Hansen's disease deformities in a high risk area in Mozambique: A case study.

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TitleHansen's disease deformities in a high risk area in Mozambique: A case study.
Publication TypeJournal Article
AuthorsMarega A, das Pires PN, Mucufo J, Muloliwa A
Abbrev. JournalRev. Soc. Bras. Med. Trop.
JournalRevista da Sociedade Brasileira de Medicina Tropical
Year of Publication2019
Volume52
Paginatione20180103
Publication Languageeng
Abstract

INTRODUCTION: Hansen's disease is no longer a public health problem in Mozambique, since 2008 (incidence under 1 / 10,000 inhabitants). The country is one of the most affected in the world and Nampula province's Murrupula district (incidence 1.7 / 10,000) has a high deformity rate (22% in 2010). This study aimed to identify high deformity rate associated determinants and proposals for better health program results.

METHODS: This study involved a descriptive quantitative survey, systematic observation of patients and health professionals, and a survey of community volunteers. Data were analyzed using Epi Info 7.2. Pearson's chi-square and Fisher's exact test were used to assess statistical association with deformity, with a significance level of 5% and 95% confidence interval. Ethical procedures followed the Helsinki declaration (2013).

RESULTS: Among 238 subjects, 175 were patients and 63 leprosy health staff. Most patients relied on subsistence agriculture facing social exclusion (43, 25%). The waiting time from first symptoms to diagnosis was over one year for 63%. Deformity affected 116 subjects (68%), particularly those who considered the disease as God's desire (p = 0.01), and practiced traditional treatments (p = 0.001). Among leprosy health staff, 35 (52%) were not trained on diagnosis and management.

CONCLUSIONS: High deformity rate is associated with low economic status, the belief that the disease is God's desire, the use of traditional healers, late diagnosis, and poor disease management. A health education program targeting professionals and population, with infection screening and self-care groups can prevent deformities.

PubMed URL

http://www.ncbi.nlm.nih.gov/pubmed/30726314?dopt=Abstract

DOI10.1590/0037-8682-0103-2018
Link to full texthttp://www.scielo.br/pdf/rsbmt/v52/1678-9849-rsbmt-52-e20180103.pdf