Fatores relacionados à prevalência de incapacidades físicas em hanseníase na microrregião de Diamantina, Minas Gerais

Abstract

Leprosy is important for public health because of its disabling power, affecting mainly the economically active age group. When the diagnosis is late, neural injuries and physical disabilities may occur. The micro-region of Diamantina presented in 2008 and 2009, 50.0% and 31.0% of their new cases with grade 2 of disability, respectively. The purpose of this study was to analyze the factors related to the occurrence of disability among the reported cases of leprosy in Diamantina and region. We chose to study a retrospective epidemiological cohort, descriptive and analytical. We interviewed the patients who underwent treatment for leprosy between 2005 and 2010. The sample consisted of 71 participants. A data collection instrument was prepared containing information of Information System for Notifiable Diseases chips and the interviews. The survey was approved by the Council of Ethics in Research/Universidade Federal de Minas Gerais seem 0512.0.203.000-10 ETIC, in accordance with Resolution 196/96 of the National Council of Ethics in Research. A characterization of the micro region was conducted electing whether socioeconomic, demographic, clinical, epidemiological factors as well as access to health service for the leprosy diagnosis and treatment. There were problems filling the Information System for Notifiable Diseases on variables such as reactive episodes and degree of disability in healing. It was found in silent towns, near hyper-endemic ones, 73.2% of multibacillary cases, 78.9% of diagnoses with some degree of physical disability, a slight predominance of females and low family income. Virtually, active search for detection of leprosy didnt exist. The population sought health facilities late, after the first symptoms of the disease appeared. The Family Health Strategies stood out as the major sites of diagnosis and treatment, and the time required for the diagnosis was around one month and patients were assisted by more than two health professionals. There was little information about self-care, and lack of educational activities in groups. In bivariate analysis there was a statistical relationship among education (p=0,032), number of affected nerves (p=0,006) and difficulty of transportation to health services (p=0,031), with the dependent variable, degree of disability at diagnosis. A small trend was noticed towards improvement in physical disability when comparing the times of diagnosis and cure, with a tendency to stagnation. We conclude that there is a strong influence on the level of education among the population in recognizing the main symptoms of leprosy. Despite the improvements to access at health services with the advent of the Family Health Strategies implementation, greater organization of leprosy care actions is still needed. It is imperative greater investment in areas of health education focused on the reality of the localities, so that people and professionals recognize early signs of leprosy, therefore avoiding late diagnosis and physical disabilities.