Vitiritti Bruno, Lima Filipe Rocha, de Castilho Nara Tescke, Somensi Lincon Bordignon, Ogoshi Rosana Cláudio Silva
Universidade Alto Vale do Rio do Peixe, Departamento de Medicina, Caçador, SC, Brasil.
Universidade de São Paulo, Departamento de Clínica Médica, Ribeirão Preto, SP, Brasil.
Braz J Infect Dis. 2024 Jul-Aug;28(4):103853. doi: 10.1016/j.bjid.2024.103853. Epub 2024 Jul 22.
Leprosy, a neglected tropical disease, is reported in over 120 countries, with upwards of 200,000 new cases annually. This Cross-Sectional Cohort Study aimed to delineate the epidemiological profile of leprosy in a low-endemic area in southern Brazil, both before and after implementing an active search strategy.
The study examined two surveillance periods in Caçador, Santa Catarina, Brazil. The active search strategy was carried out through the application of the LSQ by the community health workers as a screening and detection tool for new cases of leprosy and this was compared with passive case detection. The first spanned from 2014 to 2020, and the second from January 2021 to August 2023.
48 leprosy cases were reported throughout the study, 83.3 % of which were diagnosed as multibacillary. The first period had an average detection rate of 0.38 cases per 10,000 inhabitants, increasing to 1.19 cases per 10,000 inhabitants in the second period. Notably, there was a substantial shift in the degree of physical disability (GD), with more Grade 0 and Grade 1 disabilities observed post-active search.
The study underscores the efficacy of active search strategies in early diagnosis, highlighting a 300 % increase in the annual average of diagnosed cases. This large number of detected cases demonstrates the high sensitivity of the LSQ. This approach significantly aids in uncovering hidden cases of leprosy, enhancing disease management and control in low-endemic areas indicating that the Ministry of Health should intensify leprosy control activities in these regions.
麻风病是一种被忽视的热带疾病，在120多个国家均有报告，每年新增病例超过20万例。这项横断面队列研究旨在描绘巴西南部一个低流行地区在实施主动搜索策略前后麻风病的流行病学概况。
该研究考察了巴西圣卡塔琳娜州卡查多尔的两个监测期。主动搜索策略通过社区卫生工作者应用麻风病筛查问卷（LSQ）作为麻风病新病例的筛查和检测工具来实施，并与被动病例检测进行比较。第一个监测期从2014年至2020年，第二个监测期从2021年1月至2023年8月。
在整个研究期间共报告了48例麻风病病例，其中83.3%被诊断为多菌型。第一个时期的平均检出率为每10000名居民0.38例，在第二个时期增至每10000名居民1.19例。值得注意的是，身体残疾程度（GD）发生了显著变化，主动搜索后观察到更多0级和1级残疾病例。
该研究强调了主动搜索策略在早期诊断中的有效性，突出显示确诊病例的年平均数增加了300%。大量检测出的病例证明了LSQ的高灵敏度。这种方法极大地有助于发现隐藏的麻风病病例，加强低流行地区的疾病管理和控制，这表明卫生部应加强这些地区的麻风病控制活动。
