigma with the Explanatory Model Interview Catalogue community stigma scale (EMIC-CSS) and the Social Distance Scale (SDS). In addition, semi-structured interviews and focus group discussions were conducted with all participant groups. The quantitative data were analysed using stepwise multivariate regression. The qualitative data were analysed using open, inductive coding and content analysis. FINDINGS: A total of 446 participants were included in the study: 100 persons affected by leprosy, 111 close contacts, 185 community members and 50 health care workers. In addition, 24 in-depth interviews were conducted and 35 people were included in focus group discussions. 12.5% of the participants had adequate knowledge of leprosy, while 22% had poor knowledge. Knowledge on cause (answered correctly by 10% of the participants), mode of transmission (5%) and symptoms of leprosy (16%) was especially poor. The mean EMIC-CSS score was 15.3 (95%CI 14.6-16.0) and mean SDS score 7.2 (95%CI 6.6-7.8). Better knowledge of leprosy was associated with lower levels of social distance towards persons affected by leprosy. CONCLUSION: This study revealed poor knowledge regarding leprosy and high levels of stigma and fear and desire to keep social distance towards persons affected by leprosy. Community education that takes cultural beliefs, knowledge gaps and fears into consideration could improve knowledge, reduce misconceptions and positively influence the perception of leprosy.


Asunto(s)
Erradicación de la Enfermedad , Conocimientos, Actitudes y Práctica en Salud , Lepra/prevención & control , Percepción Social , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Investigación Participativa Basada en la Comunidad , Estudios Transversales , Femenino , Educación en Salud , Personal de Salud/psicología , Humanos , India/epidemiología , Lepra/epidemiología , Masculino , Persona de Mediana Edad , Estigma Social , Encuestas y Cuestionarios , Adulto Joven
18.
PLoS Negl Trop Dis ; 13(4): e0007329, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-31009481

RESUMEN

BACKGROUND: Leprosy elimination defined as a registered prevalence rate of less than 1 case per 10,000 persons was achieved in Kenya at the national level in 1989. However, there are still pockets of leprosy in some counties where late diagnosis and consequent physical disability persist. The epidemiology of leprosy in Kenya for the period 2012 through to 2015 was defined using spatial methods. METHODS: This was a retrospective ecological correlational study that utilized leprosy case based data extracted from the National Leprosy Control Program database. Geographic information system and demographic data were obtained from Kenya National Bureau of Statistics (KNBS). Chi square tests were carried out to check for association between sociodemographic factors and disease indicators. Two Spatial Poisson Conditional Autoregressive (CAR) models were fitted in WinBUGS 1.4 software. The first model included all leprosy cases (new, retreatment, transfers from another health facility) and the second one included only new leprosy cases. These models were used to estimate leprosy relative risks per county as compared to the whole country i.e. the risk of presenting with leprosy given the geographical location. PRINCIPAL FINDINGS: Children aged less than 15 years accounted for 7.5% of all leprosy cases indicating active leprosy transmission in Kenya. The risk of leprosy notification increased by about 5% for every 1 year increase in age, whereas a 1% increase in the proportion of MB cases increased the chances of new leprosy case notification by 4%. When compared to the whole country, counties with the highest risk of leprosy include Kwale (relative risk of 15), Kilifi (RR;8.9) and Homabay (RR;4.1), whereas Turkana had the lowest relative risk of 0.005. CONCLUSION: Leprosy incidence exhibits geographical variation and there is need to institute tailored local control measures in these areas to reduce the burden of disability.


Asunto(s)
Notificación de Enfermedades/estadística & datos numéricos , Lepra/epidemiología , Análisis Espacial , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Distribución de Chi-Cuadrado , Niño , Preescolar , Bases de Datos Factuales , Femenino , Humanos , Incidencia , Lactante , Recién Nacido , Kenia/epidemiología , Lepra/diagnóstico , Lepra/prevención & control , Masculino , Persona de Mediana Edad , Distribución de Poisson , Vigilancia de la Población , Prevalencia , Estudios Retrospectivos , Distribución por Sexo , Adulto Joven
19.
Rev. pesqui. cuid. fundam. (Online) ; 11(3): 739-747, abr.-maio 2019. tab, il
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-987983

RESUMEN

Objective: The study's target has been to analyze the causes and solutions strategies for leprosy in children using the Ishikawa Diagram. Methods: It is a literature review based on the Ishikawa Diagram production, which was carried out over April 2017 in the databases of PubMed, Virtual Health Library (VHL), EBSCO and SciELO. Results: It was identified that the prevalence of leprosy in children is due to social, environmental and cultural factors, where: socioeconomic conditions, population cluster and lack of professional qualification correspond to 70% of the mentioned causes. Conclusion: It was evidenced the need for intensifying epidemiological surveillance, promoting larger investments in preventive actions, such as health education, including the adoption of professional training towards the professionals directly responsible the disease diagnosis


Objetivo: Analisar por meio do Diagrama de Ishikawa as causas e as estratégias de soluções para hanseníase em crianças. Método: Revisão da literatura baseada na construção do Diagrama de Ishikawa, realizado em abril de 2017, nos bancos de dados do Pubmed, Biblioteca Virtual de Saúde (BVS), Scielo e Ebsco. Resultados: Identificou-se que a prevalência da hanseníase em crianças se dá por fatores sociais, ambientais e culturais, onde: condições socioeconômicas, aglomerado populacional e ausência de capacitação profissional correspondem a 70% das causas apontadas. Conclusão: Evidenciou-se a necessidade de intensificar a vigilância epidemiológica, realizar maiores investimentos nas ações preventivas, como a educação em saúde, incluindo também a adoção de capacitações dos profissionais responsáveis pelo diagnóstico


Objetivo: Analizar por medio del diagrama de Ishikawa las causas y estrategias de las soluciones para la lepra en los niños. Método: Revisión de la literatura basada en la construcción del Diagrama de Ishikawa, realizado en abril de 2017 en los bancos de datos del Pubmed, Biblioteca Virtual de Salud (BVS), Scielo y Ebsco. Resultados: Se identificó que la prevalencia de la hanseniasis en niños se da por factores sociales, ambientales y culturales, donde: condiciones socioeconómicas, aglomerado poblacional y ausencia de capacitación profesional corresponden al 70% de las causas señaladas. Conclusión: Se evidenció la necesidad de intensificar la vigilancia epidemiológica, realizar mayores inversiones en las acciones preventivas, como la educación en salud, incluyendo también la adopción de capacitaciones de los profesionales responsables del diagnóstico


Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Grupo de Atención al Paciente/estadística & datos numéricos , Lepra/diagnóstico , Lepra/prevención & control , Lepra/terapia , Salud Pública/educación , Salud Pública , Creación de Capacidad
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