RESUMO
INTRODUCTION: This study was developed to evaluate the situation of leprosy in the general population of the municipality of Buriticupu, State of Maranhão, Brazil. METHODS: We used the method of active search to identify new cases from 2008 to 2010. Bacilloscopy of intradermal scrapings was performed in all patients with skin lesions compatible with leprosy, and histopathological examination in those who had doubts on the definition of the clinical form. RESULTS: The study included 19,104 individuals, with 42 patients diagnosed with leprosy after clinical examination, representing a detection rate of 219.84 per 100,000 inhabitants. The predominant clinical presentation was tuberculoid with 24 (57.1%) cases, followed by borderline with 11, indeterminate with four, and lepromatous with three cases. The study also allowed the identification of 81 patients with a history of leprosy and other skin diseases, such as pityriasis versicolor, dermatophytosis, scabies, vitiligo, and skin carcinoma. The binomial test showed that the proportion of cases in the headquarters was significantly higher than that in the villages (p = 0.04), and the generalized exact test showed that there was no association between age and clinical form (p = 0.438) and between age and gender (p = 0.083). CONCLUSIONS: The elevated detection rate defines the city as hyperendemic for leprosy; the active search for cases, as well as the organization of health services, is an important method for disease control.
Assuntos
Doenças Endêmicas , Hanseníase/epidemiologia , Adulto , Brasil/epidemiologia , Feminino , Humanos , Hanseníase/diagnóstico , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
INTRODUCTION: This study was developed to evaluate the situation of leprosy in the general population of the municipality of Buriticupu, State of Maranhão, Brazil. METHODS: We used the method of active search to identify new cases from 2008 to 2010. Bacilloscopy of intradermal scrapings was performed in all patients with skin lesions compatible with leprosy, and histopathological examination in those who had doubts on the definition of the clinical form. RESULTS: The study included 19,104 individuals, with 42 patients diagnosed with leprosy after clinical examination, representing a detection rate of 219.84 per 100,000 inhabitants. The predominant clinical presentation was tuberculoid with 24 (57.1%) cases, followed by borderline with 11, indeterminate with four, and lepromatous with three cases. The study also allowed the identification of 81 patients with a history of leprosy and other skin diseases, such as pityriasis versicolor, dermatophytosis, scabies, vitiligo, and skin carcinoma. The binomial test showed that the proportion of cases in the headquarters was significantly higher than that in the villages (p = 0.04), and the generalized exact test showed that there was no association between age and clinical form (p = 0.438) and between age and gender (p = 0.083). CONCLUSIONS: The elevated detection rate defines the city as hyperendemic for leprosy; the active search for cases, as well as the organization of health services, is an important method for disease control.
INTRODUÇÃO: O estudo foi desenvolvido com o objetivo de avaliar a situação da hanseníase na população geral do município de Buriticupu, Estado do Maranhão, Brasil. MÉTODOS: Foi empregado o método de busca ativa na identificação de casos novos, de 2008 a 2010. Baciloscopia de raspado intradérmico foi feita em todos os pacientes com lesões de pele compatíveis com hanseníase e exame histopatológico, naqueles em que havia dúvidas na definição da forma clínica. RESULTADOS: Participaram do estudo 19.104 indivíduos, sendo que o exame clínico definiu o diagnóstico de hanseníase em 42 pacientes, o que representa um coeficiente de detecção de 219,84/100.000 habitantes. A forma clínica predominante foi a tuberculóide com 24 (57,1%) casos, seguindo-se da dimorfa, com 11, da indeterminada, com 4 e da virchowiana com 3 casos. O estudo permitiu, ainda, a identificação de 81 pacientes com passado de hanseníase, além de outras doenças da pele, tais como pitiríase versicolor, dermatofitose, escabiose, vitiligo e carcinoma de pele. O teste binomial mostrou que a proporção de casos na sede foi significativamente maior que a dos povoados, p= 0,04 e o teste exato generalizado que não há associação entre faixa etária e forma clínica (p=0,438), bem como entre faixa etária e sexo (p=0,083). CONCLUSÕES: O elevado coeficiente de detecção define o município como hiperendêmico para a hanseníase; a busca ativa de casos é um método importante, bem como a organização dos serviços de saúde, para o controle da doença.