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. 2020 May 24;9(1):53.
doi: 10.1186/s40249-020-00669-4.

Disability progression among leprosy patients released from treatment: a survival analysis

Aleksandra Rosendo Dos Santos  1   2 , Pãmela Rodrigues de Souza Silva  3 , Peter Steinmann  4   5 , Eliane Ignotti  1   2
Affiliations

Disability progression among leprosy patients released from treatment: a survival analysis

Aleksandra Rosendo Dos Santos et al. Infect Dis Poverty. .

Abstract

Background: Leprosy can be cured, but physical disability (PD) as a result of the infection can progress in the post-release from treatment phase. This study evaluated the likelihood of, and factors associated with, the progression of the PD grade post-release from treatment among leprosy patients treated in Cáceres-MT, Brazil in the period 2000 to 2017.

Methods: A retrospective cohort study and survival analysis were performed in the hyperendemic municipality of Cáceres in the state of Mato Grosso. The study population consisted of newly diagnosed leprosy patients released from treatment between January 1, 2000 and December 31, 2017. The main outcome was the progression of the PD grade with regard to probability and time; and the evaluated covariates included clinical, operational and demographic variables. The Cox proportional risk model was used to estimate the risk ratio (Hazard Ratios) of the covariates. Both an univariate and a multivariate analysis were implemented, with 95% confidence intervals.

Results: The mean time for progression of the PD grade was 162 months for PB and 151 months for MB leprosy patients. The survival curve showed that 15 years after the release from treatment, the probability of PD grade progression was 35%, with no difference between PB and MB or age groups. Leprosy reactions and registered medical complaints of any kind during treatment were identified as risk factors with Hazard Ratios of 1.6 and 1.8 respectively.

Conclusions: People released from treatment as cured of leprosy are susceptible to worsening of the PD, especially those who have had complications during multi-drug therapy treatment. This indicates that leprosy patients should be periodically monitored, even after the successful completion of multidrug therapy.

Keywords: Cure; Leprosy; Physical disability; Progression; Survival.

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Conflict of interest statement

The authors declare they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the follow-up of a cohort of leprosy patients released from treatment in Cáceres-MT, Brazil, in the period 2000 to 2017. Potentially eligible were individuals with an assessment of the physical disability grade at diagnosis and release from MDT treatment who were still living in Cáceres at the time of the study
Fig. 2
Fig. 2
Survival curve for PD grade progression post-release from MDT treatment for MB and PB leprosy patients released from treatment in 2000–2017; Cáceres – MT, Brazil
See this image and copyright information in PMC

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