Physical disabilities caused by leprosy in 100 million cohort in Brazil
Abstract 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...
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| Format: | Article |
| Language: | English |
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BMC
2021-03-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-021-05846-w |
| _version_ | 1818725174381379584 |
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| author | Mauro Niskier Sanchez Joilda Silva Nery Júlia Moreira Pescarini André Alves Mendes Maria Yury Ichihara Camila Silveira Silva Teixeira Maria Lúcia Fernandes Penna Liam Smeeth Laura Cunha Rodrigues Maurício Lima Barreto Elizabeth B. Brickley Gerson Oliveira Penna |
| author_facet | Mauro Niskier Sanchez Joilda Silva Nery Júlia Moreira Pescarini André Alves Mendes Maria Yury Ichihara Camila Silveira Silva Teixeira Maria Lúcia Fernandes Penna Liam Smeeth Laura Cunha Rodrigues Maurício Lima Barreto Elizabeth B. Brickley Gerson Oliveira Penna |
| author_sort | Mauro Niskier Sanchez |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-17T21:38:07Z |
| format | Article |
| id | doaj.art-e5a905bedb114a2abc20c9ef4d0c778c |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-17T21:38:07Z |
| publishDate | 2021-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-e5a905bedb114a2abc20c9ef4d0c778c2022-12-21T21:31:42ZengBMCBMC Infectious Diseases1471-23342021-03-0121111110.1186/s12879-021-05846-wPhysical disabilities caused by leprosy in 100 million cohort in BrazilMauro Niskier Sanchez0Joilda Silva Nery1Júlia Moreira Pescarini2André Alves Mendes3Maria Yury Ichihara4Camila Silveira Silva Teixeira5Maria Lúcia Fernandes Penna6Liam Smeeth7Laura Cunha Rodrigues8Maurício Lima Barreto9Elizabeth B. Brickley10Gerson Oliveira Penna11Núcleo de Medicina Tropical, Universidade de BrasíliaInstituto de Saúde Coletiva, Universidade Federal da BahiaCentro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz, Rua Mundo, s/n° Parque Tecnológico da Bahia – TrobogyCentro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz, Rua Mundo, s/n° Parque Tecnológico da Bahia – TrobogyCentro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz, Rua Mundo, s/n° Parque Tecnológico da Bahia – TrobogyCentro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz, Rua Mundo, s/n° Parque Tecnológico da Bahia – TrobogyDepartamento de Epidemiologia e Bioestatística, Universidade Federal Fluminense, Bloco do Hospital Universitário Antônio Pedro (Huap) – 3° andarDepartment of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical MedicineDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical MedicineCentro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz, Rua Mundo, s/n° Parque Tecnológico da Bahia – TrobogyDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical MedicineNúcleo de Medicina Tropical, Universidade de BrasíliaAbstract 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.https://doi.org/10.1186/s12879-021-05846-wPhysical disabilitiesLeprosySocioeconomic factorBrazil |
| spellingShingle | Mauro Niskier Sanchez Joilda Silva Nery Júlia Moreira Pescarini André Alves Mendes Maria Yury Ichihara Camila Silveira Silva Teixeira Maria Lúcia Fernandes Penna Liam Smeeth Laura Cunha Rodrigues Maurício Lima Barreto Elizabeth B. Brickley Gerson Oliveira Penna Physical disabilities caused by leprosy in 100 million cohort in Brazil BMC Infectious Diseases Physical disabilities Leprosy Socioeconomic factor 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 | Physical disabilities Leprosy Socioeconomic factor Brazil |
| url | https://doi.org/10.1186/s12879-021-05846-w |
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