Low performance of operational indicators for leprosy control in the state of bahia: Spatiotemporal patterns, 2001–2014

Objective To characterize spatiotemporal patterns of operational indicators for leprosy control in the state of Bahia from 2001 to 2014. Methods This is a population-based ecological study, with spatial distribution and autocorrelation of operational indicators for leprosy control. Results From 2001 to 2007, 42.7% (n=178) of the municipalities presented a cure rate lower than 75%, increasing to 61.4% (n =291) from 2009 to 2014. Between 2001 and 2007, 32.5% (n=54) of the municipalities reported more than 10% of the total number of relapses in the state, increasing to 36.9% (n=75) between 2008 and 2014. From 2001 to 2014, 38% (n=159) of the municipalities presented an assessment index of disability grading at the time of diagnosis within the regular performance parameter. Between 2009 and 2014, the number of municipalities with a high incidence of grade 2 disability (G2D) at the time of diagnosis increased, reaching 55.3% (n=230) of the municipalities. Most municipalities in the state of Bahia showed poor performance in the implementation of planned actions for leprosy control, with little change or relative worsening in the patterns of operational indicators throughout the historical series. Conclusion The operational context in Bahia indicates significant institutional vulnerability, leading to the need for expansion and qualification of the surveillance and health care network in the different regions and conditions analyzed in the public health system (Sistema Único de Saúde – SUS)

Fatores sociodemográficos e clínicos de casos de hanseníase associados ao desempenho da avaliação de seus contatos no Ceará, 2008-2019

Objective: To analyze the association between sociodemographic and clinical characteristics of new cases (NC) of leprosy as determinants in the performance of contact assessment. Methods: A cross-sectional study with temporal approach of the 100% examined contacts assessment indicator of each NC registered in the State of Ceará, Brazil, via the Notification Information System, 2008-2019. Logistic regression was undertaken to estimate the odds ratio (OR) with 95% confidence intervals (95%CI). The time trend was based on Joinpoint regression. Results: 23,675 NC of leprosy were analysed, 65.4% with examined contacts. There was a greater chance of not evaluating of 100% of registered contacts when the NC was multibacillar (OR=1.19 – 95%CI 1.11;1.28), and with contact examination as entry mode (OR=1.71 – 95%CI 1.35;2.18). An increasing time trend of the indicator was verified (annual percentage change: 2.1 (95%CI 1.2;3.0). Conclusion: Different dimensions of individual and social vulnerability of new cases of leprosy in Ceará influence the persistent unsatisfactory performance of the evaluation of their contacts.Objetivo: Analisar o efeito de características sociodemográficas e clínicas de casos novos (CN) de hanseníase como determinantes no desempenho da avaliação dos contatos. Métodos: Estudo transversal, com abordagem temporal do indicador de avaliação de 100% dos contatos examinados de CNs registrados no Ceará, Brasil, via Sistema de Informação de Agravos de Notificação, em 2008-2019. Empregou-se regressão logística para estimar razão de chances (OR) com intervalos de confiança de 95% (IC95%). A tendência temporal baseou-se em regressão joinpoint. Resultados: Analisou-se 23.675 CNs, 65,4% com contatos examinados. Verificou-se maior chance para não avaliação de 100% dos contatos registrados com CN multibacilar (OR=1,19 – IC95% 1,11;1,28) e com exame de contatos como modo de entrada (OR=1,71 – IC95% 1,35;2,18). A tendência temporal do indicador foi de aumento (variação percentual anual: 2,1 – IC95% 1,2;3,0). Conclusão: Dimensões distintas de vulnerabilidade individual e social de CNs de hanseníase influenciam o persistente desempenho insatisfatório da avaliação de contatos

Hansen's disease: care to avoid complications

The booklet "Hansen ´s Disease: care to avoid complications" was published in 1995 by UFRJ and founded by INFOLEP project. The proposal is to answer those common questions of a person who just received a diagnosis of Hansen´s Disease. This 5th 2022 edition, an e-book, with 36 pages was funded by a project coordinated by the NGO NHR, supported by Ministry of Health (MS) and PAHO. In addition to the technical update, the main characters show the diversity found in health professionals and users of the Brasilian Unified Health System (SUS), as well as replace terms such as “carriers of leprosy” to “people affected by Hansen´s Disease (HD). This disease is characterized as a chronic condition that requires longitudinal monitoring and adherence to self-care, supported by a multidisciplinary team. The booklet addresses reactions, adverse drug effects, personal life, contact examination and eye, hand and foot care. It is hoped that its expanded use, in online form, will be useful, especially in the discussion in self-care groups and added to other content related to a better understanding of HD, treatment and care to prevent disabilities in the SUS network.ONG NHR BrasilOrganização Pan-Americana da SaúdeMinistério da SaúdeA cartilha "Hanseníase: cuidados para evitar complicações" foi publicada em 1995, pela FM/NUTES/UFRJ, apoiado por projeto/INFOLEP. Proposta para responder perguntas comuns de da pessoa que acaba de receber o diagnóstico de hanseníase, tem nesta 5ª edição de 2022, a forma de e-book, com 36 páginas e financiamento de um projeto coordenado pela ONG NHR, com apoio do Ministério as Saúde (MS) e OPAS. Além da atualização técnica as personagens principais mostram a diversidade encontrada nos profissionais de saúde e usuários do Sistema Único de Saúde brasileiro (SUS), bem como a substituição de alguns termos como “pessoas acometidas pela hanseníase”, em substituição a “portadores de hanseníase. A hanseníase é uma doença que se caracteriza como uma condição crônica que impõe acompanhamento longitudinal e adesão a autocuidados, apoiados por equipe multidisciplinar. A cartilha aborda reações, efeitos adversos dos medicamentos, vida pessoal, exame de contatos e os cuidados com olhos, mãos e pés. Espera-se que a sua utilização ampliada, na forma online, seja útil, especialmente na discussão em grupos de autocuidado e complemente outros conteúdos relativos ao melhor entendimento da hanseníase, tratamento e cuidados para prevenir incapacidades, na rede do SUS

Social representation of Hansen's disease thirty years after the term 'leprosy' was replaced in Brazil

Based on the theories of social representation (SC) and Central Core (CC), a structural study was undertaken regarding the neologism hanseníase (Hansen's disease), the term adopted by Brazil's Ministry of Health in the 1970s. Carried out during 2001, this study interviewed eight hundred housewives residing in the Rio de Janeiro and Duque de Caxias municipalities. It found that Hansen's disease is part of a process of modernization of common thinking, anchored in the traditional representation of leprosy. This finding is understandable from the perspective that the central structure of a social representation has a historical determination, so short- and middle-term changes are not to be expected. Furthermore, there has been no ongoing investment in social marketing to make the new terminology more widely known. The authors discuss the relation between social representation and the concept of the history of mentalities