Adesão ao tratamento dos estados reacionais hansênicos em uma unidade de referência na região metropolitana de Belém

Abstract

Leprosy reactions are a major problem in the course of leprosy. Represent an exaggerated response of the immune system to M. Leprae, are classified as reversal reaction (RR) and erythema nodosum leprosum (ENL). Treatment is usually done with prednisone and thalidomide. They affect a large number of patients and represents a serious health problem, they may lead to physical deformities. To contribute to the understanding of adherence to treatment of leprosy reactions, this study described the clinical and socio-demographic factors associated with adherence to the treatment of reactional condition in leprosy patients in a health facility in the metropolitan area of Bethlehem from 2005 2010. It is an epidemiological study of type a descriptive, cross-sectional and analytical, quantitative approach, performed at the referral dermatology Dr. Marcelo Candia. We analyzed 640 individuals diagnosed with leprosy, these were sampled from 214 individuals in the treatment of leprosy reaction. It was identified in the sample, predominantly male adults, low education, self-employed income entre1 the two minimum wages, mostly from the metropolitan area of Bethlehem and the northern and northeastern Pará (84.58%). There was a balance between married and unmarried (50%). There's a higher incidence of clinical manifestation MHD (63.1%) and MBMDT for multibacillary (86.92). The dominant time of leprosy diagnosis was 1 to 2 years (52%). The type of reaction was predominant RR (83.18%). The most frequently prescribed medication was prednisone (79%). Reactive episodes occurred more during treatment (26%), the majority of patients had 1-3 episodes reaction (89.26%). The presence of neurites was observed in most cases in all years (78.5%). Adherence to treatment was 80.39% against 19.63% of non-compliance. The correlation of socio-demographic factors and adherence showed males with three times more likely to not adhere to treatment than women, the other characteristics showed no statistically significant relationship with the fact or not adhere to treatment. Clinical features no statistically significant relationship between the fact of joining or not the treatment. A low percentage of children and adolescents treated for leprosy and response to treatment, including noncompliance. Leprosy reactions were more incidents to reverse reactions (RR), despite the forms of leprosy have been mostly in the multibacillary forms. There was no statistical significance in adherence rates related to clinical variables. Compliance rates are good, but not require membership to be reviewed in order to reverse them.