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"I said that I was suffering from leprosy and my colleague took a step back," says Marines Uhde, a nurse who retired quickly due to illness.
She worked for years in direct contact with patients with leprosy, a nomenclature used since 1980 for leprosy.
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The Marines are among the 30 000 Brazilians who contract the disease
Brazil concentrates more than 90% of leprosy cases in Latin America. It is the second largest country in the world where the incidence is highest, behind India, according to Dahw Brazil. , A German non-profit organization that helps 61-year-olds to live and work in 21 countries.
"Leprosy is clbadified as neglected diseases, which are diseases of poverty, as well as leishmaniasis, schistosomiasis, trachoma.What happens is that most humans have a natural resistance to Therefore, even when in contact with the bacteria that causes leprosy, they do not become ill, "says (19659002)
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Data from the Brazilian Ministry of Health show that the number of cases has increased from 25,000 in 2016 to 26,000 in 2017, which corresponds to an increase of 5.8%. But for the pulp, this does not represent a growth of the disease, but rather the reflection of its greater detection.
"These figures reflect actions developed to improve the detection of new cases, aimed at early treatment to prevent the emergence of"
Leprosy is a cousin of tuberculosis [19659002] Leprosy is an infectious disease caused by a mycobacterium considered "primordial" of tuberculosis.
According to the dermatologist, it is manifested by white, pink and red patches that may be present above or also by red bumps. 19659002] She explains that the other symptoms are the stuffy nose because it affects the nasal mucosa, as well as reduced sensitivity to both points, arms and legs, even in the absence of lesions. According to the dermatologist, the disease is usually diagnosed later, as in the Marines.
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Leprosy is curable – Drugs kill bacteria – but they are disabling. Medications do not reverse neuronal damage. "The crucial problem is that it does not only affect the skin, it is mainly a peripheral nerve disease that causes daily injuries to the patient, which reinforces skin infections. The end of the feet and the hands This is not folklore, if the patient is not treated or has a late diagnosis, it can happen, explains the dermatologist.
The disease rarely causes death.
In the Midwest and North, leprosy is hyperendemic
The highest incidence of the disease occurs in Maranhão, Pará and Mato Grosso. "In the Midwest and North, leprosy is hyperendemic and in some states it appears that the disease does not exist, but it is not real." Dahw Brazil
The Marines were working at Nova Mutum, in Mato Grosso. "Even when I was working with leprosy, it took me 9 years to make the diagnosis because I did not have a single point on the skin. I have developed the rarest form that only affects the nerves. I had a treatment for a year.
Marines have trouble moving their arms and legs, being hit harder on the right side and lacking sensitivity on the skin. The illness has also altered his voice, vision and hearing. "I have a lot of difficulty writing, holding objects and identifying when I have a cut in the skin, because I do not feel I need to do everything slowly." [19659002Thefirstsymptomswerepaininthewristsandrightelbowwhichdoctorsconfusedwithtendonitis"Heusedtoputahotbaganinsulatedbagandthatwouldnotwork"
In addition to the physical limitations, she faced prejudices and her own sadness. "During the treatment, I felt sadness, but I attribute it to drugs, which cause horrible discomfort in the stomach, and reactions that can lead the person to think about suicide. It is therefore important to have a follow-up. It is treat something that has a strong bias, which is the problem of leprosy. "
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who, while treating the disease, changed the routine." I wanted to be more isolated. It was a way of protecting myself, of not wanting to explain people. The color of your skin changes and people wonder: why is your skin darker and sunbathing? What treatment does it do? "
Leprosy or leprosy?
The emergence of leprosy refers to more than 2,000 years ago, according to Bechler." About 50 years ago, there was still a total misunderstanding of the disease and it was not known what the cause was and how to treat it. "
In the 1930s, Brazil created a public policy of isolation of the disease. a concept conceived in Europe.There were 18 public lepers. "In addition to these lepers, there was a police force that was looking for the sick at home, which caused great fear among the population."
According to him, the disease also carries a religious stigma. "It was common in a family of 10, for example, one person was developing the disease, which was considered a curse." It was not long after that 92% of people proved to be resistant to bacteria. "he says.
The disease stopped being scary and called leprosy from the 1980s when his treatment was cured. "The disease is the same as in the past, what has changed is the treatment that is effective.In the 1980s, multidrug therapy (PKP) was instituted, that is to say the use of more than one drug to treat it, has changed the disease in the world, "says the dermatologist.
Since then, the isolation has been extinguished. "In the first dose of medication, the bacillary load drops by 90% .The control measures of the disease consist in examining all persons close to the patient who should receive the BCG vaccine, the same as that used against tuberculosis.This is not a specific vaccine against leprosy.It is the first vaccine that humans take before leaving maternity, "explains -t it.
BCG is composed of attenuated mycobacteria. When applied, it stimulates the body's immune action against mycobacteria, especially tuberculosis. and leprosy. "The BCG does not prevent the person from having TB, it prevents serious forms of the disease just like leprosy."
The incubation can reach up to seven years 19659002] Leprosy has a long incubation period – from three to seven years. "It is thought that even before the patient presents a clinical picture, it is possible that he is already transmitting the disease, although there is still no scientific evidence about it," Sandra explains. .
The diagnosis is made by clinical examination and bacilloscopic examination, which measures the bacillary load, as well as the biopsy, are considered complementary examinations. Disability levels of the disease are clbadified as zero (no change), 1 (sensory changes only) and 2 (motor changes, ulcers and vision problems).
"In places where the incidence of leprosy is low, for example, in southern Brazil, the number of patients diagnosed with grade 2 is higher than in places where the incidence Among the 30,000 new cases recorded each year in Brazil, only 7% are grade 2. "
SUS offers the diagnosis and treatment of leprosy. "There are already studies showing that the drug used for the treatment, created in the 1940s and collected in the 1980s, will not be more effective in 10 to 15 years.As it's a bacteria, it will naturally create a resistance to drugs and no investment is needed to improve this remedy.It must invest in it, "warns Bechler.
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