RESUMEN
INTRODUCTION: In 1993, Cuba achieved leprosy elimination according to the World Health Organization's (WHO) indicator of less than one case per 10,000 population. Despite this achievement, detection of new cases occurs every year among all age groups including children. Detection of new cases in children reveals persistent transmission of the infection. OBJECTIVE: To describe the clinical and epidemiological features of leprosy in individuals younger than 15 years (childhood leprosy) reported to the Cuban National Leprosy Control Program (NLCP) between 2012 and 2019. METHODS: We conducted a retrospective descriptive study between 2012 and 2019 to assess the clinical and epidemiologic features of individuals under the age of 15 years with a confirmed diagnosis of leprosy reported to the NLCP. We reviewed the NLCP database and collected data to better define the total number of cases of leprosy in adults, children (younger than 15 years). We assessed socio-demographic variables (age, gender, and province of residence) as well as variables of clinical interest including operational classification and staging at diagnosis, bacillary index, grade of disability by WHO staging. Additionally, we evaluated epidemiological variables including passive versus active surveillance of cases, contact investigation focusing specifically in household transmission, and the degree of kinship as well as standing of the child within the focus of transmission when there were additional cases. RESULTS: We identified fifty children during the study period corresponding to 3% of the overall cases of leprosy comprising all age groups in Cuba. In the age group younger than 15 years, the majorities of cases was from the Granma province and most were between the ages of 10 and 14 years. Clinically, multibacillary/lepromatous forms were the most common type identified with positive bacillary index. The majority of children diagnosed with leprosy during our study period had a history of a relative with a confirmed diagnosis of leprosy. CONCLUSIONS: Detection of cases of leprosy in individuals younger than 15 years of age in Cuba demonstrates ongoing transmission of M. leprae in specific geographic hotspots. Its frequency in the early adolescence, the predominant clinical forms, and the mode of detection associated with sources of suspected familiar infection demonstrated that there is a need for further efforts by the NLCP to conduct active surveillance activities among affected communities to identify cases of leprosy earlier with the goal of preventing further household and community transmission.
Asunto(s)
Lepra/epidemiología , Adolescente , Niño , Preescolar , Trazado de Contacto , Cuba/epidemiología , Femenino , Humanos , Lactante , Lepra/diagnóstico , Lepra/microbiología , Masculino , Mycobacterium leprae/genética , Mycobacterium leprae/fisiología , Estudios RetrospectivosRESUMEN
OBJETIVO: identificar las afecciones oculares diagnosticadas en los pacientes con Lepra que asistieron a consulta oftalmológica en el servicio de Uveitis e Inflamaciones Oculares (SUIO) del Instituto Cubano de Oftalmología Ramon Pando Ferrer en el periodo 2017-2019. MÉTODOS: se realizó un estudio descriptivo prospectivo observacional en pacientes con diagnóstico de lepra quienes cumplieron los criterios de inclusión y exclusión de la investigación. Las variables estudiadas fueron: edad, sexo, afecciones oftalmológicas y grado de discapacidad. RESULTADOS: predomino el sexo masculino y el grupo de edad entre 45-59 años, la mayoría de los pacientes se diagnosticaron tardíamente después del ano del comienzo de los síntomas, las afecciones oculares predominaron en el segmento anterior del ojo y se diagnosticaron cuatro pacientes con diferentes grados de discapacidad ocular. CONCLUSIONES: las afecciones oculares del segmento anterior son frecuentes en los pacientes con lepra, sobre todo en las formas lepromatosas y pueden aparecer en el momento del diagnóstico, durante o después del tratamiento. Muchas de las causas de afecciones oculares en los pacientes con lepra son prevenibles, es primordial garantizar la asistencia oftalmológica en los mismos
OBJECTIVE: to identify the ocular affections in patient with a diagnosis of leprosy in the department of Uveitis and Ocular (SUIO) Inflammations of the Cuban Institute of Ophthalmology Ramon Pando Ferrer during the period 2017-2019. METHODS: a prospective observational descriptive study in patients with diagnosis of leprosy who completed the admission or exclusion criteria of the investigation was carried out. The studied variables were age, sex, ophthalmological affections and grade of incapacity. RESULTS: The male gender and the age group among 45-59 years prevailed. Most of the patients were diagnosed belatedly after the year of the beginning of the symptoms, the ocular affections prevailed in the segment previous of the eye, and four patients were diagnosed with different grades of ocular discapacity. CONCLUSIONS: the ocular affections of the previous segment are frequent in the patients with leprosy, mainly in the lepromatous type of the disease and they can appear during the presentation of the patient and diagnosis or during or after the treatment. Many of the causes of ocular affections in the patients with leprosy can be prevented and the required ophthalmological care to avoid them must be provided