Keywords
Epidemiology
Cross-sectional analysis
Adverse drug events
Leprostatic agents
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Abstract
Objective: To describe the epidemiological profile and the adverse drug events (AE) of multidrug therapy (MDT) in patients with leprosy, treated at a reference center in the Amazon region. Methods: Epidemiological and cross-sectional study, which followed ethical standards and used medical records of patients who presented some AE when using MDT in the period from 2021 to 2023. Parameters such as gender, age group, clinical classification, diagnostic methods, therapeutic regimens and AE were considered. Results: Of the 25 patients treated during the period, 24 (96%) presented some AE during MDT. Their epidemiological profile was similar to the national scenario, with a predominance of men, aged between 31 and 60 years, prevailing the dimorphic and lepromatous forms. Type I and II leprosy reactions were observed, indicating an exacerbated immune response, especially in multibacillary cases. There were challenges in the treatment, showing side effects such as anemia, asthenia and nausea, most of which were manageable. Medication replacement was necessary in 4 cases. Conclusion: Methodological limitations, such as the cross-sectional approach, were recognized. Despite this, the study provided insight into reactions to MDT in leprosy patients in the region. The challenges in treatment highlight the need for therapeutic alternatives with less adverse impact.
References
AUGUSTO FILHO T et al. Efeitos adversos à poliquimioterapia em pacientes com hanseníase atendidos nas unidades básicas de saúde. Educ. Ci. e Saúde. 2020; 7(1):117–31.
BRASIL. Ministério da Saúde. DATASUS. Tabnet. Brasília, DF: Ministério da Saúde, 2023.
BRASIL. Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Doenças de Condições Crônicas e Infecções Sexualmente Transmissíveis. Protocolo Clínico E Diretrizes Terapêuticas Da Hanseníase. 2022.
CAVALCANTE M et al. Multiple Dimensions of Healthcare Management of Leprosy and Challenges to its Elimination. Revista da Escola de Enfermagem. 2020; 54: 1–8.
CHEN KH et al. Leprosy: A Review of Epidemiology, Clinical Diagnosis, and Management. Vol. 2022, Journal of Tropical Medicine. Hindawi Limited; 2022.
COSTA VDT. Avaliação dos efeitos adversos e comorbidades dos pacientes tratados com poliquimioterapia para Hanseníase em 13 anos no Hospital Universitário Pedro Ernesto [Dissertação]. Rio de Janeiro: Universidade do Estado do Rio de Janeiro; 2018.
CRUZ GG et al. Estudo epidemiológico das formas clínicas de hanseníase: um panorama histórico e atual. Revista Saúde Multidisciplinar. 2019.
DEPS PD et al. Adverse effects from multi-drug therapy in leprosy: a Brazilian study. Lepr Rev. 2007: 216–22.
GOULART MI et al. Adverse effects of multidrug therapy in leprosy patients: a five-year survey at a Health Center of the Federal University of Uberlândia. Rev Soc Bras Med Trop. 2002; 35: 453–60.
GOUVEIA AR et al. Interrupção e abandono no tratamento da hanseníase. Braz J Hea Rev. 2020; 3(4): 10591–603.
KAR S et al. Understanding noncompliance with WHO-multidrug therapy among leprosy patients in Assam, India. J Neurosci Rural Pract. 2010; 1(1): 9–13.
KUBOTA RMM. Efeitos adversos da poliquimioterapia para hanseníase [Dissertação]. São José do Rio Preto: Faculdade de Medicina de São José do Rio Preto; 2012.
LASTÓRIA JC, ABREU MAM. Hanseníase: revisão dos aspectos laboratoriais e terapêuticos – parte 2. An Bras Dermatol. 2014; 89(3): 389–403.
LOPES FC et al. Leprosy in the context of the family health strategy in an endemic scenario in maranhão: Prevalence and associated factors. Ciencia e Saude Coletiva. 2021; 26(5): 1805–16.
MAIA MV et al. Adverse effects of alternative therapy (minocycline, ofloxacin, and clofazimine) in multibacillary leprosy patients in a recognized health care unit in Manaus, Amazonas, Brazil. An Bras Dermatol. 2013; 88(2): 205–10.
MAYMONE MBC et al. Leprosy: Clinical aspects and diagnostic techniques. Vol. 83, Journal of the American Academy of Dermatology. Mosby Inc. 2020; 1–14.
MONTEIRO LD et al. Tendência temporal e distribuição espacial da mortalidade relacionada à hanseníase no estado do Tocantins, 2000-2015. Epidemiol Serv Saude. 2020; 29(3): 2018336.
NASCIMENTO DDS et al. Activity limitation and social participation restriction of people with leprosy: A cross-sectional analysis of magnitude and associated factors in a hyperendemic municipality in the state of Piauí, Brazil, 2001-2014. Epidemiologia e Servicos de Saude. 2020; 29(3).
NEUMANN AS et al. Heterogeneous persistence of Mycobacterium leprae in oral and nasal mucosa of multibacillary patients during multidrug therapy. Mem Inst Oswaldo Cruz. 2022; 117.
NIITSUMA ENA et al. Factors associated with the development of leprosy in contacts: A systematic review and meta-analysis. Revista Brasileira de Epidemiologia. 2021; 24.
PANTE CC et al. Severe adverse reactions to multidrug therapy for leprosy, registered in tertiary services between 2012 and 2017 in Brazil. Lepr Rev. 2018; 89: 328–34.
PENNA GO et al. National Health Survey reveals high percentage of signs and symptoms of leprosy in Brazil. Ciencia e Saude Coletiva. 2022; 27(6): 2255–8.
PINHEIRO MGC et al. Contextual analysis of health care at discharge in leprosy: an integrative review, Revista Gaucha de Enfermagem. Universidade Federal do Rio Grande do Sul, Faculdade de Educacao; 2019, 40.
PIRES CAA et al. Análise da ocorrência de reações adversas à poliquimioterapia no tratamento para hanseníase. Revista Eletrônica Acervo Saúde. 2021; 13(2): 1–10.
RAMOS ACV et al. Temporal evolution and spatial distribution of leprosy in a municipality with low endemicity in São Paulo state, Brazil. Epidemiologia e Servicos de Saude. 2022; 31(1).
RODRIGUES RMG et al. Relato de caso: nefrite intersticial aguda por uso intermitente de rifampicina – dois casos. J Bras Nefrol. 2000; 22(4): 231–5.
SANTOS AN et al. Epidemiological Profile and Tendency of Leprosy in People Younger than 15 Years. Revista da Escola de Enfermagem. 2020; 54: 1–8.
SINGH H et al. Adverse effects of multi-drug therapy in leprosy, a two years’ experience (2006-2008) in tertiary health care centre in the tribal region of Chhattisgarh State (Bastar, Jagdalpur). Lepr Ver. 2011; 82: 17–24.
SOUZA CDF et al. Leprosy and social deprivation: Definition of priority areas in an endemic state northeastern brazil. Revista Brasileira de Epidemiologia. 2020; 23.
TEIXEIRA CSS et al. Nutritional aspects of people affected by leprosy, between 2001 and 2014, in semi-arid Brazilian municipalities. Ciencia e Saude Coletiva. 2019; 24(7): 2431–41.
TORTELLY VD et al. Adverse effects of polychemotherapy for leprosy in 13 years of follow-up at a university hospital. An Bras Dermatol. 2021; 96(2): 224–7.
YANG J et al. Seventy years of evidence on the efficacy and safety of drugs for treating leprosy: a network meta-analysis. Journal of Infection. 2023; 86(4): 338–51.