Occurrence of late lepra reaction in leprosy pacients: subsidies for implementation of a specific care program

• Autor(a) principal: Rodrigues, Ana Laura Pereira
• Data de Publicação: 2000
• Outros Autores: Almeida, Andrey Peterson de, Rodrigues, Bethânia de Freitas, Pinheiro, Carla Aparecida, Borges, Daniela Santos, Mendonça, Marcelo Luiz Holanda de, Silva, Vinícius Eustáquio Ferreira da, Goulart, Isabela Maria Remarries
• Tipo de documento: Artigo
• Idioma: por; eng
• Título da fonte: Hansenologia Internationalis (Online)
• Texto Completo: https://periodicos.saude.sp.gov.br/hansenologia/article/view/35370
• topic: Hanseníase; Reações hansênicas; Programas de controle; Prevenção de incapacidades; Leprosy; Leprosy Reaction; Leprosy control programs; Prevention of Disabilities

Leprosy would be an ordinary disease; however, it is not due to its reactive episodes with risk of disability maintaining the stigma related to the leprosy. These reactions and the potential loss of the neural function may happen before, during and after treatment, through a multidrug therapy (MDT). Release from treatment results from the number of doses and regularity of the treatment, when the patient leaves the coefficientsof prevalence. The aim was to evaluate the magnitude of late leprosy reactions and the operational subjects referring to the attendance quality. Charts of the 149 patients that received discharge for leprosy from 1994 to 1999, in CSE Jaraguá - UFU, Brazil, were revised using the Record of Inquiry of Alterations After Cure of the Brazilian Ministry of Health. Of these patients, 34 (23%) presented late reaction, of which 11,76% were paucibacillary (PB) and 88,23% were multibacillary (MB). An average of 3 reactive episodes for borderline patient and 4 episodes for lepromatous patient occurred. Of PB patients, 100% presented reversal reaction (RR). Among MB, 50% presented RR, 40% erythema nodosum leprosum (ENL), 7% isolated neuritis and 3% mixed reaction. In 91% of the cases, the first reactive episode happened in the first year after treatment.There was a positive correlation among medium bacillary index (BI) at diagnosis and the number of reaction episodes during treatment and after release. Among patients with late reaction, 97% used prednisone and 32% thalidomide,meaning 22% and 8% from the total, respectively. Grade of disability 2 and 3 happened in MB patients of the economically active age. It is discussed the need of implementing leprosy control programs for that new group of patients with warranty of treatment, personnel training for simplified monitoring of neuritis and handling of the adverse effects of corticosteroids therapeutics, seeking the prevention of disabilities.