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三级医疗机构就诊患者麻风病诊断时残疾情况的临床流行病学研究

Clinico-epidemiological Study of Disability Due to Leprosy at the Time of Diagnosis among Patients Attending a Tertiary Care Institution.

作者信息

Reyila Vengarakath Puthiyapura, Betsy Ambookken, Riyaz Najeeba, Sasidharanpillai Sarita, Sherjeena Pentam Veil Beegum, Majitha Maniparambath P, Joseph Deepa Mary

机构信息

Department of Dermatology and Venereology, DM Wayanad Institute of Medical Sciences, Wayanad, Kerala, India.

Department of Dermatology and Venereology, Government Medical College, Thrissur, Kerala, India.

出版信息

Indian J Dermatol. 2019 Mar-Apr;64(2):106-111. doi: 10.4103/ijd.IJD_185_17.

Abstract

BACKGROUND

With the declared elimination of leprosy as a public health problem, the World Health Organization has shifted the focus on the disabilities and deformities associated with leprosy.

AIMS

The aim was to study the Grade 1 and Grade 2 disability among newly diagnosed leprosy patients.

MATERIALS AND METHODS

All newly diagnosed leprosy patients attending the Outpatient Department of Government Medical College, Kozhikode, from January 1, 2013 to December 31, 2013 were included in the study and the Grade 1 and Grade 2 disabilities observed were analyzed.

RESULTS

During the 1-year period, 76 patients were diagnosed to have leprosy. Grade 1 and Grade 2 disabilities were noted in 31.6% and 17.1%, respectively. Major factors identified as risk for leprosy disability at the time of diagnosis were age >45 years, >5 skin lesions, ≥2 thickened peripheral nerve trunks, pure neuritic and borderline tuberculoid spectra of leprosy.

LIMITATION

As the study was conducted in a tertiary care center, it does not perfectly indicate the status in the community.

CONCLUSION

Disability noted in nearly 50% of leprosy cases at the time of diagnosis highlights the need to improve the effectivity of existing health-care system in early case detection and timely referral. In addition, it underscores the need to educate the affected regarding protective eye, foot, and hand care, so that progression to Grade 2 disability can be prevented.

摘要

背景

随着宣布将麻风病作为公共卫生问题予以消除,世界卫生组织已将重点转向与麻风病相关的残疾和畸形。

目的

旨在研究新诊断麻风病患者中的一级和二级残疾情况。

材料与方法

纳入2013年1月1日至2013年12月31日期间在科泽科德政府医学院门诊部就诊的所有新诊断麻风病患者,并对观察到的一级和二级残疾进行分析。

结果

在这1年期间,76例患者被诊断为患有麻风病。一级和二级残疾分别占31.6%和17.1%。在诊断时确定为麻风病残疾风险的主要因素为年龄>45岁、皮肤损害>5处、外周神经干增厚≥2处、纯神经炎型和界线类偏结核样型麻风病。

局限性

由于该研究在三级医疗中心进行,不能完美反映社区的情况。

结论

近50%的麻风病病例在诊断时存在残疾,这凸显了提高现有医疗保健系统在早期病例检测和及时转诊方面有效性的必要性。此外,这强调了对患者进行眼部、足部和手部护理教育的必要性,以便预防发展为二级残疾。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0db6/6440182/b2e4c59af298/IJD-64-106-g001.jpg

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