Perfil dos contatos vacinados e dos pacientes com hanseníase com até 15 anos atendidos no centro de referência nacional em dermatologia sanitária Dona Libânia (CDERM)

Abstract

Leprosy is recognized worldwide as a serious public health problem. In Brazil it is endemic, being currently the second country in the world in number of new cases. It is an infectious-contagious disease, dermatoneurological, causing incapacities and / or deformities, caused by the bacillus Mycobacterium leprae. One of the ways of breaking the chain of transmission of the disease is the evaluation of contact and application of BCG in the communicants who did not present signs and symptoms. Under 15 years diagnosed with the disease reveal the strength of the recent transmission of leprosy and its tendency, being this important data in the evaluation of the governmental measures adopted to combat it. Revaccination with BCG was adopted with the purpose of preventing the onset of the disease in contacts, since, through previous studies, its capacity of protection in communicants of patients with leprosy. The study aimed to describe the participation of BCG revaccination in less contacts and leprosy patients, up to 15 years of age. This is a descriptive, exploratory, retrospective, quantitative study that occurred in a Reference Center for Dermatology located in Fortaleza, Ceará. The study consisted of 221 records of the minor patients with up to 15 full years of the last five years, interviewed by means of a semi-structured form to 25 minors, patients undergoing treatment for leprosy and analysis of 1435 revaccination registers in contacts between 0 and 15 years old Between the years 2011 and 2015. The ethical aspects of resolution 466/12 were respected in all phases of the study. The results revealed a predominant age group (8-15 years), with a greater number of cases and revaccinated males, coming from Fortaleza, with a larger number of dwellings in the Regional Executive Coordination V and a high coverage of BCG at birth. The clinical characteristics predominant in the medical records showed that (55.7%) were paucibacillary with predominance of the clinical form Tuberculoid (43%). Of the minors (43.4%) had taken a dose of BCG at birth, (3.4%) had two BCG scars, in 55.7% the leprosy diagnosis was made after more than one year of onset Symptoms. No relation was found between the number of scars and the clinical form, but of the 4 smaller ones with two scars 3 (2.6%) presented the paucibalcaric form. Of the interviewees, (60%) were multibacillary with predominance of the dimorphous form, all (100%) took a dose of BCG at birth, (8.0%) had two BCG scars and multibacillary diagnosis. In (40%) the diagnosis was made more than one year after the onset of symptoms. Of those who were revaccinated, the lowest were between 8 and 15 years old (57.2%), male (50.3%), coming from Fortaleza (77.4%) with residence in COLORS V (41.8%) and VI (21.0%), with a dose of BCG at birth (91.6%). Studies regarding BCG immunoprophylaxis of leprosy patients should be done to observe the real role of revaccination in contacts of people with leprosy.