Abstract
BackgroundLeprosy is a chronic infectious disease neglected, caused by Mycobacterium leprae, considered a public health problem because may cause permanent physical disabilities and deformities, leading to severe limitations. This review presents an overview of the results of epidemiological studies on leprosy occurrence in childhood in Brazil, aiming to alert health planners and managers to the actual need to institute special control strategies.Methodology/Principal findingsData collection consisted of an electronic search for publications in eight databases: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scientific Electronic Library Online (SciELO), PuBMed, Biblioteca Virtual em Saúde (BVS), SciVerse Scopus (Scopus), CAPES theses database, CAPES journals database and Web of Science of papers published up to 2016. After apply selection criteria, twenty-two papers of studies conducted in four different regions of Brazil and published between 2001 and 2016 were included in the review. The leprosy detection rate ranged from 10.9 to 78.4 per 100,000 inhabitants. Despite affecting both sexes, leprosy was more common in boys and in 10-14-year-olds. Although the authors reported a high cure proportion (82–90%), between 1.7% and 5.5% of the individuals developed a disability resulting from the disease.Conclusions/SignificanceThe findings of this review shows that leprosy situation in Brazilian children under 15 years is extremely adverse in that the leprosy detection rate remains high in the majority of studies. The proportion of cases involving disability is also high and reflects the difficulties and the poor effectiveness of actions aimed at controlling the disease. The authors suggest the development of studies in spatial clusters of leprosy, where beyond the routine actions established, are included news strategies of active search and campaigns and actions of educations inside the clusters of this disease. The new agenda needs to involve the precepts of ethical, humane and supportive care, in order to achieve a new level of leprosy control in Brazil.
Highlights
Leprosy is a chronic infectious disease caused by Mycobacterium leprae
These limitations did not allow the analysis of individual and collective risk factors among other epidemiological aspects. In spite of these limitations, the results of this study will be useful, especially for public health, since they will help to alert the decision makers to the need in identifying the care needs of those under 15 years of age affected by the disease due to social stigma and the leprosy physical repercussions in the children. It has not been the object of evaluation of most of the studies, several authors point out that one of the problems of leprosy control is the fragility of surveillance, since the action of health services is predominantly individualized, with a low proportion of search active contacts
The detection of new cases depends on the spontaneous demand of the individual, who mostly seek the health service in advanced stage of the disease, which increases the risk of permanent damage. [3, 5, 19, 23]
Summary
Leprosy is a chronic infectious disease caused by Mycobacterium leprae. The incubation period of M. leprae is very long, in some cases up to ten years, and for this reason the majority of cases only become clinically detectable in adulthood. Leprosy control has improved markedly around the world over the past thirty years. During this period the leprosy prevalence fell from 21.1 per 10,000 inhabitants in 1983 to 0.24 per 10,000 inhabitants in 2000. This decline occurred due to the generalized use of multidrug therapy (MDT), in addition to nationwide campaigns and an improvement in the quality of health services directed to leprosy treatment in endemic countries [1]. In 2016, the World Health Organization (WHO) launched a new global strategy entitled “The Global Leprosy Strategy 2016–2020: Accelerating towards a leprosy-free world” [4]
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