Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/12559
Title: Progression of leprosy disability after discharge: is multidrug therapy enough?
Authors: Sales, Anna Maria
Campos, Dayse Pereira
Hacker, Mariana Andrea
Nery, José Augusto da Costa
Düppre, Nádia Cristina
Rangel, Emanuel
Sarno, Euzenir Nunes
Penna, Maria Lucia Fernandes
Affilliation: Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ, Brasil.
Universidade Federal Fluminense. Instituto de Saúde da Comunidade. Departamento de Epidemiologia e Bioestatística. Niterói, RJ, Brasil.
Abstract: objective To evaluate the risk factors related to worsening of physical disabilities after treatment discharge among patients with leprosy administered 12 consecutive monthly doses of multidrug therapy (MDT/WHO). methods Cohort study was carried out at the Leprosy Laboratory in Rio de Janeiro, Brazil. We evaluated patients with multibacillary leprosy treated (MDT/WHO) between 1997 and 2007. The Cox proportional hazards model was used to estimate the relationship between the onset of physical disabilities after release from treatment and epidemiological and clinical characteristics. results The total observation time period for the 368 patients was 1 570 person-years (PY), averaging 4.3 years per patient. The overall incidence rate of worsening of disability was 6.5/ 100 PY. Among those who began treatment with no disability, the incidence rate of physical disability was 4.5/100 PY. Among those who started treatment with Grade 1 or 2 disabilities, the incidence rate of deterioration was 10.5/100 PY. The survival analysis evidenced that when disability grade was 1, the risk was 1.61 (95% CI: 1.02–2.56), when disability was 2, the risk was 2.37 (95% CI 1.35–4.16), and when the number of skin lesions was 15 or more, an HR = 1.97 (95% CI: 1.07– 3.63). Patients with neuritis showed a 65% increased risk of worsening of disability (HR = 1.65 [95% CI: 1.08–2.52]). conclusion Impairment at diagnosis was the main risk factor for neurological worsening after treatment/MDT. Early diagnosis and prompt treatment of reactional episodes remain the main means of preventing physical disabilities.
Keywords: Disability grade
Leprosy
Risk factors
Survival analysis
Treatment
keywords: Grau de incapacidade
DeCS: Hanseníase
Fatores de Risco
Análise de Sobrevida
Tratamento
Issue Date: 2013
Publisher: Blackwell Publishing
Citation: SALES, Anna Maria; et al. Progression of leprosy disability after discharge: is multidrug therapy enough?. Tropical Medicine and International Health, v.18, n.9, p.1145-1153, Sept. 2013.
DOI: 10.1111/tmi.12156
ISSN: 1360-2276
Copyright: restricted access
Appears in Collections:INI - Artigos de Periódicos
IOC - Artigos de Periódicos

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