Abstract
Introdution: Hansen’s disease is an infecto-contagious, chronic and curable disease, caused by the Mycobacterium Leprae with a preference for the peripheral nervous system. Objectives: To determine the clinical forms and the operational classification of patients suffering from Hansen's disease; to identify the disability grade of patients diagnosed with Hansen’s disease. Methods: Cross-sectional study with a quantitative approach of a descriptive nature performed on 104 patients diagnosed with Hansen’s disease. Most were male, 63 (60.6%), with an average age of 37 years, 49% had pardo complexion and 34.6% had an elementary education level. Data was collected from the: Notifiable Diseases Information System – SINAN in 2014; Simplified Neurologic Assessment Form for assessing the Grade of Disability (Brasil, 2010, p.35), taken from the Guide for Prevention of Disabilities (Brasil, 2008, p. 112-113). Results: The operational classification of patients suffering from Hansen’s disease revealed that 47.1% were paucibacillary while 52.9% were multibacillary and that 31.7% were diagnosed with the Borderline form and 25.9% with the Tuberculoid form. The Physical Disability Grade (PDG) at the time of diagnosis was the following: Grade 0 – 73 (70.20%); Grade 1 - 17 (16.35%); and 9 patients (8.65%) had developed Grade 2 disabilities. The odds ratios significantly indicate that for women with Hansen’s disease the risk of not having physical disabilities at the time of diagnosis is about 4 times higher than it is for men (OR= 3.868; CI 95%=1.316-11.368). Conclusions: The occurrence of disabilities resulting from Hansen’s disease mostly in men is still a public health problem in Brazil. Therefore, active search for cases within the community, examining household contacts, monitoring of patients by the healthcare units, educational campaigns and research with students in schools are examples of policies which should be implemented in order to eradicate this endemic disease and reduce sequelae thereof.
Highlights
Hansen’s disease is an infecto-contagious, curable disease which develops slowly, implicating the skin and with a preference for the peripheral nervous system
This classification considers four clinical forms: Indeterminate leprosy (IL); Tuberculoid leprosy (TL); Virchowian leprosy (VL) which is difficult to diagnose during the early stage due to chronicity, extensive general involvement and because the parasitism of the skin, eyes, nerves, viscera and other organs is visibly asymptomatic; Dimorphic leprosy (DL), in which there is extensive and intense involvement of the skin, nerves and in rarer cases of other organs and in which ulcerations are more frequent
Hansen’s disease is an infecto-contagious curable. Managing this illness should not be solely restricted to controlling the large number of cases, but it should include the consideration of its high debilitating potential which generates economic losses and psychologic traumas and may influence the patient's job and social life
Summary
Hansen’s disease is an infecto-contagious, curable disease which develops slowly, implicating the skin and with a preference for the peripheral nervous system. To the risk of the Mycobacterium leprae infecting populations exposed to the bacillus being correlated to low education levels, precarious housing and socioeconomic conditions (Pönnighaus, Fine, Sterne, Bliss, Wilson, Malema, et al 1994, p.10-23 and Sales, Ponce de Leon, Düppre, Hacker, Nery, Sarno, et al 2011 apud Carvalho, 2013, p.1), the genetic factors which can influence the illness’ process and favour the clinical development of Hansen’s disease should be taken into consideration The objectives set were the following: to identify the Physical Disability Grade; to determine the clinical forms and the operational classification of people suffering from Hansen’s disease; to characterize the participants as for sociodemographic aspects (age, gender, race, and education level) According to the World Health Organization's pact aiming to eradicate Hansen’s disease, the research carried out is up-todate and based on the following research questions: What is the physical disability grade at the time of diagnosis and at the date of discharge in people with Hansen’s disease? Which are the most prevailing clinical forms and operational classification of Hansen’s disease? Which are the characteristics of the sample regarding sociodemographic aspects (age, gender, race, and education level)? The objectives set were the following: to identify the Physical Disability Grade; to determine the clinical forms and the operational classification of people suffering from Hansen’s disease; to characterize the participants as for sociodemographic aspects (age, gender, race, and education level)
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