ABSTRACT
Abstract Background Leprosy is an infectious and contagious disease caused by Mycobacterium leprae and is mainly characterized by lesions in the skin and peripheral nerves. In Brazil, it is a public health problem due to its high endemicity. However, the state of Rio Grande do Sul presents low endemicity of this disease. Objective To characterize the epidemiological profile of leprosy in the state of Rio Grande do Sul from 2000 to 2019. Methods This was a retrospective observational study. Epidemiological data were collected from the Notifiable Diseases Information System (SINAN, Sistema de Informação de Agravos de Notificação). Results Among the 497 municipalities in the state, 357 (71.8%) registered cases of leprosy in the assessed period, with an average of 212 (81.5%) new cases per year. The average detection rate was 1.61 new cases per 100,000 inhabitants. The male sex was predominant (51.9%) and the mean age was 50.4 years. Regarding the epidemiological clinical profile; 79.0% of the patients were multibacillary; 37.5% presented the borderline clinical form; 16% had grade 2 physical disability at diagnosis and bacilloscopy was positive in 35.4% of cases. As for treatment, 73.8% of the cases were treated with the standard multibacillary therapeutic regimen. Study limitations There were missing/inconsistent data in the database available. Conclusions The findings observed in this study indicate that the state presents a low endemicity profile of the disease and these results can support adequate health policies relevant to the reality of Rio Grande do Sul, inserted in a national scenario of highly endemic leprosy.
ABSTRACT
Introdução: A Hanseníase (Doença de Hansen) é uma doença infectocontagiosa, que apresenta tropismo pela pele e nervos periféricos, cujo diagnóstico tardio pode causar sequelas físicas e emocionais. A Hanseníase em crianças é considerada um dos principais indicadores da tendência da doença e sugere intensa circulação do Mycobacterium leprae. Métodos: Um estudo retrospectivo, observacional e analítico foi conduzido com dezoito crianças diagnosticadas e tratadas no Ambulatório de Dermatologia Sanitária de Porto Alegre, Brasil. As informações clínicas e sociodemográficas foram obtidas através do Sistema de Informação de Agravos de Notificação (SINAN). Resultados: Durante o período de 2007-2017, 478 indivíduos foram diagnosticados como novos casos de Hanseníase em nosso Serviço; dentre esses, 18 (3,76%) eram crianças menores de 15 anos de idade, e sete foram diagnosticadas somente no ano de 2017. Dentre as 18 crianças, 15 (83,3%) eram multibacilares, e somente uma apresentou grau 2 de incapacidade. Aproximadamente 11% da amostra desenvolveram reações hansênicas durante o período de acompanhamento; 61,1% tinham entre 10 e 14 anos de idade. Contatos domiciliares foram identificados em 77,8% dos pacientes. Conclusão: Este estudo mostra que, apesar da situação endêmica ser menos preocupante no Sul do Brasil em relação às demais regiões brasileiras, o aumento da incidência de casos de Hanseníase em 2017 em indivíduos menores de 15 anos pode indicar uma mudança na tendência da doença e do indicador de detecção de casos novos da Hanseníase no Rio Grande do Sul, Brasil(AU).
Setting: Leprosy (Hansen's disease) is an infectious and contagious disease, which presents tropism on the skin and peripheral nerves, and its late diagnosis can lead to serious physical and emotional disabilities. Leprosy in children is considered one of the main indicators of the disease trend and suggests intense circulation of Mycobacterium leprae. Methods: A retrospective, observational and analytical study was conducted of 18 children, diagnosed as new cases of Leprosy and registered for treatment at the Ambulatory of Sanitary Dermatology, Porto Alegre, Brazil. The medical and socio-demographic details were obtained from the Information System for Notificable Diseases. Results: During 2007-2017, 478 people were diagnosed as new active cases of Leprosy at our referral center; among the registered patients, 18 (3,76%) were children aged under 15 years, of whom 15 (83,3%) were diagnosed with multibacillary disease and just one was reported with grade 2 of disability (G2D). Between new cases under 15 years of age, seven were detected in 2017. Nearly 11% of the sample developed reactions during the follow-up period; 61,1% were between 10 to 14 years old. Household contacts were identified in 77,7% of the patients. Conclusion: This study shows that despite the more favourable situation in the South of Brazil, the increase in Leprosy incidence in 2017 in individuals under 15 years may reveal a change in the trend of the disease and in the detection of the new cases of the Hansen's disease in Rio Grande do Sul, Brazil(AU).