Objectives: To describe leprosy-related disabilities, we performed a census
including people affected by leprosy in 78 municipalities of Tocantins state
in northern Brazil. The study consisted of a review of patient charts,
structured questionnaires, and clinical examinations for disabilities of eyes,
hands, and feet (August – December 2009), according to WHO standards. Results:
A total of 910 individuals diagnosed from 2006 to 2008 were included (clinical
examination and application of questionnaires), but information from patient
charts was not available in all cases, resulting in different denominators.
The majority (783/858; 91·3%) had completed multidrug therapy. The most common
clinical findings included: enlarged/painful peripheral nerves (412/910,
45·3%), namely of ulnar (207; 22·7%), posterior tibial (196; 21·6%), peroneal
(186; 20·5%), and radial cutaneous nerves (166; 18·2%); reduction/loss of
sensibility 201/907 (22·2%) and reduced motor function (185/906, 20·4%). At
diagnosis, 142/629 (22·6%) had Grade 1 disability (G1D), and 28/629 (4·5%) had
Grade 2 disability (G2D). At the time of the study, 178/910 (19·6%) presented
with G1D, and 84/910 (9·2%) with G2D. Disability grading was significantly
higher in males ( P , 0·01). Subjects with G2D showed claw hands (26; 2·9%),
followed by plantar ulcers (23; 2·5%), abrasion/excoriation on the foot (12;
1·3%), claw foot (7; 0·7%), and drop foot (7; 0·7%). Conclusions: Leprosy-
related disabilities were common in a highly endemic area. Prevention and
rehabilitation measures, especially after release from treatment, should be
intensified by the primary health care system. Policy makers need to be aware
of an ongoing demand for leprosy control programmes, even in a world of
constantly reducing leprosy detection