Physical disabilities caused by leprosy in 100 million cohort in Brazil

BMC Infectious Diseases

Maria Yury Ichihara¹  Maurício Lima Barreto¹  Júlia Moreira Pescarini¹  André Alves Mendes²  Camila Silveira Silva Teixeira³  Maria Lúcia Fernandes Penna⁴  Elizabeth B. Brickley⁵  Laura Cunha Rodrigues⁵  Liam Smeeth⁶  Joilda Silva Nery⁷  Mauro Niskier Sanchez⁸  Gerson Oliveira Penna⁹ 

[1] Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz, Rua Mundo, s/n° Parque Tecnológico da Bahia – Trobogy, CEP 41745-715, Salvador, Brazil;Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz, Rua Mundo, s/n° Parque Tecnológico da Bahia – Trobogy, CEP 41745-715, Salvador, Brazil;Departamento de Estatística, Universidade Federal Bahia, Rua Barão de Jeremoabo, s/n° - Ondina, CEP 40170-115, Salvador, Bahia, Brazil;Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz, Rua Mundo, s/n° Parque Tecnológico da Bahia – Trobogy, CEP 41745-715, Salvador, Brazil;Instituto de Saúde Coletiva, Universidade Federal da Bahia, Rua Basílio da Gama, s/n° - Canela, CEP 40110-040, Salvador, Bahia, Brazil;Departamento de Epidemiologia e Bioestatística, Universidade Federal Fluminense, Bloco do Hospital Universitário Antônio Pedro (Huap) – 3° andar, Rua Marquês do Paraná, 303, Centro, Niterói, CEP 24030-210, Rio de Janeiro, Brazil;Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, WC1E 7HT, London, UK;Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, WC1E 7HT, London, UK;Health Data Research (HDR), London, UK;Instituto de Saúde Coletiva, Universidade Federal da Bahia, Rua Basílio da Gama, s/n° - Canela, CEP 40110-040, Salvador, Bahia, Brazil;Núcleo de Medicina Tropical, Universidade de Brasília, Avenida L3 Norte, s/n°, Campus Universitário Darcy Ribeiro, Gleba A, CEP 70297-400, Brasília, Distrito Federal, Brazil;Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz, Rua Mundo, s/n° Parque Tecnológico da Bahia – Trobogy, CEP 41745-715, Salvador, Brazil;Núcleo de Medicina Tropical, Universidade de Brasília, Avenida L3 Norte, s/n°, Campus Universitário Darcy Ribeiro, Gleba A, CEP 70297-400, Brasília, Distrito Federal, Brazil;Escola Fiocruz de Governo, Fiocruz Brasília. Avenida L3 Norte, s/n°, Campus Universitário Darcy Ribeiro, Gleba A, CEP 70904-130, Brasília, Distrito Federal, Brazil;

关键词: Physical disabilities;    Leprosy;    Socioeconomic factor;    Brazil;   

DOI  :  10.1186/s12879-021-05846-w

来源: Springer

【 摘 要 】

BackgroundLeprosy continues to be an important cause of physical disability in endemic countries such as Brazil. Knowledge of determinants of these events may lead to better control measures and targeted interventions to mitigate its impact on affected individuals. This study investigated such factors among the most vulnerable portion of the Brazilian population.MethodsA large cohort was built from secondary data originated from a national registry of applicants to social benefit programs, covering the period 2001–2015, including over 114 million individuals. Data were linked to the leprosy notification system utilizing data from 2007 until 2014. Descriptive and bivariate analyses lead to a multivariate analysis using a multinomial logistic regression model with cluster-robust standard errors. Associations were reported as Odds Ratios with their respective 95% confidence intervals.ResultsAmong the original cohort members 21,565 new leprosy cases were identified between 2007 and 2014. Most of the cases (63.1%) had grade zero disability. Grades 1 and 2 represented 21 and 6%, respectively. Factors associated with increasing odds of grades 1 and 2 disability were age over 15 years old (ORs 2.39 and 1.95, respectively), less schooling (with a clear dose response effect) and being a multibacillary patient (ORs 3.5 and 8.22). Protective factors for both grades were being female (ORs 0.81 and 0.61) and living in a high incidence municipality (ORs 0.85 and 0.67).ConclusionsThe findings suggest that the developing of physical disabilities remains a public health problem which increases the burden of leprosy, mainly for those with severe clinical features and worse socioeconomic conditions. Early diagnosis is paramount to decrease the incidence of leprosy-related disability and our study points to the need for strengthening control actions in non-endemic areas in Brazil, where cases may be missed when presented at early stages in disease. Both actions are needed, to benefit patients and to achieve the WHO goal in reducing physical disabilities among new cases of leprosy.

【 授权许可】

CC BY