title: Evaluation of the social, clinical and laboratorial profile of patients diagnosed with leprosy in a reference center in São Paulo.
abstract: BACKGROUND
  Leprosy is the main infectious cause of disability. It is said to be eradicated in São Paulo since 2005, but diagnosis is still late.
  
  
  OBJECTIVE
  To investigate the social, clinical and laboratorial profile of leprosy patients diagnosed between 01/2007 and 12/2011, in a reference center in São Paulo.
  
  
  METHODS
  Retrospective descriptive study. Data of all new leprosy cases diagnosed between 01/2007 and 12/2011 were raised in São Paulo.
  
  
  RESULTS
  103 men and 71 women were diagnosed, most of them were multibacillary. Mean age at diagnosis was 49 yrs; 2,2% were children; 70% had incomplete primary education; 50% were referred without diagnostic suspicion of leprosy. Mean time since first symptoms/signs and diagnosis was 2 years; 64% of patients had some degree of disability, and 26% had grade 2. 23 cases were diagnosed only after being summoned, and 80% of these had no disability. Agreement between the Ridley and Jopling and the WHO classification was 75% (kappa index = 0.44). Serology for IgM anti-PGL1 (87 patients) showed a mean value of 0.25, and an association between MB classification and test positivity (p <0.001).
  
  
  CONCLUSIONS
  Leprosy diagnosis in São Paulo is late. The disease mainly affected the socially disadvantaged and economically active population. Failure to detect the disease (41% in the last 10 years) could be due to the lack of suspicion and to decentralization. For the classification of patients with advanced leprosy, both the WHO and R&J classifications proved to be helpful tools.
authors.affiliation: Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Ana Carolina Souza
authors.initials: AC
authors.lastname: Porto
authors.affiliation: Instituto Lauro de Souza Lima, Bauru, SP, Brazil.
authors.forename: Renata Borges Fortes Costa
authors.initials: RB
authors.lastname: Figueira
authors.affiliation: Instituto Lauro de Souza Lima, Bauru, SP, Brazil.
authors.forename: Jaison Antônio
authors.initials: JA
authors.lastname: Barreto
authors.affiliation: Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: José Roberto Pereira
authors.initials: JR
authors.lastname: Lauris
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000942:Antigens, Bacterial / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D002648:Child; D057210:Delayed Diagnosis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007918:Leprosy / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012698:Serologic Tests; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric; D055815:Young Adult
chemical_list: D000942:Antigens, Bacterial
references.citation: Lancet. 2004 Apr 10;363(9416):1209-19
references.pmid: 15081655
references.citation: Mem Inst Oswaldo Cruz. 2011 Aug;106(5):536-40
references.pmid: 21894372
references.citation: Lepr Rev. 2004 Sep;75(3):266-73
references.pmid: 15508903
references.citation: Biometrics. 1977 Mar;33(1):159-74
references.pmid: 843571
references.citation: Lepr Rev. 1962 Apr;33:119-28
references.pmid: 14492126
references.citation: Clin Dermatol. 2007 Mar-Apr;25(2):165-72
references.pmid: 17350495
references.citation: Clin Infect Dis. 2007 Apr 15;44(8):1096-9
references.pmid: 17366457
references.citation: Indian J Dermatol Venereol Leprol. 2008 Mar-Apr;74(2):174-6
references.pmid: 18388394
references.citation: Indian J Dermatol Venereol Leprol. 2008 Jul-Aug;74(4):322-6
references.pmid: 18797050
references.citation: Indian J Dermatol Venereol Leprol. 2008 Jul-Aug;74(4):327-30
references.pmid: 18797051
references.citation: Rev Soc Bras Med Trop. 2008;41 Suppl 2:11-8
references.pmid: 19618069
references.citation: Rev Soc Bras Med Trop. 2008;41 Suppl 2:27-33
references.pmid: 19618072
references.citation: Rev Soc Bras Med Trop. 2008;41 Suppl 2:45-7
references.pmid: 19618075
references.citation: Rev Soc Bras Med Trop. 2008;41 Suppl 2:48-55
references.pmid: 19618076
references.citation: Rev Soc Bras Med Trop. 2010 Jul-Aug;43(4):460-1
references.pmid: 20802951
references.citation: An Bras Dermatol. 2011 Jan-Feb;86(1):91-5
references.pmid: 21437528
references.citation: Lancet Infect Dis. 2011 Jun;11(6):464-70
references.pmid: 21616456
references.citation: Int J Lepr Other Mycobact Dis. 2004 Sep;72(3):278-83
references.pmid: 15485284