02805nas a2200265   4500000000100000008004100001260001600042653002500058653001400083653002900097653002500126653002200151653003300173653001200206653001100218100001400229700001700243700002500260700001600285245011200301856005800413050001500471520203900486022001402525       2013                            d  c2013 Jan 2810aSpatial distribution10aReactions10aPrevention of disability10aOccupational Therapy10aMultidrug therapy10aLeprosy-related disabilities10aleprosy10aBrazil1 aNardi SMT1 aPaschoal VDA1 aChiaravalloti-Neto F1 aZanetta DMT00a[Leprosy-related disabilities after release from multidrug treatment: prevalence and spatial distribution.]  uhttp://www.scielosp.org/pdf/rsp/2013nahead/ao4048.pdf  aNARDI 20133 aOBJECTIVE: To estimate the frequency of people with leprosy-related physical disabilities after release from multidrug treatment and to analyze their spatial distribution. METHODS: Descriptive cross-sectional study with 232 leprosy patients treated between 1998 and 2006. Physical disabilities were assessed using the World Health Organization disability grading and the eye-hand-foot (EHF) sum score. The residential address of patients and rehabilitation centers were geocoded. It was estimated the overall frequency of physical disability and frequency by disability grade (grade 0, grade 1, and grade 2) according to the WHO disability grading taking into consideration clinical and sociodemographic variables in the descriptive analysis. Student's t-test, chi-square test (χ2), and Fisher's test were used as appropriate at a 5% significance level. RESULTS: Of the patients studied, 51.6% were female, mean age 54 years old (SD 15.7), 30.5% had less than 2 years of formal education, 43.5% were employed, and 26.9% were retired. Borderline leprosy was the most prevalent form of leprosy (39.9%). A total of 32% of these patients had disabilities according to the WHO disability grading and the EHF score. Disabilities increased with age (p = 0.029), they were more common in patients with multibacillary leprosy (p = 0.005) and poor self-rated physical health (p < 0.001). Those who required prevention/rehabilitation care traveled on average 5.5 km to the rehabilitation center. People with physical disabilities lived scattered across the city but they were mostly concentrated in the most densely populated and socioeconomically deprived area. CONCLUSIONS: There is a high frequency of people with leprosy-related disabilities after release from multidrug therapy. Prevention and rehabilitation actions should target uneducated and older patients, those who had multibacillary forms of leprosy and poor self-rated physical health. The travel distance to rehabilitation centers calls for reorganization of local care networks.  a1518-8787