Fatores preditivos na evolução na evolução do grau de incapacidades de portadores de hanseníase atendidos em uma unidade básica de saúde de Belo Horizonte/MG, no período de 1993 a 2003.

Abstract

The aim of the present study was to determine the predictive factors which contributed to change in the WHO disability grade of leprosy patients attended by the physiotherapists of Centro de Saúde Barreiro/Belo Horizonte-MG, from 1993 to 2003. The retrospectivecohort involved 595 patients. Data was computerized and SPSS 12.0 was used for analysis. Initially, a descriptive analysis of the sample was made. Later a univariate analysis was made using the Chi-square test for linear trend and a multivariate analysis, through the ordinal logistic regression model, to verify the predictive factors of disability at diagnosis.A survival analysis was used to determine the time until the occurrence of neuritis, and the Cox regression model was used for a multivariate analysis estimating the relative risks. Finally the disability grade at diagnosis and release from treatment were compared usingthe marginal homogeneity test, followed by a univariate analysis using the Chi-square test for linear trend and a multivariate analysis using the CHAID tree, to verify the predictive factors of change in disability grade. RESULTS: 53% of the sample was male, the median age was 42, 26% presented a positive BI (Bacteriological index), 71% had less than 3nerves involved, 63% had WHO disability grade zero at diagnosis and 18% had grade 2. Gender, age and number of nerves involved were predictive factors for the disability grade at diagnosis. In relation to the time until the occurrence of neuritis, 48% of the sample haddeveloped the event until the 12th month of treatment. The predictive factors were a positive BI and disability grade 1, followed by grade 2 at diagnosis. A positive dynamics was verified regarding change in disability grade, with 15% of the sample showing improvement, 83,55% maintaining the sample and 1,32% showing worsening, whencomparing diagnosis to release from treatment. The present study showed the need for early diagnosis of neuropathy as well as an efficient association of pharmacological and nonpharmacological treatment, through adequate doses of steroids and prevention of disabilitytechniques