OBJECTIVE: To analyze predictive factors in the progression of the disability grade in patients with leprosy. METHODS: A retrospective cohort study followed up 595 patients with disability registered at a healthcare unit in the city of Belo Horizonte (Southeastern Brazil) from 1993 to 2003. Patients' sociodemographic and clinical information was collected from the respective medical records. Comparisons were made between the disability grade upon admission and at the end of treatment using a marginal homogeneity test. To determine factors associated with progression in the disability grade, univariate analysis (linear trend chi-square test) was employed, as well as multivariate analysis by means of the algorithm Chi-square Automatic Interaction Detector. RESULTS: Among the cases in which the disability grade was recorded upon admission and upon discharge, 43.2% of the patients who had grade 1 in the first assessment progressed to grade 0. Among those who began with grade 2, 21.3% progressed to grade 0 and 20% progressed to grade 1. In the univariate analysis, the variables that proved to be statistically associated with progression in the disability grade were: neuritis, time elapsed until the occurrence of neuritis, number of damaged nerves, type of physiotherapy treatment and higher dose of prednisone. In the multivariate analysis, the main factor associated with the progression of disability was the disability grade upon admission. CONCLUSIONS: The results showed the importance of an early diagnosis of neuropathy as well as the efficient association of pharmacological and non-pharmacological treatment, through disability prevention techniques and adequate doses of steroid.
OBJECTIVE: To analyze predictive factors in the progression of the disability grade in patients with leprosy. METHODS: A retrospective cohort study followed up 595 patients with disability registered at a healthcare unit in the city of Belo Horizonte (Southeastern Brazil) from 1993 to 2003. Patients' sociodemographic and clinical information was collected from the respective medical records. Comparisons were made between the disability grade upon admission and at the end of treatment using a marginal homogeneity test. To determine factors associated with progression in the disability grade, univariate analysis (linear trend chi-square test) was employed, as well as multivariate analysis by means of the algorithm Chi-square Automatic Interaction Detector. RESULTS: Among the cases in which the disability grade was recorded upon admission and upon discharge, 43.2% of the patients who had grade 1 in the first assessment progressed to grade 0. Among those who began with grade 2, 21.3% progressed to grade 0 and 20% progressed to grade 1. In the univariate analysis, the variables that proved to be statistically associated with progression in the disability grade were: neuritis, time elapsed until the occurrence of neuritis, number of damaged nerves, type of physiotherapy treatment and higher dose of prednisone. In the multivariate analysis, the main factor associated with the progression of disability was the disability grade upon admission. CONCLUSIONS: The results showed the importance of an early diagnosis of neuropathy as well as the efficient association of pharmacological and non-pharmacological treatment, through disability prevention techniques and adequate doses of steroid.
Authors: Antônio Carlos Vieira Ramos; Mellina Yamamura; Luiz Henrique Arroyo; Marcela Paschoal Popolin; Francisco Chiaravalloti Neto; Pedro Fredemir Palha; Severina Alice da Costa Uchoa; Flávia Meneguetti Pieri; Ione Carvalho Pinto; Regina Célia Fiorati; Ana Angélica Rêgo de Queiroz; Aylana de Souza Belchior; Danielle Talita Dos Santos; Maria Concebida da Cunha Garcia; Juliane de Almeida Crispim; Luana Seles Alves; Thaís Zamboni Berra; Ricardo Alexandre Arcêncio Journal: PLoS Negl Trop Dis Date: 2017-02-27
Authors: Bada Shravani; Satyaki Ganguly; Arvind K Shukla; Namrata Chhabra; Neel Prabha; Divya Sachdev; Soumil Khare Journal: J Family Med Prim Care Date: 2022-03-18
Authors: Anna Maria Sales; Dayse Pereira Campos; Mariana Andrea Hacker; José Augusto da Costa Nery; Nádia Cristina Düppre; Emanuel Rangel; Euzenir Nunes Sarno; Maria Lucia Fernandes Penna Journal: Trop Med Int Health Date: 2013-09 Impact factor: 2.622