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Este estudio tuvo como objetivo analizar los datos epidemiológicos de la lepra disponibles en los dominios públicos entre los años 2008 a 2018 en el municipio de Guaraí, Tocantins. Este es un estudio transversal, descriptivo, retrospectivo y cuantitativo basado en datos secundarios. En el período de 2008 a 2018, se registraron 328 casos de lepra co...
INTRODUCTION:
Leprosy recurrence is the reappearance of the disease after treatment with current schemes and discharged for cure and may have variable incubation periods.
METHODS:
This is a descriptive observational study of leprosy recurrence in Espírito Santo diagnosed between January 2018 and January 2020.
RESULTS:
One hundred and ninety-two c...
Citations
... Penelitian menunjukkan bahwa resistensi terhadap infeksi M. leprae dimainkan oleh imunitas selular. 1,14, 15 Faktor genetik juga dikatakan berperan dalam timbulnya penyakit kusta. Penelitian yang dilakukan pada para penderita kusta menunjukkan adanya berbagai genetic marker, seperti HLA-DR2, HLA-DRB1, MHC-I, NRAMP1 yang mengakibatkan seseorang berpotensi untuk terinfeksi kuman M. leprae. ...
Background: Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae and Mycobaterium lepromatosis. Children are one of the populations at risk of M. leprae transmission. Prompt treatment is needed to avoid complications of disability in children with leprosy. Therefore, this study aims to describe a pediatric patient who had borderline lepromatous morbus hansen with a history of close contact multibacillary leprosy. Case: A 16 years old girl, complained red spots on the right and left legs that are numb. Dermatological examination found multiple erythema macules-patches, firm boundaries, rounded to geographic shapes, discrete distribution on the face and right and left anterior and posterior extremities. Thickening of the right ulnar nerve, right and left common peronial nerve, decreased sensation of touch, pain and temperature were found. Histopathological examination found a non-caseating granulomata lesion, consistent with borderline tuberculoid leprosy type. Slit skin smear found acid fast bacilli (AFB) in the right earlobe 25-30 AFB/1 visual field (VF) (bacterial index (IB): +4)) fragmented, in the left earlobe>100 smear/1 VF (IB: +5) fragmented, and morphological index (IM): 0. The patient was diagnosed with borderline lepromatous (BL) leprosy and given multidrug therapy (MDT) for multibacillary (MB) leprosy. After 6th package of MDT, leprosy reactions or side effects of treatment were not found. Conclusion: The highest risk of transmission of leprosy is close contact with leprosy patients, especially the multibacillary type of leprosy. In this case, a child with BL type leprosy was treated with an adult dose of MDT MB according to the patient's age and body weight. Latar belakang: Morbus hansen (MH) merupakan penyakit granulomatosa kronis yang disebabkan oleh Mycobacterium leprae dan Mycobaterium lepromatosis. Anak-anak merupakan salah satu populasi berisiko terhadap transmisi M. leprae. Terapi lebih dini diperlukan untuk menghindari komplikasi kecacatan pada anak dengan morbus hansen. Untuk itu, tujuan dari studi ini adalah memaparkan seorang pasien anak anak yang mengalami morbus hansen tipe borderline lepromatous dengan riwayat narakontak erat kusta tipe multibasiler. Kasus: Seorang anak perempuan, 16 tahun, dengan keluhan utama bercak kemerahan pada kaki kanan dan kiri yang mati rasa. Pemeriksaan status dermatologis ditemukan makula hingga patch eritema multipel, batas tegas, bentuk bulat hingga geografika, tersebar diskret di lokasi wajah dan ekstremitas anterior et superior dextra et sinistra serta penebalan nervus ulnaris dekstra dan nervus peronius komunis dekstra et sinistra dan penurunan sensasi raba, nyeri dan suhu. Pemeriksaan histopatologi ditemukan kesan non-caseating granulomata lesion. Pemeriksaan bakteriologis dengan pengecatan Ziehl-Neelsen ditemukan basil tahan asam (BTA) pada cuping telinga kanan 25-30 BTA/1 lapang pandang (LP) (indeks bakteri (IB): +4)) fragmented, pada cuping telinga kiri >100 BTA/1 LP (IB: +5) fragmented, dan indeks morfologi (IM): 0. Pasien didiagnosis dengan MH tipe borderline lepromatous (BL) dan diberikan multidrug theraphy (MDT) untuk MH tipe multibasiler (MB). Evaluasi pada konsumsi MDT paket ke-VI tidak menunjukkan adanya reaksi kusta ataupun efek samping pengobatan. Simpulan: Risiko tertinggi penularan kusta adalah kontak erat dengan pasien kusta terutama kusta tipe multibasiler. Pada kasus ini didapatkan anak dengan kusta tipe BL dan diterapi dengan MDT MB dosis dewasa menyesuaikan usia dan berat badan pasien.
... A strong inability for an immunologic reaction against M. leprae results in lepromatous leprosy. Patients skin, in particular in the face, earlobes, fingers and toes, present a high number of bilateral and symmetrical, not anesthetic leproma (20 to 100) [6,7]. A large number of bacilli can be found in the dermis [8]. ...
... A large number of bacilli can be found in the dermis [8]. Leprosy manifestations may also occur in the eyes, nose, bones, testis, spleen, liver and adrenals, leading to systemic repercussions and more severe disability [2,6]. ...
... Adequate classification of the disease is a crucial step in the success of control programs and treatment scheme standardization [20]. Currently, the diagnosis of leprosy relies on detailed clinical manifestations upon physical examination, and skin biopsy and/or a smear [6,19]. ...
Leprosy disease remains an important public health issue as it is still endemic in several
countries. Mycobacterium leprae, the causative agent of leprosy, presents tropism for cells of the reticuloendothelial and peripheral nervous system. Current multidrug therapy consists of clofazimine, dapsone and rifampicin. Despite significant improvements in leprosy treatment, in most programs,
successful completion of the therapy is still sub-optimal. Drug resistance has emerged in some countries. This review discusses the status of leprosy disease worldwide, providing information regarding infectious agents, clinical manifestations, diagnosis, actual treatment and future perspectives and strategies on targets for an e�cient targeted delivery therapy.
Background:
In the past 15 years, the decline in annually detected leprosy patients has stagnated. To reduce the transmission of Mycobacterium leprae, the World Health Organization recommends single-dose rifampicin (SDR) as post-exposure prophylaxis (PEP) for contacts of leprosy patients. Various approaches to administer SDR-PEP have been piloted. However, requirements and criteria to select the most suitable approach were missing. The aims of this study were to develop an evidence-informed decision tool to support leprosy programme managers in selecting an SDR-PEP implementation approach, and to assess its user-friendliness among stakeholders without SDR-PEP experience.
Methodology:
The development process comprised two phases. First, a draft tool was developed based on a literature review and semi-structured interviews with experts from various countries, organisations and institutes. This led to: an overview of existing SDR-PEP approaches and their characteristics; understanding the requirements and best circumstances for these approaches; and, identification of relevant criteria to select an approach. In the second phase the tool's usability and applicability was assessed, through interviews and a focus group discussion with intended, inexperienced users; leprosy programme managers and non-governmental organization (NGO) staff.
Principal findings:
Five SDR-PEP implementation approaches were identified. The levels of endemicity and stigma, and the accessibility of an area were identified as most relevant criteria to select an approach. There was an information gap on cost-effectiveness, while successful implementation depends on availability of resources. Five basic requirements, irrespective of the approach, were identified: stakeholder support; availability of medication; compliant health system; trained health staff; and health education. Two added benefits of the tool were identified: its potential value for advocacy and for training.
Conclusion:
An evidence-informed SDR-PEP decision tool to support the selection of implementation approaches for leprosy prevention was developed. While the tool was evaluated by potential users, more research is needed to further improve the tool, especially health-economic studies, to ensure efficient and cost-effective implementation of SDR-PEP.
