Fatores associados ao adoecimento por hanseníase em contatos: revisão sistemática e metanálise

• Autor(a) principal: Eyleen Nabyla Alvarenga Niitsuma
• Data de Publicação: 2021
• Outros Autores: Isabela de Caux Bueno, Elis Oliveira Arantes, Ana Paula Mendes Carvalho, Gesner Francisco Xavier Junior, Gabriel da Rocha Fernandes, Francisco Carlos Félix Lana
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UFMG
• Texto Completo: https://doi.org/10.1590/1980-549720210039; http://hdl.handle.net/1843/54533; https://orcid.org/0000-0002-5781-6313; https://orcid.org/0000-0003-4501-5989; https://orcid.org/0000-0002-1899-3587; https://orcid.org/0000-0002-9068-9686; https://orcid.org/0000-0001-5190-3523; https://orcid.org/0000-0002-4897-8521; https://orcid.org/0000-0001-9043-3181
• topic: Hanseníase; Fatores de risco; Determinantes sociais da saúde; Monitoramento epidemiológico; Revisão sistemática; Metanálise; Hanseníase; Fatores de risco; Determinantes sociais da saúde; Monitoramento epidemiológico; Revisão sistemática; Metanálise

Objective: To investigate the risk factors associated with leprosy in contacts of patients. Method: We carried out a systematic review and meta-analysis by searching the databases MEDLINE, Embase, Cochrane Library, CINAHL, LILACS, Scopus, and Web of Science until September 2019. Four reviewers carried out the selection, analysis, and evaluation of quality of studies. The random effects model was used to calculate the pooled relative risk (RR) and 95% confidence intervals (95% CI) when heterogeneity was greater than 50%. Results: The search resulted in 2,148 references and included 24 reports. Most of the studies had been conducted in Brazil and India, had a cohort design and included household, neighbors, and social contacts. The risk factors associated with illness due to leprosy in contacts were: illiteracy (RR = 1,48; 95%CI 1,22 – 1,79), living in the same house (RR = 2,41; 95%CI 1,87 – 3,10) of a case of leprosy with high bacillary load (RR = 2.40; 95%CI 1.69 – 3.41), seropositivity to the Mycobacterium leprae PGL-1 (phenolic glycolipid-1) antigen (RR = 3.54; 95%CI 2.21 – 5.67), presence of the bacillus in the bloodstream (RR = 10.61; 95%CI 4.74 – 23.77) and negative Mitsuda reaction (RR = 2,68; 95%CI 1,76 – 4,07). Immunization with BCG (bacillus Calmette-Guérin) vaccine had a protective effect against leprosy. Conclusion: Leprosy in contacts of patients involves social determination, individual susceptibility, and difficulties in access to disease control actions, but modifiable risk factors are the main determinants of illness in this population.