Perfil dos comunicantes intradomiciliares de hanseníase em uma cidade hiperendêmica

Abstract

Leprosy is a public health problem in Brazil and is second on the list of endemic diseases in the world. The household has been identified as an important environment for the transmission of leprosy. Objectives: To identify and describe the clinical and epidemiological profile of leprosy patients and the sociodemographic and epidemiological profile of their household contacts. To confirm the number of household contacts with the data in the patient’s medical records and in the records of the Communicable Disease Notification Information System (SINAN). To check the intradermal Bacillus Calmette-Guérin (BCG-id) vaccination status of household contacts. Methods: A quantitative, descriptive, cross-sectional and retrospective study was carried out in the city of Fernandópolis, SP. The population studied was 99 subjects with leprosy and 146 household contacts. Data were collected from the medical records and with interviews. The inclusion criterion was that patients were diagnosed with leprosy in 2013 and 2014 in Fernandópolis with under 18-year olds being excluded. The study was approved by the Ethics Committee of the Medicine School in Sao Jose do Rio Preto (FAMERP). Results: Most of the 99 leprosy patients were of productive age with a mean age of 49 years however some were under 15 years old. Most were married with low schooling. A total of 146 household contacts were identified with sociodemographic profiles very similar to the patients. All lived ten or more years in the municipality. The majority reported that they did not take a dermato-neurological exam, the nurse was the professional who evaluated them most, and that they did not understand about the importance of the test. Regarding the vaccination situation, 124 (84.9%) contacts had a BCG-id scar, 56 (45.2%) received a booster after the leprosy case was discovered but 65 (52.4%) did not. Twenty-eight household contacts became ill after the diagnosis of the index case. Conclusion: The profile of the contacts is very similar to the index cases, a risk factor for contracting the disease. The control of contacts is one of the strategic mainstays to break the epidemiological chain of the disease. This study shows that health professionals require a more global and expanded view to control contacts, an important strategy, besides the notification of the case to the SINAN and multidrug treatment. Health clinics should use mechanisms to control contacts, analyze epidemiological and operational indicators of the control program, and implant health education measures to empower patients and their families to create stronger links with healthcare professionals.