02369nas a2200157   4500000000100000008004100001260001600042653001600058100001500074700001500089700001400104245015800118856007200276520184900348022001402197       2021                            d  bElsevier BV10aDermatology1 ade Sousa P1 aSousa ALMD1 aTurchi MD00aEvaluation of the therapeutic management of leprosy in primary care: demand case series referred to a University Hospital in the Midwest region of Brazil  uhttps://www.sciencedirect.com/science/article/pii/S03650596210005193 aBackground<br>
Leprosy still represents an important public health problem in Brazil. Early and adequate treatment of this disease, carried out in the basic health network, is essential to reduce damage and sequelae.
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Objective<br>
To analyze the therapeutic management of leprosy cases sent to a referral service.
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Methods<br>
Observational study using medical records and the Notifiable Diseases Information System. Patients with a previous diagnosis of leprosy, referred to a specialized outpatient clinic, between 2016 and 2017, in Goiás, were included. The treatment carried out in the basic health network that was in line with the Ministry of Health guidelines was considered as being appropriate.
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Results<br>
225 individuals with a previous diagnosis of leprosy were included, of which 33.3% were referred for leprosy reactions, 27.1% for sequelae, and 10.2% with suspected recurrence or reinfection. As for the management, 123 cases (54.7%) were considered inadequate, 92 (40.9%) adequate, and 10 inconclusive. Of the 200 individuals with multibacillary leprosy, 39.5% had adequate management. In contrast, of the 14 individuals with paucibacillary disease, 85.1% had adequate management (χ2 = 11.43 and p < 0.001). There was no difference between the percentage of adequate management when considering the health macroregions (χ2 = 7.23; 4 degrees of freedom; p = 0.12).
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Study limitations<br>
Use of secondary data, with incomplete medical records and lack of patient follow-up.
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Conclusions<br>
The study demonstrated the main difficulties in leprosy management conducted in primary care, with an emphasis on leprosy reactions and suspected recurrence. The authors emphasize the need for training and monitoring in a timely manner, aiming to reduce damage.  a0365-0596