02103nas a2200229   4500000000100000008004100001653001200042653001500054653002500069100001700094700002200111700001400133700001300147700001300160700001700173245015700190856005400347300001100401490000700412050002100419520143300440       2014                            d10aleprosy10aDisability10aBiological reactions1 aDe Alencar M1 aCaracas Barbosa J1 aPereira T1 aSantas S1 aEggens H1 aHeukelbach J00aLeprosy reactions after release from multidrug therapy in an endemic cluster in Brazil: patient awareness of symptoms and self-perceived changes in life  uhttp://www.scielo.br/pdf/cadsc/v21n4/v21n4a14.pdf  a450-560 v21  aDE ALLENCAR 20143 a<p>We assessed diagnosis and consequences of leprosy reactions as perceived by affected individuals. A cross-sectional study was performed in five municipalities in an endemic disease cluster in Brazil. Structured interviews included 280 leprosy-affected individuals who had experienced reactions after release from treatment (RFT), 2007–2009. Open questions included information on diagnostic features of leprosy reactions, sensory loss and self-perceived changes in life after experiencing leprosy reactions. In this study, 43.2% were diagnosed with reaction during multi-drug therapy. In the majority of cases, the patient himself/herself perceived disease symptoms first (n=240; 85.8%). Primary Health Care Centres were the first entry point into the health system for 95/150 (63.3%). In 72.6% of these, leprosy diagnosis was made within the primary care setting. Patient-perceived signs and symptoms of reactions included skin lesions (42%) and neurological symptoms (39%). In total, 216/280 (77.1%) stated that they had perceived changes in life. Physical impairments limiting possibilities to work and reduced income were mentioned commonly (n=118; 54.6%). Discrimination and social isolation were also experienced. Our study indicates an inadequate response of health services for individuals with reactions after RFT. An integrated approach is needed, including physical, psychological care and self-care groups</p>