Assessment of epidemiological and spatial factors associated with physical disabilities due to leprosy at the end of treatment

Abstract

Introduction: Identifying clinical, epidemiological, and operational factors associated with the development of physical disabilities (PD) after leprosy treatment is essential to improve prevention and care strategies, reduce the socioeconomic impact of the disease, and improve the quality of life of those affected. Objective: Therefore, this study evaluated the factors associated with the presence of PD at the end of treatment in a hyperendemic setting. Method: This was a retrospective study of 495 leprosy patients living in Cáceres, Mato Grosso (MT), using data obtained from the Regional Health Office. Epidemiological, clinical, and geospatial variables were analyzed. Data analysis was performed using logistic regression, with a p-value <0.05 considered significant. An analysis of the spatial flow between the patients' place of residence and the health services responsible for reporting was also performed. Results: Among the 247 records with complete data, the independent factors associated with PD at the end of treatment were: age (odds ratio [OR], 1.04 [1.02–1.08]; p<0.01), multibacillary operational classification (OR, 2.69 [1.08–6.71]; p=0.03), and presence of PD at diagnosis (OR, 5.10 [2.07–12.55]; p<0.01). In the geospatial analysis, centralization of care was observed in a reference service, with a mean patient travel distance of 2.09 km. This service concentrated 76.5% of the notifications; the remaining 23.5% were notified by primary health care (PHC). Implications: The findings suggest late detection and highlight the need to strengthen PHC for early diagnosis and systematic monitoring of PD, starting at the time of diagnosis, in order to reduce PD rates at the end of treatment.