Leprosy in children in Cuba: Epidemiological and clinical description of 50 cases from 2012-2019.

INTRODUCTION: In 1993, Cuba achieved leprosy elimination according to the World Health Organization's (WHO) indicator of less than one case per 10,000 population. Despite this achievement, detection of new cases occurs every year among all age groups including children. Detection of new cases in children reveals persistent transmission of the infection. OBJECTIVE: To describe the clinical and epidemiological features of leprosy in individuals younger than 15 years (childhood leprosy) reported to the Cuban National Leprosy Control Program (NLCP) between 2012 and 2019. METHODS: We conducted a retrospective descriptive study between 2012 and 2019 to assess the clinical and epidemiologic features of individuals under the age of 15 years with a confirmed diagnosis of leprosy reported to the NLCP. We reviewed the NLCP database and collected data to better define the total number of cases of leprosy in adults, children (younger than 15 years). We assessed socio-demographic variables (age, gender, and province of residence) as well as variables of clinical interest including operational classification and staging at diagnosis, bacillary index, grade of disability by WHO staging. Additionally, we evaluated epidemiological variables including passive versus active surveillance of cases, contact investigation focusing specifically in household transmission, and the degree of kinship as well as standing of the child within the focus of transmission when there were additional cases. RESULTS: We identified fifty children during the study period corresponding to 3% of the overall cases of leprosy comprising all age groups in Cuba. In the age group younger than 15 years, the majorities of cases was from the Granma province and most were between the ages of 10 and 14 years. Clinically, multibacillary/lepromatous forms were the most common type identified with positive bacillary index. The majority of children diagnosed with leprosy during our study period had a history of a relative with a confirmed diagnosis of leprosy. CONCLUSIONS: Detection of cases of leprosy in individuals younger than 15 years of age in Cuba demonstrates ongoing transmission of M. leprae in specific geographic hotspots. Its frequency in the early adolescence, the predominant clinical forms, and the mode of detection associated with sources of suspected familiar infection demonstrated that there is a need for further efforts by the NLCP to conduct active surveillance activities among affected communities to identify cases of leprosy earlier with the goal of preventing further household and community transmission.

Tratamiento del acné con ácido glicirricínico / Treatment of acne with acid Glycyrrhizin

Se desarrolló un estudio en el Servicio de Dermatología del Hospital Pediátrico Docente Juan M. Márquez de Ciudad Habana, Cuba, para evaluar la eficacia y tolerancia del ácido glicirricínico de aplicación tópica en el acné, comedoniano, acné papulopustuloso y acné noduloquistico según la clasificación vigente del Grupo Latinoamericano para el estudio del Acné. Fueron comprendidos en el estudio pacientes entre 10 y 17 años que no recibieron tratamiento en los últimos tres meses. Se le administró dos aplicaciones diarias de ácido glicirricínico por vía tópica en las áreas afectadas por el acné, este tratamiento se prolongó por un periodo de 8 semanas y se realizó una reevaluación del paciente a los 15 días a las 4 y las 8 semanas. Predominaron las formas papulopustulosa leve y la comedoniana. El 98 por ciento de los presentaron una respuesta buena al tratamiento(AU)

Caracterización de los casos de Lepra Infantil atendidos en el Hospital Pediátrico Universitario Juan Manuel Márquez / Characterization of cases of leprosy treated at the Children's Pediatric Hospital Universitario Juan Manuel Marquez

La lepra es una enfermedad crónica transmisible tan antigua como el hombre mismo. En Cuba se ha desarrollado un programa nacional orientado a prevenir, diagnosticar oportunamente y tratar de forma adecuada esta enfermedad. En este trabajo nos propusimos mostrar su comportamiento en los niños entre 0 años y 17 años, 11 meses y 29 días. Se realizó un estudio descriptivo, retrospectivo y transversal de los casos de lepra atendidos en la consulta de Dermatología del Hospital Pediátrico Universitario Juan Manuel Márquez de Ciudad Habana desde su inauguración (Noviembre 1989) hasta el año 2006. Como hallazgo significativo se encontro que predominan las formas clínicas con mayor posibilidad de transmitir la enfermedad, y que juega un rol fundamental como fuente de transmisión la familia inmediata. Todos los casos diagnóticados eran mayores de 10 años(AU)