Porto Ana Carolina Souza, Figueira Renata Borges Fortes Costa, Barreto Jaison Antônio, Lauris José Roberto Pereira
Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Instituto Lauro de Souza Lima, Bauru, SP, Brazil.
An Bras Dermatol. 2015 Mar-Apr;90(2):169-77. doi: 10.1590/abd1806-4841.20153385.
Leprosy is the main infectious cause of disability. It is said to be eradicated in São Paulo since 2005, but diagnosis is still late.
To investigate the social, clinical and laboratorial profile of leprosy patients diagnosed between 01/2007 and 12/2011, in a reference center in São Paulo.
Retrospective descriptive study. Data of all new leprosy cases diagnosed between 01/2007 and 12/2011 were raised in São Paulo.
103 men and 71 women were diagnosed, most of them were multibacillary. Mean age at diagnosis was 49 yrs; 2,2% were children; 70% had incomplete primary education; 50% were referred without diagnostic suspicion of leprosy. Mean time since first symptoms/signs and diagnosis was 2 years; 64% of patients had some degree of disability, and 26% had grade 2. 23 cases were diagnosed only after being summoned, and 80% of these had no disability. Agreement between the Ridley and Jopling and the WHO classification was 75% (kappa index = 0.44). Serology for IgM anti-PGL1 (87 patients) showed a mean value of 0.25, and an association between MB classification and test positivity (p <0.001).
Leprosy diagnosis in São Paulo is late. The disease mainly affected the socially disadvantaged and economically active population. Failure to detect the disease (41% in the last 10 years) could be due to the lack of suspicion and to decentralization. For the classification of patients with advanced leprosy, both the WHO and R&J classifications proved to be helpful tools.
麻风病是导致残疾的主要传染病病因。自2005年以来,据说圣保罗已消灭麻风病,但诊断仍较晚。
调查2007年1月至2011年12月期间在圣保罗一家参考中心诊断出的麻风病患者的社会、临床和实验室特征。
回顾性描述性研究。收集了圣保罗2007年1月至2011年12月期间所有新诊断的麻风病病例的数据。
共诊断出103名男性和71名女性,其中大多数为多菌型。诊断时的平均年龄为49岁;2.2%为儿童;70%小学教育未完成;50%在未被怀疑患有麻风病的情况下被转诊。从首次出现症状/体征到诊断的平均时间为2年;64%的患者有某种程度的残疾,26%为2级残疾。23例患者是在被传唤后才被诊断出来的,其中80%没有残疾。里德利和乔普林分类法与世界卫生组织分类法之间的一致性为75%(kappa指数=0.44)。87名患者的抗PGL1 IgM血清学检测显示平均值为0.25,多菌型分类与检测阳性之间存在关联(p<0.001)。
圣保罗的麻风病诊断较晚。该疾病主要影响社会弱势群体和经济活跃人群。未能检测到该疾病(过去10年中占41%)可能是由于缺乏怀疑以及诊断权力下放。对于晚期麻风病患者的分类,世界卫生组织和里德利与乔普林分类法都被证明是有用的工具。