Clinical - epidemiological aspects and spatial analysis of leprosy relapses in an endemic area of Brazil

Beatriz Almeida Santos,Luciene Barbosa,Ítalo Fernando Lisboa De Melo,Thayane Santos Siqueira,Layanne Barbosa Dos Santos,Mariana Do Rosário Souza,José Rodrigo Santos Silva,Rosiene Batista Santos,Allan Dantas Dos Santos,Alexrangel Henrique Cruz Santos,Amanda Francielle Santos,Ariel Oliveira Celestino

doi:10.33448/rsd-v10i10.18761

Abstract

Objective: to analyze the trend, spatial distribution and factors associated with leprosy recurrence in Sergipe. Methods: this is a population-based ecological study, using spatial analysis and logistic regression techniques. Data from all leprosy recurrences reported to SINAN (Notifiable Diseases Information System) in the state of Sergipe, Brazil, were used from 2007 to 2017. Results: there was a tendency for an increase in recurrences in the period from 2011 to 2017: APC: 14.69 (p-value = 0.003). The recurrence incidence map showed a heterogeneous behavior, with the Moran index (I = 0.16; p-value: 0.0159). The multivariate analysis showed a higher risk of recurrence in adults (aOR = 2.81) and young adults (aOR = 2.85) Conclusion: the risk factors associated with the appearance of recurrences are: the age group, the zone, the operational classification , the clinical form and the degree of disability.

Highlights

In 1986, there was a significant reduction in the prevalence of leprosy worldwide with the establishment of multidrug therapy (MDT) in 1986
The ineffective therapeutic regimen, mainly caused by irregular dosage, time and the intake of medications, can compromise the cure, stimulating the occurrence of recurrent cases of the disease (Almeida et al, 2018).Another relevant point in the context of relapses is the monitoring of individuals after discharge, considering the reality of the services offered by the Unified Health System (SUS); the healthcare professional is limited to the assessment of the physical context in the definition of the degree of disability and during the (MDT)( de Souza et al, 2018)
The study presented new approaches and discussions regarding the operationalization of leprosy care actions and services, focusing on recurrences as a major factor for maintaining the disease in the territory

Summary

Introduction

In 1986, there was a significant reduction in the prevalence of leprosy worldwide with the establishment of multidrug therapy (MDT) in 1986. The ineffective therapeutic regimen, mainly caused by irregular dosage, time and the intake of medications, can compromise the cure, stimulating the occurrence of recurrent cases of the disease (Almeida et al, 2018).Another relevant point in the context of relapses is the monitoring of individuals after discharge, considering the reality of the services offered by the Unified Health System (SUS); the healthcare professional is limited to the assessment of the physical context in the definition of the degree of disability and during the (MDT)( de Souza et al, 2018) In this scenario, questions are raised about the effectiveness of the leprosy control program based on the new guidelines of the Ministry of Health (MS)(Barbosa et al, 2014). Among the quality indicators of health services is the assessment of reported cases of recurrences in the year, noting that this indicator was incorporated into the guidelines of the Ministry of Health in 2016, with the objective of identifying and monitoring municipalities that fail in the treatment of the disease (Gonçalves et al, 2019; Melo et al, 2014)

Objectives

Methods

Results

Discussion

Conclusion