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A morbidade causada pela hansen&#237;ase afeta gravemente a qualidade de vida dos pacientes&#44; podendo induzir problemas psicol&#243;gicos&#46; Entretanto&#44; apesar de medidas eficazes terem sido amplamente implementadas&#44; o n&#250;mero de novos casos em todo o mundo permaneceu em quase 250&#46;000 a cada ano&#46; Embora a hansen&#237;ase geralmente apresente baixo n&#237;vel epid&#234;mico no noroeste da China&#44; a propor&#231;&#227;o de casos MB e a taxa de incapacidade permanecem em n&#237;vel alto&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#8211;4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Para analisar os fatores sociodemogr&#225;ficos e cl&#237;nicos associados &#224; hansen&#237;ase MB em &#225;reas de planejamento de elimina&#231;&#227;o da doen&#231;a no noroeste da China&#44; dados de tr&#234;s hospitais especializados foram inclu&#237;dos&#46; Os registros m&#233;dicos de hansen&#237;ase na prov&#237;ncia no noroeste da China de 2004 a 2020 foram coletados do Sistema de Informa&#231;&#227;o de Gest&#227;o da Hansen&#237;ase &#40;LEPMIS&#44; <span class="elsevierStyleItalic">Leprosy Management Information System</span>&#41;&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Este foi um estudo observacional e retrospectivo de 305 casos coletados no LEPMIS de 2004 a 2020&#46; As vari&#225;veis inclu&#237;ram dados demogr&#225;ficos&#44; sociol&#243;gicos&#44; cl&#237;nicos e laboratoriais&#46; O n&#237;vel de signific&#226;ncia foi estabelecido em p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46; A an&#225;lise de regress&#227;o log&#237;stica foi utilizada para ajustar as vari&#225;veis categ&#243;ricas e determinar os fatores de risco independentes da hansen&#237;ase MB&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Foi demonstrado que&#44; na prov&#237;ncia no noroeste da China&#44; entre 2004 e 2020&#44; houve diferen&#231;as estatisticamente significantes em rela&#231;&#227;o ao sexo e algumas outras vari&#225;veis &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#44; como mostrado na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#46; Dos casos de hansen&#237;ase MB&#44; 21&#44;32&#37; tinham menos de cinco les&#245;es de pele&#44; como mostrado na <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Esses resultados mostraram caracter&#237;sticas de alta endemia da hansen&#237;ase&#44; sugerindo que o atraso no diagn&#243;stico da doen&#231;a<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> ainda existia no noroeste da China&#44; o que determinou incapacidades mais graves&#46; A hansen&#237;ase apresentou tend&#234;ncia de baixa preval&#234;ncia nesta fase&#44; e os pacientes do sexo masculino ainda representaram uma propor&#231;&#227;o relativamente alta dos novos casos diagnosticados em cada ano&#44; o que pode estar relacionado a diferentes suscetibilidades gen&#233;ticas em g&#234;neros diferentes&#46; Al&#233;m disso&#44; as mulheres t&#234;m mais consultas relacionadas a doen&#231;as de pele do que os homens&#44; e os homens podem ser mais facilmente expostos aos bacilos da hansen&#237;ase devido a fatores comportamentais<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> e culturais&#44; o que pode explicar em parte a predomin&#226;ncia dos casos no sexo masculino&#46; A suscetibilidade dos idosos &#224; hansen&#237;ase MB pode estar relacionada ao prolongado per&#237;odo de incuba&#231;&#227;o dos bacilos da hansen&#237;ase&#44; resultando em resposta tardia&#46; Al&#233;m disso&#44; o envelhecimento do sistema imunol&#243;gico em idosos<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> foi fator agravante para o controle da infec&#231;&#227;o&#46; Pessoas com ensino superior<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> s&#227;o mais propensas a procurar servi&#231;os m&#233;dicos para evitar atrasos no diagn&#243;stico e tratamento&#46; Os dados mostraram que pessoas casadas constituem um grupo especial na hansen&#237;ase MB&#44; o que pode indicar que o contato pr&#243;ximo no domic&#237;lio esteja relacionado &#224; exposi&#231;&#227;o aos bacilos da hansen&#237;ase&#44; mas n&#227;o podemos descartar a import&#226;ncia do contato social na transmiss&#227;o da doen&#231;a&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">A detec&#231;&#227;o passiva foi um fator de prote&#231;&#227;o para a hansen&#237;ase MB&#44; por isso &#233; necess&#225;rio aumentar a divulga&#231;&#227;o e educa&#231;&#227;o sobre a preven&#231;&#227;o e controle da hansen&#237;ase em &#225;reas de baixa preval&#234;ncia&#44; e melhorar o &#237;ndice de conscientiza&#231;&#227;o<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> do povo e quanto aos cuidados pessoais&#46; Mais de cinco les&#245;es foram associadas &#224; hansen&#237;ase MB&#44; o que indicou que a alta concentra&#231;&#227;o de infec&#231;&#227;o por bacilos da hansen&#237;ase pode levar &#224; maior destrui&#231;&#227;o tecidual&#44; mais danos &#224; pele e mais deformidades&#46; Os casos MB t&#234;m maior probabilidade de incapacidade grau I ou II ap&#243;s o ajuste do modelo&#46; A taxa de incid&#234;ncia de incapacidade de Classe II na presente amostra &#233; muito maior do que a m&#233;dia global de 6&#37; relatada pela OMS<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> em 2016&#44; o que indicou que h&#225; atraso no diagn&#243;stico ou erro de diagn&#243;stico nesses pacientes&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Este estudo baseou&#8208;se em dados obtidos do LEPMIS&#59; portanto&#44; apresenta algumas limita&#231;&#245;es&#44; como informa&#231;&#245;es inconsistentes&#44; vi&#233;s de preval&#234;ncia e defeito de desenho transversal&#46; Pesquisas futuras precisam considerar estudos longitudinais ou de distribui&#231;&#227;o geogr&#225;fica para esclarecer fatores relacionados &#224; hansen&#237;ase&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Em conclus&#227;o&#44; os pacientes MB foram a principal fonte infecciosa da hansen&#237;ase&#59; portanto&#44; a detec&#231;&#227;o e o tratamento precoces podem efetivamente bloquear a transmiss&#227;o da hansen&#237;ase no elo de controle da fonte infecciosa&#44; o que &#233; de grande import&#226;ncia para reduzir a probabilidade de doentes de hansen&#237;ase com incapacidade&#46; Este estudo avaliou as caracter&#237;sticas epid&#234;micas e regionais da hansen&#237;ase MB no noroeste da China&#44; que podem ser &#250;teis para prevenir e controlar efetivamente a hansen&#237;ase&#46;</p><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Suporte financeiro</span><p id="par0080" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Contribui&#231;&#227;o dos autores</span><p id="par0085" class="elsevierStylePara elsevierViewall">Ge Li&#58; Co&#8208;escreveu o artigo&#59; &#233; o autor para correspond&#234;ncia&#44; revisou os dados e resultados deste artigo&#59; contribuiu na interpreta&#231;&#227;o dos dados&#44; comentou o manuscrito&#44; revisou o manuscrito e aprovou a vers&#227;o final para publica&#231;&#227;o&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Chao Li&#58; Co&#8208;escreveu o artigo&#59; contribuiu na interpreta&#231;&#227;o dos dados&#44; comentou o manuscrito&#44; revisou o manuscrito e aprovou a vers&#227;o final para publica&#231;&#227;o&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Qingping Zhang&#58; &#201; o autor para correspond&#234;ncia&#59; revisou os dados e resultados desse artigo&#59; contribuiu na interpreta&#231;&#227;o dos dados&#44; comentou o manuscrito&#44; revisou o manuscrito e aprovou a vers&#227;o final para publica&#231;&#227;o&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Hong Zhang&#58; Contribuiu na obten&#231;&#227;o e aquisi&#231;&#227;o dos dados do artigo&#59; contribuiu na interpreta&#231;&#227;o dos dados&#44; comentou o manuscrito&#44; revisou o manuscrito e aprovou a vers&#227;o final para publica&#231;&#227;o&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Ping Chen&#58; Contribuiu na obten&#231;&#227;o e aquisi&#231;&#227;o dos dados do artigo&#59; contribuiu na interpreta&#231;&#227;o dos dados&#44; comentou o manuscrito&#44; revisou o manuscrito e aprovou a vers&#227;o final para publica&#231;&#227;o&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Zhaoxing Lin&#58; Forneceu orienta&#231;&#227;o sobre m&#233;todos de pesquisa e revis&#227;o de casos&#59; contribuiu na interpreta&#231;&#227;o dos dados&#44; comentou o manuscrito&#44; revisou o manuscrito e aprovou a vers&#227;o final para publica&#231;&#227;o&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflito de interesses</span><p id="par0115" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">N&#237;vel educacional &#40;anos&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mais de 9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">6 &#40;2&#44;21&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0 &#40;0&#44;00&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;002&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3&#44;145&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;1&#44;504&#8208;6&#44;573&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Entre 1 e 9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">184 &#40;67&#44;65&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">14 &#40;42&#44;42&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Menor de 1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">82 &#40;30&#44;15&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">19 &#40;57&#44;58&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Estado civil</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Solteiro&#40;a&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">69 &#40;25&#44;37&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">20 &#40;60&#44;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;221&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;0&#44;104&#8208;0&#44;468&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Casado&#40;a&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">203 &#40;74&#44;63&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">13 &#40;39&#44;39&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hist&#243;ria domiciliar</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Local&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">267 &#40;98&#44;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;90&#44;91&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;014&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5&#44;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;1&#44;215&#8208;23&#44;465&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>N&#227;o local&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;1&#44;84&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;9&#44;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Idade &#40;anos&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mais de 60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;14&#44;71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;27&#44;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;063&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;460&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#44;199&#8208;1&#44;061&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Entre 20 e 60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">224 &#40;82&#44;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;69&#44;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Menos de 20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;2&#44;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;3&#44;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Fatores comportamentais</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Modo de diagn&#243;stico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  """
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Rea&#231;&#227;o do tipo II&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Positivo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;12&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&#40;4&#44;612&#8208;39&#44;566&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Negativo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Nenhum&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;003&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#44;355&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#44;500&#8208;3&#44;678&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1 nervo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;11&#44;40&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;33&#44;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8805; 2 nervos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">188 &#40;69&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;51&#44;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Incapacidade</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Nenhuma&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61 &#40;22&#44;43&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;33&#44;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;578&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#44;266&#8208;1&#44;259&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Grau&#160;I&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">93 &#40;34&#44;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;9&#44;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Grau&#160;II&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">103 &#40;37&#44;87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;57&#44;58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Indefinida&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;5&#44;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#44;00&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3688217.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Rela&#231;&#227;o entre fatores cl&#237;nicos e formas cl&#237;nicas de hansen&#237;ase</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Refer&#234;ncias"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Active search for leprosy cases in Midwestern Brazil&#58; A serological evaluation of asymptomatic household contacts before and after prophylaxis with bacillus Calmette&#8208;Guerin"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "O&#46;M&#46; Limeira"
                            1 => "C&#46;M&#46; Gomes"
                            2 => "O&#46;O&#46; Morais"
                            3 => "M&#46;V&#46; Cesetti"
                            4 => "R&#46;R&#46; Alvarez"
                          ]
                        ]
                      ]
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Vol. 97. Núm. 6.
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Hanseníase multibacilar no Programa de eliminação da hanseníase no noroeste da China
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Ge Lia,b,1, Chao Lic,1, Qingping Zhanga,
Autor para correspondência
1016009751@qq.com

Autor para correspondência.
, Hong Zhanga, Ping Chena, Zhaoxing Lina
a Shaanxi Provincial Institute for Endemic Disease Control, Xi’an, China
b Escola de Saúde Pública, Xi’an Jiaotong University Health Science Center, Xi’an, China
c Departamento de Ortopedia, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
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Tabela 1. Relação entre fatores sociodemográficos e comportamentais e formas clínicas de hanseníase
Tabela 2. Relação entre fatores clínicos e formas clínicas de hanseníase
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A hanseníase, causada por Mycobacterium leprae, é uma doença infecciosa crônica que pode causar danos permanentes aos nervos periféricos e deformidades.1 De acordo com a Organização Mundial de Saúde (OMS), a hanseníase é classificada nas formas clínicas PB (paucibacilar) ou MB (multibacilar), com base no número de lesões na pele: hanseníase PB (duas a cinco lesões) e hanseníase MB (mais de cinco lesões). A hanseníase MB é causada principalmente pela diminuição da resposta de imunidade celular aos bacilos da hanseníase, e é caracterizada por altas infectividade e taxa de incapacidade funcional. A morbidade causada pela hanseníase afeta gravemente a qualidade de vida dos pacientes, podendo induzir problemas psicológicos. Entretanto, apesar de medidas eficazes terem sido amplamente implementadas, o número de novos casos em todo o mundo permaneceu em quase 250.000 a cada ano. Embora a hanseníase geralmente apresente baixo nível epidêmico no noroeste da China, a proporção de casos MB e a taxa de incapacidade permanecem em nível alto.2–4

Para analisar os fatores sociodemográficos e clínicos associados à hanseníase MB em áreas de planejamento de eliminação da doença no noroeste da China, dados de três hospitais especializados foram incluídos. Os registros médicos de hanseníase na província no noroeste da China de 2004 a 2020 foram coletados do Sistema de Informação de Gestão da Hanseníase (LEPMIS, Leprosy Management Information System).

Este foi um estudo observacional e retrospectivo de 305 casos coletados no LEPMIS de 2004 a 2020. As variáveis incluíram dados demográficos, sociológicos, clínicos e laboratoriais. O nível de significância foi estabelecido em p <0,05. A análise de regressão logística foi utilizada para ajustar as variáveis categóricas e determinar os fatores de risco independentes da hanseníase MB.

Foi demonstrado que, na província no noroeste da China, entre 2004 e 2020, houve diferenças estatisticamente significantes em relação ao sexo e algumas outras variáveis (p <0,05), como mostrado na tabela 1. Dos casos de hanseníase MB, 21,32% tinham menos de cinco lesões de pele, como mostrado na tabela 2.

Tabela 1.

Relação entre fatores sociodemográficos e comportamentais e formas clínicas de hanseníase

  Hanseníase MB (n=272)  Hanseníase PB (n=33)  p‐valor  OR  IC 95% 
Fatores sociodemográficos
Sexo
Masculino  184 (67,65)  28 (84,85)  0,043  0,373  (0,139‐1,000) 
Feminino  88 (32,35)  5 (15,15)       
Etnia
Han  268 (98,53)  33 (100,00)  0,483  0,89  (0,856‐0,926) 
Outras  4 (1,47)  0 (0,00)       
Profissão
Agricultor  24 (8,82)  3 (9,09)  0,959  0,968  (0,275‐3,407) 
Outras  248 (91,18)  30 (90,91)       
Nível educacional (anos)
Mais de 9  6 (2,21)  0 (0,00)  0,002  3,145  (1,504‐6,573) 
Entre 1 e 9  184 (67,65)  14 (42,42)       
Menor de 1  82 (30,15)  19 (57,58)       
Estado civil
Solteiro(a)  69 (25,37)  20 (60,61)  <0,001  0,221  (0,104‐0,468) 
Casado(a)  203 (74,63)  13 (39,39)       
História domiciliar
Local  267 (98,16)  30 (90,91)  0,014  5,34  (1,215‐23,465) 
Não local  5 (1,84)  3 (9,09)       
Idade (anos)
Mais de 60  40 (14,71)  9 (27,27)  0,063  0,460  (0,199‐1,061) 
Entre 20 e 60  224 (82,35)  23 (69,70)       
Menos de 20  8 (2,94)  1 (3,03)       
Fatores comportamentais
Modo de diagnóstico           
Detecção ativa  53 (19,49)  15 (45,45)  0,001  0,290  (0,137‐0,614) 
Detecção passiva  219 (80,51)  18 (54,55)       
Tabela 2.

Relação entre fatores clínicos e formas clínicas de hanseníase

  Hanseníase MB (n=272)  Hanseníase PB (n=33)  p‐valor  OR  IC 95% 
Lesão cutânea
Nenhuma  8 (2,94)  5 (15,15)  <0,001  0,170  (0,052‐0,554) 
1 lesão  6 (2,21)  7 (21,21)       
2‐5 lesões  44 (16,18)  15 (45,45)       
>5 lesões  214 (78,68)  6 (18,18)       
Reação hansênica
Sem reação  233 (85,66)  30 (90,91)  0,3  0,597  (0,174‐2,053) 
Reação do tipo I  15 (5,51)  3 (9,09)       
Reação do tipo II  20 (7,35)  0 (0,00)       
Reação mista  4 (1,47)  0 (0,00)       
Resultado do esfregaço de pele
Positivo  177 (65,07)  4 (12,12)  <0,001  13,508  (4,612‐39,566) 
Negativo  95 (34,93)  29 (87,88)       
Dano neural
Nenhum  53 (19,49)  5 (15,15)  0,003  1,355  (0,500‐3,678) 
1 nervo  31 (11,40)  11 (33,33)       
≥ 2 nervos  188 (69,12)  17 (51,52)       
Incapacidade
Nenhuma  61 (22,43)  11 (33,33)  0,007  0,578  (0,266‐1,259) 
Grau I  93 (34,19)  3 (9,09)       
Grau II  103 (37,87)  19 (57,58)       
Indefinida  15 (5,51)  0 (0,00)       

Esses resultados mostraram características de alta endemia da hanseníase, sugerindo que o atraso no diagnóstico da doença5 ainda existia no noroeste da China, o que determinou incapacidades mais graves. A hanseníase apresentou tendência de baixa prevalência nesta fase, e os pacientes do sexo masculino ainda representaram uma proporção relativamente alta dos novos casos diagnosticados em cada ano, o que pode estar relacionado a diferentes suscetibilidades genéticas em gêneros diferentes. Além disso, as mulheres têm mais consultas relacionadas a doenças de pele do que os homens, e os homens podem ser mais facilmente expostos aos bacilos da hanseníase devido a fatores comportamentais6 e culturais, o que pode explicar em parte a predominância dos casos no sexo masculino. A suscetibilidade dos idosos à hanseníase MB pode estar relacionada ao prolongado período de incubação dos bacilos da hanseníase, resultando em resposta tardia. Além disso, o envelhecimento do sistema imunológico em idosos7 foi fator agravante para o controle da infecção. Pessoas com ensino superior8 são mais propensas a procurar serviços médicos para evitar atrasos no diagnóstico e tratamento. Os dados mostraram que pessoas casadas constituem um grupo especial na hanseníase MB, o que pode indicar que o contato próximo no domicílio esteja relacionado à exposição aos bacilos da hanseníase, mas não podemos descartar a importância do contato social na transmissão da doença.

A detecção passiva foi um fator de proteção para a hanseníase MB, por isso é necessário aumentar a divulgação e educação sobre a prevenção e controle da hanseníase em áreas de baixa prevalência, e melhorar o índice de conscientização9 do povo e quanto aos cuidados pessoais. Mais de cinco lesões foram associadas à hanseníase MB, o que indicou que a alta concentração de infecção por bacilos da hanseníase pode levar à maior destruição tecidual, mais danos à pele e mais deformidades. Os casos MB têm maior probabilidade de incapacidade grau I ou II após o ajuste do modelo. A taxa de incidência de incapacidade de Classe II na presente amostra é muito maior do que a média global de 6% relatada pela OMS10 em 2016, o que indicou que há atraso no diagnóstico ou erro de diagnóstico nesses pacientes.

Este estudo baseou‐se em dados obtidos do LEPMIS; portanto, apresenta algumas limitações, como informações inconsistentes, viés de prevalência e defeito de desenho transversal. Pesquisas futuras precisam considerar estudos longitudinais ou de distribuição geográfica para esclarecer fatores relacionados à hanseníase.

Em conclusão, os pacientes MB foram a principal fonte infecciosa da hanseníase; portanto, a detecção e o tratamento precoces podem efetivamente bloquear a transmissão da hanseníase no elo de controle da fonte infecciosa, o que é de grande importância para reduzir a probabilidade de doentes de hanseníase com incapacidade. Este estudo avaliou as características epidêmicas e regionais da hanseníase MB no noroeste da China, que podem ser úteis para prevenir e controlar efetivamente a hanseníase.

Suporte financeiro

Nenhum.

Contribuição dos autores

Ge Li: Co‐escreveu o artigo; é o autor para correspondência, revisou os dados e resultados deste artigo; contribuiu na interpretação dos dados, comentou o manuscrito, revisou o manuscrito e aprovou a versão final para publicação.

Chao Li: Co‐escreveu o artigo; contribuiu na interpretação dos dados, comentou o manuscrito, revisou o manuscrito e aprovou a versão final para publicação.

Qingping Zhang: É o autor para correspondência; revisou os dados e resultados desse artigo; contribuiu na interpretação dos dados, comentou o manuscrito, revisou o manuscrito e aprovou a versão final para publicação.

Hong Zhang: Contribuiu na obtenção e aquisição dos dados do artigo; contribuiu na interpretação dos dados, comentou o manuscrito, revisou o manuscrito e aprovou a versão final para publicação.

Ping Chen: Contribuiu na obtenção e aquisição dos dados do artigo; contribuiu na interpretação dos dados, comentou o manuscrito, revisou o manuscrito e aprovou a versão final para publicação.

Zhaoxing Lin: Forneceu orientação sobre métodos de pesquisa e revisão de casos; contribuiu na interpretação dos dados, comentou o manuscrito, revisou o manuscrito e aprovou a versão final para publicação.

Conflito de interesses

Nenhum.

Agradecimentos

Os autores gostariam de agradecer a todos os participantes do estudo sobre hanseníase. Em particular, gostaríamos de expressar nossos agradecimentos a National Health Commission of the People's Republic of China e Health Commission da Província de Shaanxi.

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Contribuíram igualmente

Como citar este artigo: Li G, Li C, Zhang Q, Zhang H, Chen P, Lin Z. Multi‐bacillary leprosy under the Chinese leprosy elimination program. An Bras Dermatol. 2022;97:804–6.

Trabalho realizado no Shaanxi Provincial Institute for Endemic Disease Control, Xi’an, China.

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To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.