Evaluation of neurological sequelae of leprosy in Sergipe state
Bibliographic record
Abstract
Leprosy is a chronic disease caused by intimate and prolonged contact with contagious untreated patients. Mycobacterium leprae has a predilection for skin and peripheral nerves. In Brazil the disease is a public health problem and the State of Sergipe is priority to control. The most complication of leprosy is occurrence of reactional episode, when no treated properly, promotes progression of nerve damage. The overall strategy to control the disease burden is to reduce the degree 2 of disability over the next five years. Studies showing the epidemiology and geographical distribution of leprosy cases, as well as risk factors for the disease are needed to control actions. The objective of this study is to evaluate the leprosy in the Sergipe State, focusing neurological sequelae as well as evaluating the overall detection rate and geographical distribution of leprosy and the degree of disability and define clinical aspects associated with neurological lesion in patients in reference units of the State. This is a retrospective study with data from System of Notifiable Diseases (SINAN), Brazilian Institute of Geography and Statistics (IBGE) and analysis records of reference units between the years 2005 to 2011. The variables used were gender, age, clinical form, operational classification, physical disability at diagnosis and after treatment, reactional episodes, treatment with corticosteroids and number of cities with household clusters (5 and 9 people / home). Maps showing the geographical distribution of leprosy cases and the degree of neurological disability in the municipalities of the state were created by Spring program, version 5.1.8 and ArcGIS, version 9.3.1. Categorical variables were described in simple frequencies, percentages, and with association analysis, using the chi-square (95% significance). Quantitative variables were described as mean and standard deviation and the clinical variables associated with the "severity of illness" (multibacillary and / or reactive episodes) through the logistic regression model. The state has hyperendemic municipalities indicating that the disease remains a public health problem. In 2005, Ontario had a detection rate of 33.0/100, 000 inhabitants, followed by a gradual reduction in the number of new cases by the year 2010. However, at the same time, increase was recorded with disability. The cases of leprosy were found in counties that have clusters of homes with more than five people / home. We observed a significant association with male and multibacillary, leprosy reactions and disability at diagnosis. This predisposition to severe forms of leprosy in men may be due a delay in diagnosis and treatment. Reactional episodes were detected in 40% of patients and neurological injury in 43.5%. Most patients with leprosy reactions were treated with corticosteroids but dose and time used below the recommended treatment, maintaining and/or developed disability. The association between male gender and more severe forms of the disease suggests that this group needs more attention by leprosy programs as there is need for better conduct of treatment and monitoring of neurological damage in leprosy in order to prevent disability.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".