Perception of cure among leprosy patients post completion of multi-drug therapy.

BACKGROUND: Leprosy is a treatable disease; however, the release from treatment after completion of multidrug therapy (MDT) often does not equal absence of health problems. Consequently, sequelae interfere with the patient's perception of cure. The objective of this study was to analyze the factors associated with the perception of not being healed among people treated for leprosy in a highly endemic area in Brazil. METHOD: A cross-sectional study of perceived cure of leprosy in the post-release from treatment period was conducted in Cáceres in the state of Mato Grosso, Brazil. The study included a total of 390 leprosy patients treated with MDT and released after completion of treatment from 1 January 2000 to 31 December 2017. The dependent variable was self-reported cure of leprosy; the independent variables included clinical, operational and socioeconomic variables. RESULTS: Out of the 390 former leprosy patients, 304 (77.9%) perceived themselves as cured and 86 (22.1%) considered themselves unhealed. Among the latter, 49 (57.0%) reported muscle weakness and joint pains. Individuals with complaints related to leprosy post-release from treatment had a 4.6 times higher chance to self-report as unhealed (OR 4.6; 95% CI 2.5-8.5). Patients with physical disabilities (PD) grade 1 and 2 at the time of the study had a 3.1 (OR 3.1; 95% CI 1.3-7.4) and 8.8 (OR 7.7; 95% CI 3.5-21.9) times higher likelihood to self-identify as unhealed, respectively. CONCLUSION: Among successfully treated leprosy patients, a quarter self-report as unhealed of the disease. The factors associated with the perception of being unhealed are PD and complaints related to leprosy in the post-release from treatment phase.

Factors associated with the worsening of the disability grade during leprosy treatment in Brazil.

OBJECTIVES: To analyse factors associated with the worsening of physical disabilities during the treatment of leprosy in Brazil in cases that were newly diagnosed in 2009. METHODS: This epidemiological study performed as a retrospective cohort investigated the factors associated with the worsening of the physical disability grade during the treatment of paucibacillary and multibacillary leprosy cases. Logistic regression with a confidence interval of 95% was used to analyse the variables associated with the worsening of disability grade. RESULTS: The cases with the greatest odds for worsening physical disability grade were patients from the south (odds ratio [OR] = 2.60) and southeast regions (OR = 1.74); with multibacillary disease (OR = 3.48); who were illiterate (OR = 2.26); and with reactive episodes (OR = 2.42). CONCLUSIONS: The factors associated with higher odds of worsening physical disability during treatment demonstrate failure to apply appropriate remedial measures to prevent disabilities, and greater attention should be given to patients with the most severe disease.

Detecção de infecção pelo vírus da hepatite B nos municípios brasileiros segundo cobertura dos serviços de hemoterapia, no período de 2001 a 2008 / Detection of infection by hepatitis B virus in the brazilian municipalities according to the coverage of hemotherapy services, in the period from 2001 to 2008

OBJETIVO: descrever a taxa de detecção de infecção pelo vírus da hepatite B no Brasil e a razão de taxas de detecção nos municípios segundo cobertura dos serviços de hemoterapia (SH) durante o período 2001-2008. MÉTODOS: estudo descritivo, compreendeu o cálculo da taxa de detecção de infecção pelo vírus da hepatite B por sexo, faixa etária, Regiões brasileiras e presença de SH; regressão linear para tendência; teste de qui-quadrado para comparação de proporções da detecção e razão de taxas; os dados foram coletados do Sistema de Informação de Agravos de Notificação (Sinan-NET). RESULTADOS: a taxa de detecção de infecção pelo vírus da hepatite B apresentou incremento no Brasil, sendo 2,4 vezes mais elevada nos municípios com SH. CONCLUSÃO: a detecção da infecção pelo vírus da hepatite B apresentou pequeno incremento no período estudado e em todas as Regiões brasileiras foram encontradas taxas mais elevadas em municípios com serviço de hemoterapia.

OBJECTIVE: to describe the detection rate of infection by hepatitis B virus in Brazil and detection rates ratio in municipalities regarding hemotherapy service (HS) during the period 2001-2008. METHODS: a descriptive study reached the detection rate of infection by hepatitis Bvirus by gender, age, Brazilian macro-regions and presence of HS; it was applied linear regression for trend, and chi-squared test to compare proportions of detection and ratio rates; data from the Reportable Diseases Database (Sinan-NET) was used. RESULTS: the detection rates of infection by hepatitis B virus showed increase in Brazil, and were 2.4 higherin municipalities with HS. CONCLUSION: the detection of infection by hepatitis B virus showed small increase during the study period, and all Brazilian regions presented higher rates in municipalities with hemotherapy service.