Acta leprologica最新文献

{"title":"[Hansen disease in Mercosur].","authors":"F A Vazquez,&nbsp;N N Varela,&nbsp;M C Antola,&nbsp;M L Wand-Del-Rey,&nbsp;O R Leguizamón","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the context of the important changes of a political economic, social and health order upon which the Argentina, Brazil, Paraguay and Uruguay have now embarked in the framework of the commitment undertaken to create instruments for the Common Market of the South America (MERCOSUR), the importance of leprosy for public health in this new region is analysed. In this connection a description is given of the background and reasons which led to the creation of the MERCOSUR Committee for technical cooperation on leprosy, composed of the heads of the national leprosy control programmes of the countries in question, for the purpose of implementing the Protocol of Intention signed by the representatives of the Ministers of member countries, with the object of establishing policies of technical cooperation in activities to control this disease, with a view to attaining the goal proposed by WHO of eliminating leprosy as a public health problem by the year 2000. Using the data contributed by the different programmes, the epidemiological situation existing in this region in December 1995 is outlined, with analysis of certain epidemiological, demographic and operational variables, showing that MERCOSUR has a prevalence of 6.03 per 10,000 population, one of the highest rates in comparison with other WHO regions; a high percentage of cases lost to view (abandons); and a low rate of coverage with multidrug therapy. In this region a total of 33,654 new cases were detected during 1995, of which more than 50% were multibacillary forms, while nearly 10% of them were youngsters of less of 15 years of age. The action carried out jointly among the four countries, the successes achieved and the results to be achieved in the short term are also described.</p>","PeriodicalId":6905,"journal":{"name":"Acta leprologica","volume":"10 2","pages":"79-84"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20010162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The Congress in Yaoundé].","authors":"H Sansarricq","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":6905,"journal":{"name":"Acta leprologica","volume":"10 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19929877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Tumoral proliferations in chronic plantar ulcers: how to treat?].","authors":"M Y Grauwin,&nbsp;I Mane,&nbsp;J L Cartel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Between 1983 and 1994, 66 Senegalese leprosy patients were seen for cauliflower growths developed in chronic plantar ulcer (CPU), (2 patients had each 2 tumors). 68 biopsies for pathological examination were taken: the diagnosis of squamous cell carcinoma was effectively made in 39 cases (38 patients) and that of pseudo-epitheliomatous hyperplasia in the remaining 29 cases (28 patients). The mean annual frequency of cauliflower growths was 0.45 per 100 CPU. Among these tumors, the percentage of carcinoma was 57%. Of the 38 patients with a carcinoma, 5 refused amputation and all of them died. The 33 others were amputated and of these 8 died as a direct result of their carcinoma (24%). In the case of the 28 patients with hyperplasia, amputation was carried out on 18 patients and local excision on 10. In the months following the operation 8 recurrences were observed in 10 of the patients on whom excision had been carried out. These recurrences were treated by amputation. This gives a total of 93% of amputations in the cases of hyperplasia. These facts lead as to conclude that at least in countries where pathological examination is not available below knee amputation is the most reasonable action to take in the proliferative tumors developed on a CPU.</p>","PeriodicalId":6905,"journal":{"name":"Acta leprologica","volume":"10 2","pages":"101-4"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20010160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stigma and socio-economic reintegration of leprosy sufferers in Nigeria.","authors":"N Awofeso","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Leprosy is the commonest cause of peripheral neuropathy in the world. This feature causes gross deformities of the face and limbs of infected individuals as well as crippling disabilities involving sight, touch and manual dexterity. Such stigmata intensified the social and economic isolation of patients. Although concerted efforts by national governments and international organisations have made leprosy cease to be a medical problem in most parts of the world, leprosy still remains a \"human problem\": about 30% of past or present leprosy sufferers in Nigeria are disabled and/or handicapped as a result of the disease. This paper reviews the various factors contributing to leprosy stigma in Nigeria and proposes ways of minimising it.</p>","PeriodicalId":6905,"journal":{"name":"Acta leprologica","volume":"10 2","pages":"89-91"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19933477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the courses of prevention of disabilities in Hansen's disease national reference center in Brazil--a national investigation.","authors":"A Gonçalves,&nbsp;M Pedroso,&nbsp;R Bacarelli,&nbsp;S De Oliveira","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Among the efforts endeavored for inclusion of prevention of disabilities in programmes of control of Hansen's Disease in Brazil, \"Lauro de Sousa Lima\" sanitary dermatology Hospital, Bauru, São Paulo State, performed the role of the main center of formation of human resources as national reference center and as reference center for Portuguese speaking countries, by World Health Organization. In this communication, results obtained are presented on a study performed with the aim of knowing judgements of ex-students about this process. Four hundred and sixteen professionals have been investigated, with a final amount of 151 respondents. Data obtained, besides distinguishing them in conformity with their basic formation and geographic area, quantify their appreciations on degree of learning, distribution according to the scheme of work in respective sanitary units and contributions of the course for their activities, not only in service level, but also as multipliers. Frequency and quantity of co-workers in the same unity, period of performance, as well as relationship between training and existence of systematic activities of prevention of disabilities in their place of work are also inquired. In conclusion, maintenance of the existing course is strongly recommended, since case studies of Brazilian sanitary realities were taken as models of discussion, with emphasis on primary attention and integration of prevention of disabilities to general conditions of treatment.</p>","PeriodicalId":6905,"journal":{"name":"Acta leprologica","volume":"10 2","pages":"111-6"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19933479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The training of health personnel by the Marchoux Institute in Bamako from 1979 to 1995].","authors":"A Tiendrébéogo,&nbsp;L Blanc,&nbsp;P M Sylla,&nbsp;P Bobin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Marchoux Institute, an OCCGE centre for leprosy research, has provided training for more than a thousand health workers between 1979 and 1995. Formerly, this training was offered entirely at the Marchoux Institute. It was aimed at leprosy control workers administering dapsone monotherapy within the framework of vertically integrated programmes. With the introduction of treatment programmes using multidrug therapy, leprosy control was integrated into the comprehensive health services. This change in approach dramatically increased the need for training and made it necessary to adapt the training offered by the Marchoux Institute. Since 1990, the Marchoux Institute has targeted doctors in training and health care staff at the supervisory level. The rise in the number of health agents to be trained has led to the arrangement of short-term training courses in the States concerned, with the participation of facilitators from the Marchoux Institute.</p>","PeriodicalId":6905,"journal":{"name":"Acta leprologica","volume":"10 1","pages":"37-43"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19929881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Anatomopathologic study of five cases of leprosy in HIV seropositive patients].","authors":"O Faye,&nbsp;A Mahé,&nbsp;P Jamet,&nbsp;M Huerre,&nbsp;P Bobin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In an effort to establish whether the human immunodeficiency virus (HIV) modifies the histological image of lepromatous skin lesion, a comparative study was conducted in 1994 at the Marchoux Institute in Bamako, Mali, on persons newly suffering from leprosy who had been tested seropositive and seronegative for the HIV virus. These new leprosy patients had never been treated and could be grouped as follows: 5 HIV-positive (1 TT, 1 BT, 1 BL, 2 LL) and 10 controls testing HIV-negative, selected according to the following criteria: each seropositive leprosy subject was matched with two seronegative controls having the same clinical features, same stage under the Ridley classification system, same age and sex. No discordance between the clinical classifications and the histological features in the subjects testing HIV-positive has been observed. They display features similar to those testing negative, with the presence of histiocytes, in particular epithelioid cells and giant cells in normal proportion depending on the form of leprosy. The only remarkable difference was a greater incidence of oedema in the subjects testing seropositive, compared with patients testing seronegative. In conclusion, HIV infection does not appear to cause major modifications in cellular response to Mycobacterium leprae, and no changes should be made in leprosy control programmes.</p>","PeriodicalId":6905,"journal":{"name":"Acta leprologica","volume":"10 2","pages":"93-9"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20010164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nerve abscess in children and adults leprosy patients: analysis of 145 cases and review of the literature.","authors":"A Salafia,&nbsp;G Chauhan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The authors report on their experience of nerve abscess in leprosy. They have found that in the last 5 years there is a significant increase in this type of pathology, at a time when the total number of patients has decreased in adults. Nerve abscesses are, recently, noticed in a large number of children and teenagers. This was not the case 7-9 years ago. Abscesses were excised from one hundred forty-five nerves in one hundred and sixteen patients between May 1985 and May 1994, out of which, 14 patients (12.6%) were operated during the period May 1985 to December 1989 and 102 (87.93%) in the period January 1990 to May 1994. Children and teenagers account for 47% of all cases of nerve abscess in this series. The incidence of abscess in multiple nerves is high too in these groups. Abscess of cutaneous nerves is very common too (35% of cases) though rarely reported in the literature. There is a higher incidence of nerve abscess in male adults as compared to females. The authors believe that this sudden increase in neural pathology can be attributed, in part, to the extension of multidrug therapy (MDT) programmes without adequate infrastructure to detect and treat early neuritis.</p>","PeriodicalId":6905,"journal":{"name":"Acta leprologica","volume":"10 1","pages":"45-50"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19831468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The genetic susceptibility to leprosy in humans].","authors":"P H Lagrange,&nbsp;L Abel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The capacity of certain individuals to resist certain diseases, including leprosy, has for a long time been considered as being influenced by genetic factors. The clinical and pathological spectrum of leprosy, epidemiological heterogeneity, both geographic and ethnic, in the prevalence of polar forms, may be explained by genetic differences in host resistance. While the specific genes in question have not been identified, recent studies suggest a genetic basis for differences in the capacity of macrophages in the host to reduce bacterial multiplication. Experimental models analyzing the reactions of antimycobacterial defence have underscored at existing differences in resistance or vulnerability to infection (M. bovis, BCG, M. lepraemurium, M. tuberculosis) were guided by a dominant gene which exists in two allelic forms, bcgr and bcg5. The bcgr allele confers resistance and is more dominant than the bcgs allele which represents greater vulnerability to infection. The murine candidate gene for the bcg gene has been named NRAMP (Natural Resistance-associated Macrophage Protein). Even though the exact function of NRAMP is not currently known, it has been demonstrated that this gene is expressed mainly in macrophages, and that it brings about increased bacteriostatic capacity in these cells. NRAMP is structurally homologous to the family of membranous proteins having a transport function linking ATP. NRAMP is similar to the membranous bacterial system transporting nitrites. The NRAMP protein is also involved as a signal of transduction during the activation of macrophages. It is therefore possible to conceive of genetic polymorphism at this locus intervening in specific and non-specific immune responses to infection. Apart from such potential polymorphism during the initial phase of infection, immunogenetic studies suggest that the polymorphism of class II HLA molecules could intervene in the evolution of secondary immune response to M. leprae. Knowing that HLA molecules are expressed in a co-dominant form, and attributing extraordinary allelic polymorphism to this locus, there may be a rather wide range of immune responses to the M. leprae antigens in subjects with discordant HLA and in populations which have varied genetic profiles. In general it has been acknowledged that HLA-DR isotypes are associated with protective response, while HLA-DQ isotypes are said to be associated with multibacillary lepromatous forms. The chief role of the HLA systems controlling cell-mediated immunity leads to the probability that differences in HLA haplotypes could contribute to the wide spectrum of immune responses observed in leprosy. Genetic determinants of resistance to leprosy cannot be described in a straightforward manner using a classic approach because the complex mechanisms of resistance, yet to be clarified and for which at least two loci are believed to be contributory, may be re-assessed like a multifactorial, multigenetic complex in which environ","PeriodicalId":6905,"journal":{"name":"Acta leprologica","volume":"10 1","pages":"11-27"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19929878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Organization of a program for the prevention of disabilities and physical rehabilitation at the center of a national program in the campaign against leprosy: practical advice].","authors":"A M Diallo,&nbsp;M Y Grauwin,&nbsp;C B Hirzel,&nbsp;C Lienhardt,&nbsp;A Tiendrébéogo,&nbsp;D Groupe","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Patients treated and cured on the bacteriological level by multidrug therapy may nevertheless present handicaps, such as deformities resulting from the disease, which have personal and social consequences. It is actually the handicap and disability from which most patients suffer and which concern populations. The number of persons suffering from such handicaps worldwide has been estimated at 4 million. Therefore, the main goal is to gradually integrate the activities of the prevention of disabilities and physical rehabilitation programme (PIRP) into the national leprosy control programme (PNL). The persons involved in the implementation of the programme outline the activities planned under the PIRP, detailed objectives, priorities, the means by which they will be implemented, the content of training programmes, assessment criteria and documents available.</p>","PeriodicalId":6905,"journal":{"name":"Acta leprologica","volume":"10 1","pages":"29-35"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19929879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}