02183nas a2200337   4500000000100000008004100001260001300042653001000055653000900065653002300074653001100097653002500108653001100133653001100144653001200155653002400167653002500191653000900216653001600225653001700241100001800258700001500276700001400291700001300305245009800318856005200416300001200468490000600480520134500486022001401831       1998                            d  c1998 May10aAdult10aAged10aAttitude to Health10aBrazil10aCase-Control Studies10aFemale10aHumans10aleprosy10aLeprosy, Borderline10aLeprosy, Tuberculoid10aMale10aMiddle Aged10aRisk Factors1 aFeliciano K V1 aKovacs M H1 aSevilla E1 aAlzate A00a[Perceptions regarding leprosy and resulting handicaps prior to diagnosis in Recife, Brazil].  uhttp://www.scielosp.org/pdf/rpsp/v3n5/3n5a2.pdf  a293-3020 v33 a<p>This article reports on a case-control study conducted in Recife, Brazil, between November 1993 and July 1994, to determine how leprosy patients' perceptions and notions influence disease management and use of health services. The sample was composed of 183 residents of Recife between the ages of 20 and 70 years who sought diagnostic services in the dermatology clinics of two referral centers situated in the third, fourth, and sixth political and administrative regions. Sixty-four patients having handicaps or their precursor lesions were classified as cases; the remaining 119 were used as controls. All were diagnosed during the study period. For the analysis, adjustments were made for sex, age, schooling, and a previous history of Hansen's disease among patients. The study revealed the simultaneous presence of two types of "invisibility" of the disease in an area where endemicity is increasing: 1) for patients in both groups, the low frequency of spontaneous explanatory models related to the illness, even in the presence of disease, and 2) for health professionals, the limitations of detection methods. Since such deficiencies affect decisions bearing on individual and collective disease management, they are a risk factor in and of themselves and stand in the way of eliminating leprosy as a public health problem.</p>  a1020-4989