Investigação epidemiológica para o diagnóstico precoce de hanseníase em uma estratégia saúde da família

Abstract

To carry out epidemiological investigation for the early diagnosis of leprosy in a family health strategy and to train / update health professionals about leprosy, verifying the knowledge acquired immediately. Methodology: Cross-sectional, descriptive, quantitative research, comprising 1276 (42.5%) subjects belonging to the 486 families residing in the area covered by a family health strategy team, from October 2018 to October 2019 and nurses who have been working in the public health network of Andradina Municipality. The study was approved by CEP / FAMERP, Opinion nº 2,735,538. All residents / families / professionals who agreed to participate in the study signed the Informed Consent Form. For statistical analysis, the SPSS Statistics Software was used. Results: A total of 695 (54.5%) women responded with symptoms of suspected leprosy, 557 (43.7%) did not work, 707 (55.4%) were married. Of the 1276 participants, 274 (21.5%) reported more than one symptom, with 89 (7%) presenting> three suspicious symptoms and were invited for evaluation. Of the summoned group, 49 (55.1%) attended the service and were evaluated by dermatological examination. Of these interviewees, 21 from different families had leprosy in the past and 16 cases had some kind of sequel (residual skin spot, loss of sensation, difficulty holding objects , and hand injury). Some were unknown to the FHS and there was no previous information about the disease in the medical records. One (2%) new suspect case was found during the assessment. When comparing between October 2018 and October 2019, the municipality recorded three cases of leprosy (with 57,157 inhabitants - proportional to 0.01% of the population), and through the active search for this study, one (1) case was obtained suspect (1,276 inhabitants - propositional of 0.08% of the population), it can be estimated that the proportion of cases that should seek service in the municipality should be 41 cases. As for the training / updating of the health team, it was found that compared to the correct answers in the pre and post-test on the general aspects, transmission, diagnosis, treatment and laboratory tests of leprosy, a significant improvement can be observed immediately in the post-test and the service flow created by the professionals showed the knowledge, new perception and difficulties of the professionals and the needs of patients and contacts and the service, facilitating the look at this disease. Conclusion: Among the study population, a case of leprosy was detected and the discovery of several others already treated, some without follow-up after discharge with complications of the disease. The great impact that this study could show to us is that, when comparing the cases from the same period in the studied municipality and the suspicious cases found in this evaluation, it was observed that the projection of the scenario of leprosy diagnoses using active search throughout the municipality would estimate 41 carriers, that is, the active search is an efficient technique for detecting new cases of leprosy. Health professionals, before training, already had satisfactory knowledge (above 70%) for questions regarding the general aspect of the disease, transmission, diagnosis and treatment, but poor results for laboratory examination and after training there was improvement in the categories evaluated.