Abstract
BackgroundLeprosy has a global presence; more than 180 thousand new cases were registered in 2013, 15% of which were found in the Americas. The elderly are a very susceptible demographic in terms of developing illnesses, mainly because of characteristics natural to the senescence of the human organism. This study’s goals were to analyze leprosy in an elderly population from a hyperendemic region of the Brazilian Amazon in a historical series from 2004 to 2013 and to determine the clinical and epidemiological profile of a series of leprosy cases of elderly people in the period spanning from 2009 to 2013.MethodsTo achieve these goals, an observational, longitudinal, retrospective and descriptive study was put together to analyze leprosy in elderly people from data acquired from the Notification Aggravations Information System. Furthermore, a profile of the disease from a retrospective cohort based on data collected from medical records was developed.ResultsThe number of new cases and the leprosy detection rate decreased across the observed period but remained stable among the elderly. The trend for the next ten years indicates decreases in the number of cases and in the detection rate in the general population and an increase in only the elderly. The overall profile was characterized by a predominance of males (64.32%), the multibacillary clinical form (87.57%), Type 1 reaction episodes (37.50%) and some physical incapacity at diagnosis (49.19%). The risk of reaction was greater in the first six months of multidrug therapy, and the positive result from the skin smear was associated with the greater chance of reactional condition development.ConclusionsThe resulting data demonstrate that leprosy amongst the elderly deserves attention because of the increased susceptibility to disability in this age group, with their higher risk of reaction and their greater level of co-morbidity.
Highlights
The number of new cases and the leprosy detection rate decreased across the observed period but remained stable among the elderly
Poverty is closely related to the occurrence of Neglected Tropical Diseases (NTDs), and leprosy has high endemicity mainly in Africa, the Americas, Southeast Asia and the Eastern Pacific, where social and economic inequalities reflect adverse conditions of life and health for the population [1]
The elderly population of the state showed a reduction in the number of cases, but the detection rate suffered a less significant drop and an approximately constant conformation
Summary
Poverty is closely related to the occurrence of Neglected Tropical Diseases (NTDs), and leprosy has high endemicity mainly in Africa, the Americas, Southeast Asia and the Eastern Pacific, where social and economic inequalities reflect adverse conditions of life and health for the population [1]. Brazil is number two in the world for leprosy, registering more than 30 thousand new cases a year [2]. In North Brazil, the state of Para, a region with a low Development Human Index (DHI) in the country, is considered hyperendemic with 3,917 notified cases in 2014 alone [3]. Leprosy can affect people of all ages, including the elderly. When diagnosed and treated late, leprosy leads to physical disability [5] that, when combined with the aging process and other comorbidities, can cause the loss of personal autonomy to the elderly person [6]. Leprosy has a global presence; more than 180 thousand new cases were registered in 2013, 15% of which were found in the Americas. This study’s goals were to analyze leprosy in an elderly population from a hyperendemic region of the Brazilian Amazon in a historical series from 2004 to 2013 and to determine the clinical and epidemiological profile of a series of leprosy cases of elderly people in the period spanning from 2009 to 2013
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