Physical disability and its social and functional repercussions in patients with leprosy after discharge from multidrug therapy
Purpose: This paper analysed the clinical characteristics, social insertion and functional limitations in patients with leprosy. They were evaluated in a university hospital in southeast Brazil between 1998 and 2013.
Methods: One hundred thirty six leprosy patients (aged 12–82 years) participated in a cross-sectional descriptive study after discharge from multidrug therapy treatment. Clinical and functional evaluations and characterisation of the restrictions to social involvement, through SALSA (Screening of Activity Limitation and Safety Awareness) and Participation Scales were performed.
Results: The patients (79 males, 57 females) mean age was 44·67 ^ 15·05 years. The major characteristics were male (79%), multibacillary (86%) and some disability (91·2%). 33·8% of the disabilities were graded 2. During the evaluation 56·5% of patients reported pain and 27·2% had used corticosteroid therapy. Ninety-five patients underwent neural decompression or tendon transfer surgery. Age bellow 64 years and pain represented a higher risk to activity limitation. According to SALSA and Participation Scores, 75% of patients had functional limitation and 52·2% social restriction.
Conclusion: Despite the context of a reference hospital, it is important to highlight the late diagnostics in this study. Our findings suggest that age over 64 was a protective factor for activity limitations, which may be related with a higher impact of the disease in the young, causing more limitations on activities. There was no association between SALSA score and the presence of deformity, demonstrating adaptation to physical disabilities. The treatment with MDT eradicates M. leprae, however it does not overcome the physical deformities already placed.