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Physical disabilities caused by leprosy in 100 million cohort in Brazil

BACKGROUND: Leprosy continues to be an important cause of physical disability in endemic countries such as Brazil. Knowledge of determinants of these events may lead to better control measures and targeted interventions to mitigate its impact on affected individuals. This study investigated such fac...

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Autores principales: Sanchez, Mauro Niskier, Nery, Joilda Silva, Pescarini, Júlia Moreira, Mendes, André Alves, Ichihara, Maria Yury, Teixeira, Camila Silveira Silva, Penna, Maria Lúcia Fernandes, Smeeth, Liam, Rodrigues, Laura Cunha, Barreto, Maurício Lima, Brickley, Elizabeth B., Penna, Gerson Oliveira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983385/
https://www.ncbi.nlm.nih.gov/pubmed/33752632
http://dx.doi.org/10.1186/s12879-021-05846-w
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author Sanchez, Mauro Niskier
Nery, Joilda Silva
Pescarini, Júlia Moreira
Mendes, André Alves
Ichihara, Maria Yury
Teixeira, Camila Silveira Silva
Penna, Maria Lúcia Fernandes
Smeeth, Liam
Rodrigues, Laura Cunha
Barreto, Maurício Lima
Brickley, Elizabeth B.
Penna, Gerson Oliveira
author_facet Sanchez, Mauro Niskier
Nery, Joilda Silva
Pescarini, Júlia Moreira
Mendes, André Alves
Ichihara, Maria Yury
Teixeira, Camila Silveira Silva
Penna, Maria Lúcia Fernandes
Smeeth, Liam
Rodrigues, Laura Cunha
Barreto, Maurício Lima
Brickley, Elizabeth B.
Penna, Gerson Oliveira
author_sort Sanchez, Mauro Niskier
collection PubMed
description BACKGROUND: Leprosy continues to be an important cause of physical disability in endemic countries such as Brazil. Knowledge of determinants of these events may lead to better control measures and targeted interventions to mitigate its impact on affected individuals. This study investigated such factors among the most vulnerable portion of the Brazilian population. METHODS: A large cohort was built from secondary data originated from a national registry of applicants to social benefit programs, covering the period 2001–2015, including over 114 million individuals. Data were linked to the leprosy notification system utilizing data from 2007 until 2014. Descriptive and bivariate analyses lead to a multivariate analysis using a multinomial logistic regression model with cluster-robust standard errors. Associations were reported as Odds Ratios with their respective 95% confidence intervals. RESULTS: Among the original cohort members 21,565 new leprosy cases were identified between 2007 and 2014. Most of the cases (63.1%) had grade zero disability. Grades 1 and 2 represented 21 and 6%, respectively. Factors associated with increasing odds of grades 1 and 2 disability were age over 15 years old (ORs 2.39 and 1.95, respectively), less schooling (with a clear dose response effect) and being a multibacillary patient (ORs 3.5 and 8.22). Protective factors for both grades were being female (ORs 0.81 and 0.61) and living in a high incidence municipality (ORs 0.85 and 0.67). CONCLUSIONS: The findings suggest that the developing of physical disabilities remains a public health problem which increases the burden of leprosy, mainly for those with severe clinical features and worse socioeconomic conditions. Early diagnosis is paramount to decrease the incidence of leprosy-related disability and our study points to the need for strengthening control actions in non-endemic areas in Brazil, where cases may be missed when presented at early stages in disease. Both actions are needed, to benefit patients and to achieve the WHO goal in reducing physical disabilities among new cases of leprosy.
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spelling pubmed-79833852021-03-22 Physical disabilities caused by leprosy in 100 million cohort in Brazil Sanchez, Mauro Niskier Nery, Joilda Silva Pescarini, Júlia Moreira Mendes, André Alves Ichihara, Maria Yury Teixeira, Camila Silveira Silva Penna, Maria Lúcia Fernandes Smeeth, Liam Rodrigues, Laura Cunha Barreto, Maurício Lima Brickley, Elizabeth B. Penna, Gerson Oliveira BMC Infect Dis Research Article BACKGROUND: Leprosy continues to be an important cause of physical disability in endemic countries such as Brazil. Knowledge of determinants of these events may lead to better control measures and targeted interventions to mitigate its impact on affected individuals. This study investigated such factors among the most vulnerable portion of the Brazilian population. METHODS: A large cohort was built from secondary data originated from a national registry of applicants to social benefit programs, covering the period 2001–2015, including over 114 million individuals. Data were linked to the leprosy notification system utilizing data from 2007 until 2014. Descriptive and bivariate analyses lead to a multivariate analysis using a multinomial logistic regression model with cluster-robust standard errors. Associations were reported as Odds Ratios with their respective 95% confidence intervals. RESULTS: Among the original cohort members 21,565 new leprosy cases were identified between 2007 and 2014. Most of the cases (63.1%) had grade zero disability. Grades 1 and 2 represented 21 and 6%, respectively. Factors associated with increasing odds of grades 1 and 2 disability were age over 15 years old (ORs 2.39 and 1.95, respectively), less schooling (with a clear dose response effect) and being a multibacillary patient (ORs 3.5 and 8.22). Protective factors for both grades were being female (ORs 0.81 and 0.61) and living in a high incidence municipality (ORs 0.85 and 0.67). CONCLUSIONS: The findings suggest that the developing of physical disabilities remains a public health problem which increases the burden of leprosy, mainly for those with severe clinical features and worse socioeconomic conditions. Early diagnosis is paramount to decrease the incidence of leprosy-related disability and our study points to the need for strengthening control actions in non-endemic areas in Brazil, where cases may be missed when presented at early stages in disease. Both actions are needed, to benefit patients and to achieve the WHO goal in reducing physical disabilities among new cases of leprosy. BioMed Central 2021-03-22 /pmc/articles/PMC7983385/ /pubmed/33752632 http://dx.doi.org/10.1186/s12879-021-05846-w Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Sanchez, Mauro Niskier
Nery, Joilda Silva
Pescarini, Júlia Moreira
Mendes, André Alves
Ichihara, Maria Yury
Teixeira, Camila Silveira Silva
Penna, Maria Lúcia Fernandes
Smeeth, Liam
Rodrigues, Laura Cunha
Barreto, Maurício Lima
Brickley, Elizabeth B.
Penna, Gerson Oliveira
Physical disabilities caused by leprosy in 100 million cohort in Brazil
title Physical disabilities caused by leprosy in 100 million cohort in Brazil
title_full Physical disabilities caused by leprosy in 100 million cohort in Brazil
title_fullStr Physical disabilities caused by leprosy in 100 million cohort in Brazil
title_full_unstemmed Physical disabilities caused by leprosy in 100 million cohort in Brazil
title_short Physical disabilities caused by leprosy in 100 million cohort in Brazil
title_sort physical disabilities caused by leprosy in 100 million cohort in brazil
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983385/
https://www.ncbi.nlm.nih.gov/pubmed/33752632
http://dx.doi.org/10.1186/s12879-021-05846-w
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