LATE DIAGNOSIS AND AMPUTATIONS IN YOUNG PEOPLE AFFECTED BY LEPROSY IN THE XXI CENTURY

INTRODUCTION AND OBJECTIVE: The leprosy is a chronic, infectious disease, with immune character. When leprosy is detected and treated early, the disabilities may be reversible. However, 11-51% of patients don’t recover and 6-27% develop secondary disabilities. It’s important to show that a disease with healing criteria defined by WHO since 1982 can still, in 2014, lead to limb amputations in working-age people, as demonstrated in our study. METHOD: Transversal, cross sectional study, conducted by data collection from medical records and evaluation/interviews of follow-up patients treated for leprosy in Rio de Janeiro, Brazil, from 2004-2014. We analyzed 7 patients, from 35 to 80 years, with multibacillary forms and applied both SALSA and participation scales. RESULTS AND CONCLUSIONS: In the past 2 years, 7 patients with limbs amputation for leprosy complications were analyzed, 5 males and 2 females, all after multibacillary treatment for lepromatous leprosy and grade II of disability at diagnosis. In SALSA scale, 76% of patients had moderate to severe activity limitation. We observed social restriction in 24,9% of patients, between the amputations, 7 were in lower limbs, including first and fifth toes, forefoot, left leg, and 1 in upper limb. Physical disability is intrinsically associated with social restriction. These results suggest that there may have been a delayed diagnosis of leprosy. As a result, the importance of systematic monitoring and determination of criteria for the follow-up of these patients is highlighted. The early diagnosis and immediate treatment should be guaranteed in the Family Health Strategy/Primary Health Care.