Prevalence of hepatitis B and C virus infection among leprosy patients in a leprosy-endemic region of central Brazil

Leprosy and hepatitis B virus (HBV) are highly endemic in some regions of the state of Mato Grosso, in central Brazil. The association of leprosy with HBV and hepatitis C virus (HCV) was assessed using a seroprevalence study and 191 leprosy outpatients were included. Demographic data and the clinical classification of leprosy were recorded. Evidence of previous HBV infection was present in 53 patients (27.7 percent, 95 percent confidence interval: 21.9-34.5) and two (1 percent) were HBsAg positive. Five (2.6 percent) had antibodies to HCV. The prevalence of previous exposure to HBV was higher than expected for an adult population in central Brazil. In contrast, the prevalence of anti-HCV antibodies was not much higher regarding the age range of participants. HBV markers were associated with a higher number of sex partners and the use of injections without proper sterilisation of the syringes. The number of HBV carriers was small, suggesting that there was no increased likelihood of chronification among these patients.

Incapacidade pós-tratamento em pacientes hansenianos em Várzea Grande, Estado de Mato Grosso / Disability after treatment among leprosy patients in Várzea Grande, State of Mato Grosso

INTRODUÇÃO: A hanseníase é um importante problema de saúde pública. O Brasil responde por mais de 90 por cento dos casos do continente americano. Aproximadamente, 23 por cento dos pacientes hansenianos apresentam algum tipo de incapacidade após a alta. MÉTODOS: Neste estudo, estimou-se a prevalência das incapacidades em 169 pacientes (94 homens e 75 mulheres) com qualquer das formas clínicas de hanseníase no município de Várzea Grande, MT, que já haviam concluído tratamento nos anos anteriores. Foi realizada entrevista e exame clínico da sensibilidade em mãos e pés mediante os filamentos de Semmes-Weinstein. RESULTADOS: A prevalência de incapacidades na amostra analisada foi de 42,6 por cento sendo 10,1 por cento de grau dois. Encontrou-se relação estatisticamente significante entre maior prevalência de incapacidades e formas multibacilares de hanseníase. Desde o término do tratamento, 84 (50,2 por cento) pacientes apresentaram piora evolutiva da sensibilidade, sendo esta piora associada à presença de lesão neural no momento do diagnóstico. CONCLUSÕES: Estes resultados enfatizam a importância de monitorar a função neural dos pacientes, muito além do momento de finalizar a poliquimioterapia, com o intuito de prevenir a aparição de incapacidades em pacientes que já receberam alta.

INTRODUCTION: Leprosy is a major public health concern. Brazil accounts for more than 90 percent of the cases in the Americas. Around 23 percent of leprosy patients present some kind of disability after discharge. METHODS: In the present study, the prevalence of disabilities among 169 patients (94 men and 75 women) with any of the clinical forms of leprosy, in the municipality of Várzea Grande, Mato Grosso, was estimated. They had already completed treatment over previous years. Interviews were conducted and clinical examinations of hand and foot sensitivity using Semmes-Weinstein filaments were carried out. RESULTS: The prevalence of disabilities among the study sample was 42.6 percent, among which 10.1 percent was grade 2. A statistically significant relationship was found between disabilities and multibacillary forms of leprosy. Since the end of the treatment, sensitivity had worsened in 84 patients (50.2 percent), and this was associated with presence of neural injury at the time of diagnosis. CONCLUSIONS: These results emphasize the importance of monitoring patients' neural functioning well beyond the time of concluding polychemotherapy, with the aim of preventing the appearance of disabilities among patients who have already been discharged.