Lesshafft Hannah, Heukelbach Jörg, Barbosa Jaqueline Caracas, Rieckmann Nina, Liesenfeld Oliver, Feldmeier Hermann
Institute of Microbiology and Hygiene, Charité University Medicine, Campus Benjamin Franklin, Hindenburgdamm 27, 12203 Berlin, Germany.
Lepr Rev. 2010 Mar;81(1):69-78.
In Brazil, isolation of individuals affected with leprosy was compulsory by law from 1920 to 1962, but in reality, confinement of patients to leprosaria continued until the 1980s. The social participation restriction of people still living in these institutions has never been investigated systematically.
To examine the extent and type of participation restriction perceived by former leprosy patients living in the Centro de Convivência Antônio Diogo (CCAD), a previous leprosy colony in rural Northeast Brazil, by using the Participation Scale.
Forty (51-9%) out of 77 individuals reported significant participation restrictions, mainly related to work and mobility. Perceived participation restriction was significantly higher in people living in nursing units of the CCAD (P = 0-001), if diagnosis of leprosy was made before 1982 (P = 0.002), in the presence of walking limitation (P < 0.001) and visible physical alterations (P = 0-002), such as foot deformities (P = 0.002), saddle nose (P = 0.03) and blindness (P = 0.04), and in those individuals who did not receive visitors (P = 0.004).
Social rehabilitation, especially in the areas of work and mobility, is strongly needed together with prevention of debilitating physical sequelae and reduction of stigmatisation.
在巴西,1920年至1962年法律规定麻风病患者必须隔离,但实际上,患者被关押在麻风病院的情况一直持续到20世纪80年代。从未对仍生活在这些机构中的人们的社会参与限制进行过系统调查。
通过使用参与量表,调查居住在巴西东北部农村地区以前的麻风病聚居地安东尼奥·迪奥戈共处中心(CCAD)的前麻风病患者所感知的参与限制的程度和类型。
77名个体中有40名(51.9%)报告存在显著的参与限制,主要与工作和行动能力有关。居住在CCAD护理单元的人、1982年之前被诊断为麻风病的人、存在行走限制的人、有明显身体改变(如足部畸形、鞍鼻和失明)的人以及没有访客的人,其感知到的参与限制明显更高(P分别为0.001、0.002、<0.001、0.002、0.03、0.04和0.004)。
迫切需要进行社会康复,特别是在工作和行动能力方面,同时要预防身体虚弱的后遗症并减少污名化。