Laboratório de Hanseníase, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brasil.
Mem Inst Oswaldo Cruz. 2012 Dec;107 Suppl 1:49-54. doi: 10.1590/s0074-02762012000900009.
Contact surveillance is an important strategy to ensure effective early diagnosis and control of leprosy; passive detection may not be as efficient because it is directly tied to the ready availability of heath care services and health education campaigns. The aim of this study was to reinforce that contact surveillance is the most effective strategy for the control of leprosy. The analysed data were obtained from a cohort of contacts and cases diagnosed through a national referral service for leprosy. We analysed data from patients diagnosed between 1987-2010 at the Souza Araújo Ambulatory in Rio de Janeiro. Epidemiological characteristics of leprosy cases diagnosed through contact surveillance and characteristics of passively detected index cases were compared using a conditional logistic regression model. Cases diagnosed by contact surveillance were found earlier in the progression of the disease, resulting in less severe clinical presentations, lower levels of initial and final disability grades, lower initial and final bacterial indices and a lower prevalence of disease reaction. In this respect, contact surveillance proved to be an effective tertiary prevention strategy, indicating that active surveillance is especially important in areas of high endemicity, such as Brazil.
接触者监测是确保麻风病有效早期诊断和控制的重要策略；被动检测可能效率不高，因为它直接与卫生保健服务的随时可及性和卫生教育活动有关。本研究旨在强调接触者监测是控制麻风病的最有效策略。分析的数据来自通过全国麻风病转诊服务诊断的接触者和病例队列。我们分析了 1987 年至 2010 年间在里约热内卢 Souza Araújo 门诊诊断的患者的数据。使用条件逻辑回归模型比较了通过接触者监测诊断的病例和被动发现的指数病例的流行病学特征。通过接触者监测诊断的病例在疾病进展中更早被发现，导致临床症状较轻，初始和最终残疾等级较低，初始和最终细菌指数较低，疾病反应发生率较低。在这方面，接触者监测被证明是一种有效的三级预防策略，表明在巴西等高流行地区，主动监测尤为重要。
