Determination of persistence and delayed diagnosis of leprosy in Valle del Cauca from 2010 to 2016
Lepra en Valle del Cauca, 2010-2016
DOI:
https://doi.org/10.17533/udea.rfnsp.e343156Keywords:
Hansen’s disease, Leprosy, disability, multibacillary, paucibacillary, delayed diagnosisAbstract
Objective: To describe the frequency, clinical-demographic characteristics and factors related to delayed diagnosis, incomplete treatments, and development of disability from admission to discharge of patients enrolled in the “Hansen's Disease Control Program of Valle del Cauca”, from 2010 to 2016.
Methodology: A descriptive observational study of a retrospective cohort of patients with leprosy was conducted.
Results: The average incidence was 0.99 cases / 100 000 inhabitants. The median age was 54 years (interquartile range: 39-65); 58.82% were men, 49.73 % belonged to the subsidized regime. 83.68% were new cases, of which 76.47% were multibacillary (47.9% with lepromatous leprosy). 59.54% were disabled, and 10.54% experienced leprotic reactions. 50% had a delayed diagnosis, and 9.09 % abandoned treatment. Significant dependence was found between delayed diagnosis and disability at admission (OR: 2.09, CI 95 %: 1.28-3.41, p = 0.003), and between non-completion of treatment and prior treatment (OR: 2.82, CI 95 %: 1.28-6.18, p = 0.009).
Conclusion: Leprosy continues to be frequent in Valle del Cauca. Delayed diagnosis and disability at admission imply late identification of patients in advanced stages. Abandonment and disability are additional factors in this complex situation. It is evident the need to strengthen current interventions aimed at the patient, their home contacts, healthcare workers, and the community.
Downloads
References
Torres-Guerrero E, Sánchez-Moreno EC, Atoche-Diéguez CE, et al. Identification of Mycobacterium leprae and Mycobacterium lepromatosis in formalin-fixed and paraffin-embedded skin samples from Mexico. Ann Dermatol. 2018;30(5):562-5. DOI: https://doi.org/10.5021/ad.2018.30.5.562
Terencio J. Consideraciones histórico-epidemiológicas de la lepra en América. Med Cutan Iber Lat Am [internet]. 2006 [citado 2020 dic. 20]; 34(4):179-94. Disponible en: https://www.medigraphic.com/pdfs/cutanea/mc-2006/mc064i.pdf
Botero N, Polo Rivas D, Sinuco Rueda L. La lepra en Colombia: estigma, identidad y resistencia en los siglos XX y XXI. Rev Salud Bosque. 2015:5(1);5:67-79. DOI: https://doi.org/10.18270/rsb.v5i1.185
Torres Guerrero E, Vargas Martínez F, Atoche Diéguez CE, et al. Lepra. Clasificación y cuadro clinico. Dermatol Rev Mex [internet]. 2015 [citado 2020 dic. 20]; 56(1):47-54. Disponible en: http://www.medigraphic.com/pdfs/derrevmex/rmd-2012/rmd121g.pdf
World Health Organization (WHO). Global leprosy (Hansen disease) update, 2019: Time to step-up prevention initiatives – Situation de la lèpre (maladie de Hansen) dans le monde, 2019: le moment est venu d’intensifier les initiatives de prévention. Weekly Epidemiological Record = Relevé épidémiologique hebdomadaire [internet]. 2020 [citado 2020 dic. 20]; 95(36):417-38. Disponible en: https://apps.who.int/iris/handle/10665/334141
Instituto Nacional de Salud (INS). Informe del evento Lepra Colombia, 2018. Bogota: INS [internet]; 2019 [citado 2020 jul. 10]. Disponible en: https://www.ins.gov.co/buscador-eventos/Informesdeevento/LEPRA_2018.pdf
Guerrero MI, Muvdi S, León CI. Retraso en el diagnóstico de lepra como factor pronóstico de discapacidad en una cohorte de pacientes en Colombia, 2000-2010. Rev Panam Salud Publica [internet]. 2013 [citado 2020 dic. 20]; 33(2):137-43. Disponible en: https://www.scielosp.org/pdf/rpsp/2013.v33n2/137-143/es
Colombia, Ministerio de Salud. Resolución 8430, por la cual se establecen las normas científicas, técnicas y administrativas para la investigación en salud (1993 oct. 4).
Instituto Nacional de Salud (INS). Boletín epidemiológico semanal número 52 del 2016. Bogotá: INS [internet]. 2016 [citado 2020 jun. 10]; (52):46-47. Disponible en: http://www.ins.gov.co/buscador-eventos/BoletinEpidemiologico/2016%20Bolet%C3%ADn%20epidemiol%C3%B3gico%20semana%2052%20-.pdf
Instituto Nacional de Salud (INS). Informe final del evento lepra, Colombia, 2015. Bogotá: INS [internet]. 2015 [citado 2021 jun. 23]; (2):5-6. Disponible en: https://www.ins.gov.co/buscador-eventos/Informesdeevento/Lepra%202015.pdf
Instituto Nacional de Salud (INS). Informe final del evento lepra, Colombia, 2014. Bogotá: INS [internet]. 2014 [citado 2021 jun. 23]; (2):5-6. Disponible en: https://www.ins.gov.co/buscador-eventos/Informesdeevento/Lepra%202014.pdf
Instituto Nacional de Salud (INS). Informe final lepra, 2013. Bogotá: INS [internet]. 2013 [citado 2021 jun. 23]; (1):5-7. Disponible en: https://www.ins.gov.co/buscador-eventos/Informesdeevento/Lepra%202013.pdf
Instituto Nacional de Salud (INS). Informe del evento lepra, hasta el periodo epidemiológico 13 del año 2012. Bogotá: INS [internet]. 2012 [citado 2021 jun. 23]; (1):5-7. Disponible en: https://www.ins.gov.co/buscador-eventos/Informesdeevento/Lepra%202012.pdf
Instituto Nacional de Salud (INS). Situación de la lepra según SIVIGILA, Colombia, semana 1 a 52 de 2011. Bogotá: INS [internet]. 2011 [citado 2021 jun. 23]; (01):3-5. Disponible en: https://www.ins.gov.co/buscador-eventos/Informesdeevento/Lepra%202011.pdf
Instituto Nacional de Salud (INS). Situación de la lepra según SIVIGILA, Colombia, semana 1 a 52 de 2010. Bogotá: INS [internet]. 2010 [citado 2021 jun. 23]; (01):4-8. Disponible en: https://www.ins.gov.co/buscador-eventos/Informesdeevento/Lepra%202010.pdf
Colombia, Ministerio de la Protección Social, Instituto Nacional de Salud, Organización Panamericana de la Salud. Plan estratégico de Colombia para aliviar la carga de la enfermedad y sostener las actividades de control de lepra 2010-2015. Bogotá: INS [internet]; 2015 [citado 2020 jul. 10]. Disponible en: https://aicepsigestionparaelbuenvivir.files.wordpress.com/2015/11/anexo-2-plan-estrategico-lepra_f-1612091.pdf
Souza EA, Ferreira AF, Boigny RN, et al. Leprosy and gender in Brazil: Trends in an endemic area of the Northeast region, 2001-2014. Rev Saude Publica. 2018;52:20. DOI: https://doi.org/10.11606/s1518-8787.2018052000335
Simionato de Assis I, Arcoverde MA, Ramos AC, et al. Social determinants, their relationship with leprosy risk and temporal trends in a tri-border region in Latin America. PLoS Negl Trop Dis. 2018;12(4):e0006407. DOI: https://doi.org/10.1371/journal.pntd.0006407
Ortiz L, Hoz F de la, León CI, et al. Caracterización clínica y sociodemográfica de casos nuevos de lepra en municipios endémicos y no endémicos de Colombia. Rev Salud Pública [internet]. 2004 [citado 2020 dic. 20]. 6 (Supl. 1):50-63. Disponible en: https://www.scielosp.org/pdf/rsap/2004.v6suppl1/50-63/es
Sabeena J, Bindu RS. Grade 2 disability in leprosy and its predictors: A 10 year retrospective study from Kerala, India. Indian J Lepr [internet]. 2020 [citado 2020 dic. 20]. 92:199-209. Disponible en: http://www.ijl.org.in/2020/08%20Sabeena%20and%20Bindu%20%20199-209%20final.pdf
Moreira S, Batos C, Tawil L. Epidemiological situation of leprosy in Salvador from 2001 to 2009. An Bras Dermatol. 2014;89(1):107-17. DOI: https://doi.org/10.1590/abd1806-4841.20142175
De Assis I, Berra T, Alves L, et al. Leprosy in urban space, areas of risk for disability and worsening of this health condition in Foz Do Iguaçu, the border region between Brazil, Paraguay and Argentina. BMC Public Health. 2020;20(1):119. DOI: https://doi.org/10.1186/s12889-020-8236-5
Nyblade L, Stockton MA, Giger K, et al. Stigma in health facilities: Why it matters and how we can change it. BMC Med [internet]. 2019 [citado 2020 jul. 10];17(1):1-15. DOI: https://doi.org/10.1186/s12916-019-1256-2
Henry M, Galan N, Teasdale K, et al. Factors contributing to the delay in diagnosis and continued transmission of leprosy in Brazil--An explorative, quantitative, questionnaire based study. PLoS Negl Trop Dis. 2016;10(3):e0004542. DOI: https://doi.org/10.1371/journal.pntd.0004542
Gómez L, Rivera A, Vidal Y, et al. Factors associated with the delay of diagnosis of leprosy in north-eastern Colombia: a quantitative analysis. Trop Med Int Health. 2018;23(2):193-8. DOI: https://doi.org/10.1111/tmi.13023
Lima AS de, Pinto K, Bona M, et al. Leprosy in a university hospital in southern Brazil. An Bras Dermatol. 2015;90(5):654-9. DOI: http://dx.doi.org/10.1590/abd1806-4841.20153959
Shen J, Zhou M, Xu X, et al. A big challenge in case finding at low endemic situation: Analysis on 1462 new leprosy patients detected in China in 2007. Lepr Rev. 2010;81(3):176-83. DOI: http://dx.doi.org/10.47276/lr.81.3.176
World Health Organization (WHO). Global leprosy strategy 2016-2020. Accelerating towards a leprosy-free world. Geneva: WHO [internet]; 2016 [citado 2020 jul. 10]. Disponible en: https://apps.who.int/iris/bitstream/handle/10665/208824/9789290225096_ en.pdf?sequence=14&isAllowed=y
Sales AM, Pereira Campos D, Hacker MA, et al. Progression of leprosy disability after discharge: is multidrug therapy enough? Trop Med Int Health. 2013;18(9):1145-53. DOI: http://dx.doi.org/10.1111/tmi.12156
Monteiro LD, Alencar CH, Barbosa JC, et al. Incapacidades físicas em pessoas acometidas pela hanseníase no período pós-alta da poliquimioterapia em um município no Norte do Brasil. Cad Saude Publica. 2013;29(5):909-20. DOI: http://dx.doi.org/10.1590/S0102-311X2013000500009
Ferreira SMB, Yonekura T, Ignotti E, et al. Effectiveness of rifampicin chemoprophylaxis in preventing leprosy in patient contacts: A systematic review of quantitative and qualitative evidence. JBI Database System Rev Implement Rep. 2017;15(10):2555-84. DOI: http://dx.doi.org/10.11124/JBISRIR-2016-003301
Khoudri I, Elyoussfi Z, Mourchid Y, et al. Trend analysis of leprosy in Morocco between 2000 and 2017: Evidence on the single dose rifampicin chemoprophylaxis. PLoS Negl Trop Dis [internet]. 2018 [citado 2020 jul. 10]; 12(12):1-10. DOI: http://dx.doi.org/10.1371/journal.pntd.0006910
Cavaliero A, Greter H, Fürst T, et al. An innovative approach to screening and chemoprophylaxis among contacts of leprosy patients in low endemic settings: Experiences from Cambodia. PLoS Negl Trop Dis [internet]. 2018 [citado 2020 jul. 10]; 13(3):1-4. DOI: http://dx.doi.org/10.1371/journal.pntd.0007039
Duthie MS, Goto W, Ireton GC, et al. Use of protein antigens for early serological diagnosis of leprosy. Clin Vaccine Immunol [internet]. 2007 [citado 2020 jul. 10]; 14(11):1400-8. DOI: http://dx.doi.org/10.1128/CVI.00299-07
Santos DF dos, Mendonça MR, Antunes DE, et al. Molecular, immunological and neurophysiological evaluations for early diagnosis of neural impairment in seropositive leprosy household contacts. PLoS Negl Trop Dis [internet]. 2018 [citado 2020 jul. 10]; 12(5):1-12. DOI: http://dx.doi.org/10.1371/journal.pntd.0006494
Reis EM, Araujo S, Lobato J, et al. Mycobacterium leprae DNA in peripheral blood may indicate a bacilli migration route and high-risk for leprosy onset. Clin Microbiol Infect [internet]. 2014 [citado 2020 jul. 10]; 20(5):447-52. DOI: http://dx.doi.org/10.1111/1469-0691.12349
Scollard DM. Infection with Mycobacterium lepromatosis. Am J Trop Med Hyg. 2016;95(3):500-1. DOI: http://dx.doi.org/10.4269/ajtmh.16-0473
Instituto Nacional de Salud (INS). Boletín epidemiológico semanal, semana epidemiológica 03 de 2020. Lepra en Colombia 2019. Bogotá: INS [internet]. 2020 [citado 2021 jun. 23]; (03):2. Disponible en: https://www.ins.gov.co/buscador-eventos/BoletinEpidemiologico/2020_Boletin_epidemiologico_semana_3.pdf
Nova J, Sánchez G. Reacciones por lepra en un centro de referencia nacional en Colombia. Biomédica [internet]. 2013 [citado 2020 jul. 10]; 33(1):99-106. DOI: http://dx.doi.org/10.7705/biomedica.v33i1.582
Queiroz TA., Carvalho FP, Simpson CA, et al. Clinical and epidemiological profile of patients with leprosy-related reactions. Rev Gaúcha Enferm. 2015;36(Spe):185-91. DOI: http://dx.doi.org/10.1590/1983-1447.2015.esp.57405
Hurtado MN, Atehortúa MC, Bravo JH. Fundamentos epidemiológicos y perfil de la situación de discapacidad de la población con enfermedad de Hansen del Valle del Cauca. Colombia Médica [internet]. 2003 [citado 2020 jul. 10]; 34(1):36-39. Disponible en: https://colombiamedica.univalle.edu.co/index.php/comedica/article/view/251/254
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2021 Universidad de Antioquia
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The contents of the articles are the responsibility of the authors
The editorial committee has editorial independence from the National School of Public Health "Héctor Abad Gómez" of the University of Antioquia.
The editorial committee is not responsible for aspects related to copying, plagiarism or fraud that may appear in the articles published in it.
When you are going to reproduce and disclose photographs or personal data in printed or digital format, informed consent is required. Therefore, this requirement is required of the author at the time of receipt of the manuscript.
Authors are responsible for obtaining the necessary permissions to reproduce any material protected by reproduction rights.
The authors preserve the moral rights and assign the economic rights that will correspond to the University of Antioquia, to publish it, distribute electronic copies, include them in indexing services, directories or national and international databases in Open Access, under the Creative Commons Attribution license -Not Commercial-Share Equal 4.0 International Commercial (CC BY-NC-SA) which allows others to distribute, remix, retouch, and create from the work in a non-commercial way, as long as the respective credit and license are granted. new creations under the same conditions.
The authors will sign the declaration of transfer of economic rights to the University of Antioquia, after the acceptance of the manuscript.
The editorial committee reserves the right to reject the articles whose authors do not offer satisfactory explanations about the contribution of each author, to meet the criteria of authorship in the submission letter. All authors must meet the four criteria of authorship according to ICMJE: "a) .- That there is a substantial contribution to the conception or design of the article or to the acquisition, analysis or interpretation of the data. b) That they have participated in the design of the research work or in the critical review of its intellectual content. c) .- That has been intervened in the approval of the final version that will be published.d). That they have the capacity to respond to all aspects of the article in order to ensure that issues related to the accuracy or integrity of any part of the work are adequately investigated and resolved. "
-- 
--
