Universität zu Köln

Haefner, Kathrin, Walther, Friederike, Chichava, Olga Andre, Ariza, Liana, Alencar, Carlos Henrique ORCID: 0000-0003-2967-532X, Freitas De Alencar, Maria De Jesus, Ramos, Alberto Novaes, Jr., Richter, Joachim and Heukelbach, Jorg ORCID: 0000-0002-7845-5510 (2017). High occurrence of disabilities caused by leprosy: census from a hyperendemic area in Brazil's savannah region. Lepr. Rev., 88 (4). S. 520 - 533. COLCHESTER: LEPRA. ISSN 2162-8807

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Abstract

Objectives: To describe leprosy-related disabilities, we performed a census including people affected by leprosy in 78 municipalities of Tocantins state in northern Brazil. The study consisted of a review of patient charts, structured questionnaires, and clinical examinations for disabilities of eyes, hands, and feet (August December 2009), according to WHO standards. Results: A total of 910 individuals diagnosed from 2006 to 2008 were included (clinical examination and application of questionnaires), but information from patient charts was not available in all cases, resulting in different denominators. The majority (783/858; 91.3%) had completed multidrug therapy. The most common clinical findings included: enlarged/painful peripheral nerves (412/910, 45.3%), namely of ulnar (207; 22.7%), posterior tibial (196; 21.6%), peroneal (186; 20.5%), and radial cutaneous nerves (166; 18.2%); reduction/loss of sensibility 201/907 (22.2%) and reduced motor function (185/906, 20.4%). At diagnosis, 142/629 (22.6%) had Grade 1 disability (G1D), and 28/629 (4.5%) had Grade 2 disability (G2D). At the time of the study, 178/910 (19.6%) presented with G1D, and 84/910 (9.2%) with G2D. Disability grading was significantly higher in males (P < 0.01). Subjects with G2D showed claw hands (26; 2.9%), followed by plantar ulcers (23; 2.5%), abrasion/excoriation on the foot (12; 1.3%), claw foot (7; 0.7%), and drop foot (7; 0.7%). Conclusions: Leprosy-related disabilities were common in a highly endemic area. Prevention and rehabilitation measures, especially after release from treatment, should be intensified by the primary health care system. Policy makers need to be aware of an ongoing demand for leprosy control programmes, even in a world of constantly reducing leprosy detection.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Haefner, Kathrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Walther, Friederike UNSPECIFIED UNSPECIFIED UNSPECIFIED Chichava, Olga Andre UNSPECIFIED UNSPECIFIED UNSPECIFIED Ariza, Liana UNSPECIFIED UNSPECIFIED UNSPECIFIED Alencar, Carlos Henrique UNSPECIFIED orcid.org/0000-0003-2967-532X UNSPECIFIED Freitas De Alencar, Maria De Jesus UNSPECIFIED UNSPECIFIED UNSPECIFIED Ramos, Alberto Novaes, Jr. UNSPECIFIED UNSPECIFIED UNSPECIFIED Richter, Joachim UNSPECIFIED UNSPECIFIED UNSPECIFIED Heukelbach, Jorg UNSPECIFIED orcid.org/0000-0002-7845-5510 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-208346
Journal or Publication Title:	Lepr. Rev.
Volume:	88
Number:	4
Page Range:	S. 520 - 533
Date:	2017
Publisher:	LEPRA
Place of Publication:	COLCHESTER
ISSN:	2162-8807
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HANSENS-DISEASE CONTROL; PHYSICAL-DISABILITIES; MULTIDRUG THERAPY; AFTER-DISCHARGE; AMAZON REGION; IMPAIRMENTS; STATE; DIAGNOSIS Multiple languages Dermatology; Infectious Diseases; Pathology; Tropical Medicine Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/20834