Faculdade de Enfermagem, Universidade de Cuiabá, Cuiabá, MT, Brasil.
Rev Saude Publica. 2011 Aug;45(4):756-64. doi: 10.1590/s0034-89102011005000043. Epub 2011 Jul 1.
To analyze factors associated with relapse of leprosy.
Retrospective case-control study including 159 patients older than 15 diagnosed with leprosy attending reference centers for leprosy in five municipalities in the state of Mato Grosso, central-western Brazil. Cases (n=53) were patients with relapsed leprosy diagnosed from 2005 to 2007 who were compared with controls (n=106) matching for gender and operational classification who were considered cured after treatment in 2005. Data was obtained from the local Notifiable Diseases Database, medical records and interviews. For the analyses conditional logistic regression and hierarchical approaches were used.
After adjustment, the following factors were associated with relapse of leprosy: living in rental housing (OR = 4.1; 95%CI: 1.43;12.04); living in houses constructed of wood and mud (OR = 3.2; 95%CI: 1.16;8.76); living with dwellings with more than five people (OR = 2.1; 95%CI: 1.03;4.36); alcohol use disorder (OR = 2.8; 95%CI: 1.17;6.79); irregular treatment (OR =3.8; 95%CI: 1.44;10.02); lack of knowledge about the disease/treatment (OR = 2.6; 95%CI: 1.09;6.13); use of public transportation to get to the clinic (OR = 5.5; 95%CI: 2.36;12.63); clinical form of the disease (OR = 7.1; 95%CI: 2.48;20.52), and treatment regimen (OR = 3.7; 95%CI: 1.49;9.11).
The predictive factors of relapse are associated with housing conditions, living habits, organization of health services, clinical forms of leprosy and treatment regimen. Health services should educate patients on the disease as well as ensure consistent treatment.
分析麻风病复发的相关因素。
本研究为回顾性病例对照研究,共纳入了 159 名年龄大于 15 岁、在巴西中西部马托格罗索州五个城市的麻风病参考中心确诊的麻风病患者。病例组(n=53)为 2005 年至 2007 年诊断为复发性麻风病的患者,将其与性别和操作分类相匹配的对照组(n=106)进行比较,这些对照组在 2005 年接受治疗后被认为已治愈。数据来自当地法定传染病数据库、病历和访谈。采用条件逻辑回归和分层方法进行分析。
调整后,以下因素与麻风病复发相关:居住在出租房(OR=4.1;95%CI:1.43;12.04);居住在木泥房屋(OR=3.2;95%CI:1.16;8.76);与居住在五人以上的住所(OR=2.1;95%CI:1.03;4.36);酒精使用障碍(OR=2.8;95%CI:1.17;6.79);不规则治疗(OR=3.8;95%CI:1.44;10.02);缺乏对疾病/治疗的了解(OR=2.6;95%CI:1.09;6.13);使用公共交通工具去诊所(OR=5.5;95%CI:2.36;12.63);疾病的临床形式(OR=7.1;95%CI:2.48;20.52)和治疗方案(OR=3.7;95%CI:1.49;9.11)。
复发的预测因素与住房条件、生活习惯、卫生服务组织、麻风病的临床形式和治疗方案有关。卫生服务机构应向患者宣传疾病知识,并确保治疗的一致性。