Navegando por Assunto "Leprosy"

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Análise da adesão medicamentosa de pacientes hansenianos em uma Unidade Básica de Saúde
(Universidade Federal do Pará, 2023-06-16) PINHEIRO, Alcivaldo Mendes; MELLO, Amanda Gabryelle Nunes Cardoso; http://lattes.cnpq.br/8951750304102610; https://orcid.org/0000-0001-7661-1615
Introduction: Leprosy is a chronic transmissible infectious disease that still persists as a public health problem in Brazil. However, through the analysis of polychemotherapy medication adherence, a better quality of life is sought for diagnosed leprosy patients, with the pharmacist playing an important role in promoting early diagnosis and rational use of medication. Objective: To analyze the therapeutic adherence of patients undergoing treatment for leprosy treated at a basic health unit in Belém. Methodology: It is a prospective observational study to characterize the sociodemographic profile of patients undergoing polychemotherapy drug treatment at the Basic Health Unit located in the Guamá neighborhood, in Belém do Pará. Results: The study had the participation of 75 patients, 60 were undergoing treatment and 15 had already been discharged, in which the latter were consulted only to assess the dermatological quality of life. For the demographic and economic survey of patients, those who did not have confirmed diagnoses or had not started treatment were excluded. Final considerations: The predominant age group was between 50 and 59 years old, approximately (11.25%), male (41.25%), self-declared black patients (18.75%), married (21, 0%), high school (15.75%) and who had a formal contract with an income of up to one minimum wage (11.25%). Most patients adhered positively to the treatment, and at the end of the research a Therapeutic Adherence Manual was prepared for the follow-up of patients with leprosy, aiming at updating pharmaceutical practices with an exclusive focus on the care of patients with leprosy.
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Uma análise sócio-demográfica da incidência de hanseníase na Amazônia legal brasileira: abordagem baseada em redes bayesianas
(Universidade Federal do Pará, 2019-02-08) GOMES, José Maria da Silveira; FRANCÊS, Carlos Renato Lisboa; http://lattes.cnpq.br/7458287841862567
Leprosy is a millenarian contagious disease, with chronic and stigmatizing characteristics, from the remotest times of humanity until today. It is characterized as a disease of the poor and Brazil is the second country in the world with the highest incidence. The lack of public policies aimed at reducing poverty through the improvement of socio-economic factors in the country is directly related to the incidence of the disease in Brazil. Strategies for control and monitoring should follow intelligent actions. One of the solutions for monitoring the disease is the use of Bayesian networks as a probabilistic method for taking decisions on both the control and the procedures to adopt in order to reduce the incidence of the disease. The objective of the present study is to analyse the association of leprosy incidence in relation to indicators of human development, habitation and income level, considering the Brazilian Amazon region in relation to the entire country. An ecological study, based on data obtained on cases of leprosy in Brazil for the year 2010, obtained from the Information System of Hardship Notifications (SINAN) through the Informatics Department of the National Health Service (DATASUS) and the socio-economic indicators found in the Demographic Census Research database of the Brazilian Institute for Geographical and Statistical Survey – IBGE, as well as information from the Municipal Human Development Index, regarding education and income, obtained from the website of the Human Development Atlas of Brazil, also for the year 2010. The methodology combined data mining with the analysis of spatial distribution. The Bayesian network technique was used aimed at measuring the association between variables of the domain of the problem as well as to establish the analogy of the data between the municipalities under study with data for all other Brazilian municipalities. Applying the algorithm K2 relevant associations were found for the following indicators applied in the investigation: Brazilian Legal Amazon, Municipal Human Development Index of Income and Education and Household Housing Condition. Using the Bayesian network model adopted, there is a significant association between the percentage of homes with more than 2 inhabitants and the rate of incidence of leprosy. Although the relationship between the rate of incidence, socio-economic factors (no water supply, no toilet, poverty and overcrowding of the home), low educational indices and income has already been reported in several studies, the insertion of the indicators that considers population density of the home was a novel proposition of the present study and the indicators of greatest most significance of this investigation. The analysis of leprosy incidence with respect to spatial distribution, comparing the Amazon region with the entire country, revealed that public policies for habitation in the studied region were almost non-existent, since the population density of homes is very high, facilitating the appearance of contagious diseases such as leprosy.
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Baú de memórias: o leprosário de Marituba/PA em meio a recordações de uma ex-interna (1940-1970)
(Universidade Federal do Pará, 2019-12) CRISTO, Moisés Levy Pinto; SILVA, Gercina Ferreira da; FRANÇA, Maria do Perpétuo Socorro Gomes Avelino de
The present study aims to reflect on the contributions of the memory narratives of ex-inmates at the Hospital Colônia de Marituba/PA, from 1940 to 1970; memories of a lived time that allow to enter the cultural universe of this institution. In the form of a total institution, the City Hospital housed hundreds of lives for the treatment of leprosy. We used as materials for the construction of this analysis interviews with ex-interns of the institution, images about the institution and newspapers. Narratives appear as a form of teaching, which combined with iconographies, texts and testimonies, become important sources of evidence. We used as a theoretical contribution the authors: Bresciani and Naxara (2004), Bosi (1998), Burke (2017), Goffman (1994), Halbwachs (2003), Meihy and Holanda (1997). The narratives and images point to life experiences of the leprosy, a group that has been silenced by brazilian history. Marituba is revealed by agile memories and tired feet that still leave marks on the stones of the city.
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A Cidade dos Lázaros: isolacionismo, políticas públicas e lepra no Pará (1900-1934)
(Universidade Federal do Pará, 2024-06-28) VIEIRA, Elis Regina Corrêa; SANJAD, Nelson Rodrigues; http://lattes.cnpq.br/9110037947248805; https://orcid.org/0000-0002-6372-1185
At the end of the XIX century and the beginning of XX, leprosy went through a process of singularization marked by an intense debate about etiology, therapy and prophylaxis of the disease. In this context, there was a theoric effort to consolidate leprosy as a disease caused by a bacillus and transmitted by contagion. At the same time, if the disease was contagious and its means of transmission was uncertain, the idea of isolating the patients was the only way of avoiding the spread of the disease became strength. In Brazil, many doctors and intellectuals participated in an international network of scientists that debated about the disease. In the same context, the health movement demanded that the Union increase its responsibilities in public health. The leprosy prophylaxis was benefited by these discussions and the federal government started to implement several leprosariums in partnership with the state government. Lazarópolis do Prata, in the state of Pará, was created in this context. It was installed in 1923 and officially opened in June 1924. My thesis proposes that doctors created a model of isolation to Lazarópolis, however, the experience of different individuals recreated the senses of this isolation, challenging the hygienist ideal of a kind, disciplined, and submissive "lázaro" to the doctors. Thus, even an institution seen as a model faced challenges such as escapes and violations to the established norms.
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Ciência de dados e aprendizado de máquina aplicados ao estudo de variáveis epidemiológica hanseníase na Amazônia
(Universidade Federal do Pará, 2024-12-18) FALCÃO, Igor Wenner Silva; CARDOSO, Diego Lisboa; http://lattes.cnpq.br/0507944343674734; SERUFFO, Marcos César da Rocha; http://lattes.cnpq.br/3794198610723464
Leprosy is a significant public health problem that largely affects low-income populations. Although the World Health Organization (WHO) establishes guidelines for diagnosis, prevention, and treatment, disease detection faces limitations, often resulting in late or inaccurate diagnoses and leading to serious neurological complications and multidrug-resistant cases. Therefore, early diagnosis is essential to reduce the burden of this disease. Machine learning has been widely used in several areas of science and industry, but especially in health, where it plays an essential role in the analysis and treatment of large volumes of data. In this sense, this thesis investigates the application of a model based on Data Science and Machine Learning to act in the specification of the clinical profile of possible leprosy cases in the Amazon Region and, thus, to be able to act preventively in the early diagnosis and treatment of patients under medical followup. The work takes into account clinical data of patients from a non-public dataset, collected between 2015 and 2020 in the North region of Brazil. Therefore, this thesis proposes a learning model to identify groups clinically affected by the disease using Clustering and Random Forest techniques. In the results obtained, the proposed model demonstrated efficiency in evaluating the probability of individuals being ill, achieving an accuracy of 90.39% in the performance evaluation and identifying a probability of 83.46% of an individual being ill, considering a set of epidemiological and non-generic variables. This approach offers a promising vision for the future of health, allowing the formulation of effective strategies for the early identification of possible cases.
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Diagnóstico situacional e operacional das ações de controle da hanseníase em município hiperendêmico do maranhão
(Universidade Federal do Pará, 2023-06-16) GORDON, Ariadne Siqueira de Araujo; BARRETO, Josafá Gonçalves
INTRODUCTION: Limitations for the proper implementation of leprosy control actions (LCA) in states and municipalities can strongly contribute to the perpetuation of Mycobacterium leprae transmission in their communities. Thus, constant monitoring of local leprosy control programs seems to be essential for identifying weaknesses, performance and implementing solutions. OBJECTIVE: To conduct a situational and operational diagnosis of leprosy control actions in a hyperendemic municipality in Maranhão. METHOD: Exploratory, analytical, ecological study, with qualitative and quantitative research approach. Developed in the municipality of Imperatriz, covering the teams of the family health strategy (FHS), professionals linked to the leprosy control program, individuals notified with leprosy in the period from 2001 to 2020. Data from the Notifiable Diseases Information System (SINAN) were collected and analyzed. The cases were georeferenced and analyzed to identify spatial clusters. The home addresses of notified cases were georeferenced and analyzed to identify spatial clusters. The FHS territories were also georeferenced to produce digital maps of the coverage areas. These results guided an active search among contacts of index cases and students from two municipal public schools. RESULTS: After evaluating the ACH in the city through the LEM, it was identified that the Basic Health Units (BHU) do not act as recommended for the evaluation of people affected by the disease, causing difficulties in making a diagnosis and initiating treatment. From 2001 to 2020, 6,726 cases were reported in the municipality of Imperatriz, 5,842 were georeferenced (90.8%). The spatial distribution pattern of the cases was heterogeneous with the formation of statistically significant clusters. The distribution of cases by BHU identified that 13.99% of all cases in the period were identified by a BHU. Until 2020, the municipality of Imperatriz had 41 FHS teams in the urban area of the municipality, which represented 60% of FHS coverage. The coverage area of 39 teams (95%) was georeferenced. The analysis indicated that individuals residing in a discovered area by the FHS are 14% more likely to be diagnosed with multibacillary (OR: 1.14; 95%:1.05-1.32; p=0.04) and 40% more chance of having chronic grade 2 disabilities at diagnosis (OR: 1.40; 95% :1.07-1.84; p=0.01). It was observed that over the years the chance of occurrence of multibacillary cases increased (year 2002: OR: 1.67; 95%:1.14-2.44; p<0.001; year 2019: OR: 8.06; 95%:4.86-13.36; p<0.001). The active search action resulted in three (17.6%) diagnoses of relapses among the index cases, 17 (25.3%) new cases among their household contacts and nine (12.3%) new cases among the students. CONCLUSION: Despite the high number of diagnoses carried out by the municipality, the present study identified weaknesses that result in relevant hidden endemic disease. The desired control of leprosy as a public health problem will not be achieved before the effective diagnosis and treatment of current cases that have not yet been identified. Case detection would increase significantly if the fight against leprosy was adequately carried out by the health system.
Acesso aberto (Open Access)
Do índio Passos ao doutor Chernoviz: experiências de cura da lepra no Pará do século XIX
(Fundação Oswaldo Cruz, 2023) COUTO, Márcio Couto
This article analyzes an experiment to cure leprosy using the assacu plant (Hura crepitans L.) conducted in Santarém, Pará, in 1847, by an Indigenous man named Antonio Vieira dos Passos. The experiment was later repeated in other Brazilian provinces and abroad. This article establishes relationships between medical practices in other parts of the country while focusing on the dialog between official and Indigenous medicine. Newspaper articles and official documents of the time show that Indigenous knowledge of medicinal plants was widely recognized and utilized by physicians wishing to incorporate it into the official therapeutic repertoire.
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Escravos no purgatório: o leprosário do Tucunduba (Pará, século XIX)
(Casa de Oswaldo Cruz, Fundação Oswaldo Cruz, 2012-12) HENRIQUE, Márcio Couto
The article analyzes the experience of the slaves interned at the Tucunduba Leprosarium in Belém, state of Pará during the nineteenth century. The slaves were freed once they showed the marks of their leprosy, and expectations were that they would submit to the segregation policy meant to keep them from contact with the rest of the population. The documentation produced by Santa Casa de Misericórdia hospital in Pará and by the province's political authorities reveals the strategies the slaves devised in response to this policy; they used their numerical predominance at the leprosarium to create a network of solidarity that allowed them to recreate their lives and stand in opposition to the type of nation that the era's hygienist theories envisioned.
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Evaluation of agreement between tests for the diagnosis of leprosy
(Sociedade Brasileira de Patologia Clínica, 2017-04) SILVA, Alison Rodrigues da; QUEIROZ, Marcos Fabiano de Almeida; ISHIKAWA, Edna Aoba Yassui; SILVESTRE, Maria do Perpétuo Socorro Amador; XAVIER, Marilia Brasil
Introduction: Leprosy is a chronic infectious disease caused by the intracellular parasite Mycobacterium leprae. The diagnosis is essentially clinical, based on symptoms, skin exam, peripheral nerves and epidemiological history. Laboratory tests are carried out to complement the result of clinical diagnosis, or even serving as a confirmatory method. Objective: To investigate the positivity and agreement between skin smear, enzyme-linked immunosorbent assay (ELISA) with synthetic antigen ND-O-BSA, ML Flow test and polymerase chain reaction (PCR) for detection of Mycobacterium leprae in new cases of leprosy. Methods: We conducted a case series study assessing a convenience sample of 39 new cases of leprosy and a control group of 18 household contacts in Belém (PA) and in Igarapé-Açu (PA) from March 2014 to September 2015. Results: The agreement between ELISA, ML Flow and PCR tests combinations showed slight to absent reproducibility (Kappa ≤ 0.24). The results showed greater sensitivity in PCR assay, with higher positivity in multibacillary cases. The ELISA test showed low positivity, even in multibacillary cases, resulting in no reaction to paucibacillary cases and household contacts. Conclusion: The high sensitivity of PCR decreases the agreement with other tests.
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Força de preensão manual e funcionalidade em pessoas atingidas pela hanseníase, seus contatos intradimiciliares e escolares de área endêmica: Correlação com biomarcador molecular e sorológico de infecção pelo Mycobacterium leprae
(Universidade Federal do Pará, 2023-04-26) CONDE, Renatto Castro; BARRETO, Josafá Gonçalves; http://lattes.cnpq.br/1894551542259862
Leprosy can cause significant physical disabilities if not early diagnosed and treated. The diagnosis is essentially clinical, through dermatoneurological examination, including a subjective and low sensitivity manual muscle strength test. Household contacts of untreated patients are most at risk of developing the disease. Early diagnosis is essential for breaking the chain of transmission and preventing disability. In this context, the use of dynamometry provides objective data on handgrip strength through a simple and cost-effective clinical test, and with functional tests, could contribute to an early detection of peripheral nerve disorders. The aim of this study is to correlate handgrip strength and functionality data with biomarkers of Mycobacterium leprae infection among people affected by leprosy, their household contacts, and schoolchildren in endemic areas. The study was approved (report 5384136) and carried out in Imperatriz (MA), São Luís (MA) and Marituba (PA). Subjects diagnosed with leprosy, their household contacts and school contacts <15 years old were clinically examined and have biological samples collected for the detection of IgM-anti-PGL-I antibodies and for the molecular detection of M. leprae by means of RT-PCR. Strength was measured using a handheld dynamometer, while we used a scale and functional tests to assess functionality. A total of 179 subjects were included in the study, 94 females (52.51%), 67 cases of leprosy (28 new cases and 10 index cases) and 60 healthy household contacts (36.5 ±14.69 years) and 52 healthy schoolchildren from an endemic region. We found a significant prevalence of loss of muscle weakness (p=0.0003) in leprosy cases compared to healthy individuals. Healthy male subjects >15 years old had significantly higher mean values of grip strength and pinch strength (p<0.05) compared to male leprosy cases, except for the pulp pinch. Leprosy cases > 15 years old showed significant functional losses (p<0.05), evaluated by TFMJT and 9-PnB and a longer test time, when compared to the healthy group, mainly women. It was observed that leprosy cases had significantly more activity limitations when assessed on the SALSA scale (p<0.05). Subjects with changes in nerve palpation and decreased tactile sensitivity showed significantly more muscle weakness and functional loss (p<0.05). We found an inversely proportional correlation between anti-PGL-I IgM titers and muscle grip strength and pinch strength in individuals over 15 years of age (p<0.05). While muscle weakness was observed in most RT-PCR positive cases. Of the positive individuals for RT-PCR, 42.31% presented functional loss in the tests, showing a significantly longer time in the TFMJT (p=0.028). Those positive for RT-PCR presented significantly greater times in the block stacking (p=0.046) and feeding simulation (p=0.025) subtests. We observed muscle weakness in 28.75% and loss of function in 33.33% of subjects double positive for anti-PGL-I and RT-PCR. Therefore, these data show us that there may be motor and functional impairment in this population that is more vulnerable to the development of leprosy, where these tests can find disabilities, in addition to those of the traditional clinical evaluation.
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Hanseníase e atenção primária à saúde: uma avaliação de estrutura do programa
(Centro Brasileiro de Estudos de Saúde, 2017-03) SOUSA, Gutembergue Santos de; SILVA, Rodrigo Luis Ferreira da; XAVIER, Marília Brasil
Objective: to evaluate the structure of the municipal program of leprosy control in Canaã dos Carajás (Pará), in the context of Primary Health Care. Methods: this is an assessment of health programs, focusing on leprosy, targeting managers of the leprosy program and managers of health facilities of primary care. Two different questionnaires, developed specifically for this purpose, were used. Conclusion: the municipality in question has a structure classified between poor and regular, showing several weaknesses in the assessed program for the care of leprosy.