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Silva-Sobrinho RA, Oliveira KS, Deschutter EJ, Arcoverde MAM, Hoare I, Izurieta R, Zilly A, Topanotti ML, de Almeida AM, Meira MCR, da Luz LDP, Cicchelero LM, Zimermann F. Risk areas for the occurrence of leprosy in border countries of South America - Brazil and Argentina. PLoS One 2022; 17:e0276977. [PMID: 36417347 PMCID: PMC9683543 DOI: 10.1371/journal.pone.0276977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 10/17/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The aim was to analyze the spatial association and relative risk (RR) of leprosy cases diagnosed in southern Brazil and in the Argentinean province of Misiones during 2010 to 2016. METHODS This ecological-type epidemiological study analyzed data from the Health Ministries of both countries. The analysis included frequency measures, spatial autocorrelation, RR cluster analysis and map construction. RESULTS A hyperendemic occurrence was identified in all study regions, in the state of Paraná 71.2% of the municipalities were hyperendemic and in Misiones, Argentina 41.2%. The GI* statistical analysis showed clusters of high incidence rates in the state of Paraná and low-risk clusters in much of the state of Rio Grande do Sul, both in Brazil. The analysis indicated an area with RR equal to 3.87 - (p < .0001) when considering the entire territory and an RR of 2.80 - (p < .0001) excluding the state of Paraná, with the number of departments of Misiones, Argentina included in the risk clusters increasing significantly. CONCLUSIONS The findings indicate a high probability of similar illness in adjacent areas, according to their relative position in space, as the occurrence of the disease is influenced by neighboring clusters.
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Affiliation(s)
- Reinaldo Antonio Silva-Sobrinho
- Program in Public Health in Border Region—Master’s Degree, Western Paraná State University, Foz do Iguaçu, Paraná, Brazil
- * E-mail:
| | - Keurilene Sutil Oliveira
- Program in Public Health in Border Region—Master’s Degree, Western Paraná State University, Foz do Iguaçu, Paraná, Brazil
| | - Enrique Jorge Deschutter
- Master’s Degree in Public Health and Communicable Diseases, College of Pharmacy and Biochemistry, National University of Misiones, Posadas, Misiones, Argentina
| | | | - Ismael Hoare
- Public Health Doctoral Program, College of Public Health, University of South Florida, Tampa, Florida, United States of America
| | - Ricardo Izurieta
- Public Health Doctoral Program, College of Public Health, University of South Florida, Tampa, Florida, United States of America
| | - Adriana Zilly
- Program in Public Health in Border Region—Master’s Degree, Western Paraná State University, Foz do Iguaçu, Paraná, Brazil
| | - Maria Luzia Topanotti
- Master’s Degree in Public Health and Communicable Diseases, College of Pharmacy and Biochemistry, National University of Misiones, Posadas, Misiones, Argentina
| | - Ana Maria de Almeida
- Department of Maternal-Infant Nursing and Public Health, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Mara Cristina Ripoli Meira
- Program in Public Health in Border Region—Master’s Degree, Western Paraná State University, Foz do Iguaçu, Paraná, Brazil
| | | | - Laiz Mangini Cicchelero
- Program in Public Health in Border Region—Master’s Degree, Western Paraná State University, Foz do Iguaçu, Paraná, Brazil
| | - Fatima Zimermann
- Department of Epidemiological Surveillance, Hospital Samic of Puerto Iguazú, Puerto Iguazú, Misiones, Argentina
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Dharmawan Y, Fuady A, Korfage IJ, Richardus JH. Delayed detection of leprosy cases: A systematic review of healthcare-related factors. PLoS Negl Trop Dis 2022; 16:e0010756. [PMID: 36067195 PMCID: PMC9481154 DOI: 10.1371/journal.pntd.0010756] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 09/16/2022] [Accepted: 08/19/2022] [Indexed: 11/23/2022] Open
Abstract
Background In new leprosy cases, grade 2 disability (G2D) is still a public health burden worldwide. It is often associated with the delayed leprosy diagnoses that healthcare systems should play a crucial role in preventing. The aim of this systematic review was to identify healthcare factors related to delays in case detection in leprosy. Methods PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) was used as a guideline in this research. The study protocol was registered in the PROSPERO (International Prospective Register of Systematic Reviews) with reference code CRD42020189274. Data was collected from five electronic databases: Embase, Medline All Ovid, Web of Science, Cochrane CENTRAL, and the WHO Global Health Library. Results After applying the selection criteria for original empirical studies, and after removing duplicates, we included 20 papers from 4313 records. They had been conducted in ten countries and published between January 1, 2000, and January 31, 2021. We identified three categories of healthcare factors related to delayed case. 1) Structural factors, such as i) financial and logistic issues, and geographical circumstances (which we classified as barriers); ii) Health service organization and management including the level of decentralization (classified as facilitators). 2) Health service factors, such as problems or shortages involving referral centers, healthcare personnel, and case-detection methods. 3) Intermediate factors, such as misdiagnosis, higher numbers of consultations before diagnosis, and inappropriate healthcare services visited by people with leprosy. Conclusions Delays in leprosy case detection are due mainly to misdiagnosis. It is crucial to improve the training and capacity of healthcare staff. To avoid misdiagnosis and reduce detection delays, national leprosy control programs should ensure the sustainability of leprosy control within integrated health services. New leprosy patients diagnosed with visible physical deformities represent a significant disease burden that also poses an important public health challenge. The physical deformities often result from long delays in case detection. Greater insight into the healthcare factors that contribute to such delays will support the development of effective prevention programs. We therefore reviewed all studies on the healthcare factors related to case-detection delay that had been published between January 1, 2000, and January 31, 2021. Twenty studies were included in our analysis. We found that misdiagnosis was a core healthcare factor related to delays. Other common factors included inappropriate health services, a high number of consultations before diagnosis; and a lack of referral centers, healthcare personnel, and case-detection methods. Detection delay was further influenced by geographical circumstances, financial and logistic issues, and health-service organization and management including the level of the decentralization of healthcare programs. Because delays in leprosy case detection are due mainly to misdiagnosis, we recommend to improve the training and capacity of healthcare staff. To avoid misdiagnosis and reduce detection delays, national leprosy control programs should ensure the sustainability of leprosy control within integrated health services.
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Affiliation(s)
- Yudhy Dharmawan
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Faculty of Public Health, Universitas Diponegoro, Semarang, Indonesia
- * E-mail: ,
| | - Ahmad Fuady
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Primary Health Care Research and Innovation Center, Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Ida J. Korfage
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jan Hendrik Richardus
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Schoenmakers A, Hambridge T, van Wijk R, Kasang C, Richardus JH, Bobosha K, Mitano F, Mshana SE, Mamo E, Marega A, Mwageni N, Letta T, Muloliwa AM, Kamara DV, Eman AM, Raimundo L, Njako B, Mieras L. PEP4LEP study protocol: integrated skin screening and SDR-PEP administration for leprosy prevention: comparing the effectiveness and feasibility of a community-based intervention to a health centre-based intervention in Ethiopia, Mozambique and Tanzania. BMJ Open 2021; 11:e046125. [PMID: 34446483 PMCID: PMC8395349 DOI: 10.1136/bmjopen-2020-046125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 08/02/2021] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Leprosy, or Hansen's disease, remains a cause of preventable disability. Early detection, treatment and prevention are key to reducing transmission. Post-exposure prophylaxis with single-dose rifampicin (SDR-PEP) reduces the risk of developing leprosy when administered to screened contacts of patients. This has been adopted in the WHO leprosy guidelines. The PEP4LEP study aims to determine the most effective and feasible method of screening people at risk of developing leprosy and administering chemoprophylaxis to contribute to interrupting transmission. METHODS AND ANALYSIS PEP4LEP is a cluster-randomised implementation trial comparing two interventions of integrated skin screening combined with SDR-PEP distribution to contacts of patients with leprosy in Ethiopia, Mozambique and Tanzania. One intervention is community-based, using skin camps to screen approximately 100 community contacts per leprosy patient, and to administer SDR-PEP when eligible. The other intervention is health centre-based, inviting household contacts of leprosy patients to be screened in a local health centre and subsequently receive SDR-PEP when eligible. The mobile health (mHealth) tool SkinApp will support health workers' capacity in integrated skin screening. The effectiveness of both interventions will be compared by assessing the rate of patients with leprosy detected and case detection delay in months, as well as feasibility in terms of cost-effectiveness and acceptability. ETHICS AND DISSEMINATION Ethical approval was obtained from the national ethical committees of Ethiopia (MoSHE), Mozambique (CNBS) and Tanzania (NIMR/MoHCDEC). Study results will be published open access in peer-reviewed journals, providing evidence for the implementation of innovative leprosy screening methods and chemoprophylaxis to policymakers. TRIAL REGISTRATION NUMBER NL7294 (NTR7503).
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Affiliation(s)
| | - Thomas Hambridge
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Robin van Wijk
- Medical Technical Department, NLR, Amsterdam, The Netherlands
| | - Christa Kasang
- Deutsche Lepra- und Tuberkulosehilfe e.V, Wuerzburg, Germany
| | - Jan Hendrik Richardus
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Kidist Bobosha
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Fernando Mitano
- Lúrio University, Nampula, Mozambique
- Nampula Provincial Health Directorate, Ministry of Health Mozambique, Maputo, Mozambique
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, United Republic of Tanzania
| | - Ephrem Mamo
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | | | - Nelly Mwageni
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, United Republic of Tanzania
| | - Taye Letta
- Ministry of Health Ethiopia, Addis Ababa, Ethiopia
| | - Artur Manuel Muloliwa
- Lúrio University, Nampula, Mozambique
- Nampula Provincial Health Directorate, Ministry of Health Mozambique, Maputo, Mozambique
| | | | | | | | - Blasdus Njako
- Deutsche Lepra- und Tuberkulosehilfe e.V. Tanzania, Dar es Salaam, United Republic of Tanzania
| | - Liesbeth Mieras
- Medical Technical Department, NLR, Amsterdam, The Netherlands
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Status and forecast of leprosy in the still endemic province of Formosa in northern Argentina. PLoS Negl Trop Dis 2021; 15:e0008881. [PMID: 33400698 PMCID: PMC7785118 DOI: 10.1371/journal.pntd.0008881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 10/13/2020] [Indexed: 11/19/2022] Open
Abstract
Background The province of Formosa, Argentina, is endemic for leprosy. In the present paper, we assessed the trend (T, 2002–2016 time series) and the forecast for 2022 of new case detection rate (NCDR) and determined the spatial distribution of new cases detected (NCD) of leprosy. Methodology/Principal findings This is a descriptive observational study of 713 NCD of leprosy from provincial medical records between January 2002 and December 2016. The whole dataset from the provincial medical record was used to independently estimate the NCDR trends of the general population, age groups, sexes and Departments. This same database was used to estimate the NCDR forecast of the general population for 2022, applying a dynamic linear model with a local linear trend, using the MCMC algorithm. The NCDR was higher in men (p<0.05), increased with age (0.20, 8.17, 21.04, and 29.49 for the 0–14, 15–44, 45–64 and over 65-year-old age groups, respectively; p<0.05) and showed a downward trend (negative values) of estimated slopes for the whole province and each Department. Bermejo Department showed the highest (T:-1.02, 95%CI: [-1.42, -0.66]) and Patiño the lowest decreasing trend (T:-0.45, 95%CI: [-0.74, -0.11]). The NCDR trend for both sexes was similar (T:-0.55, 95%CI: [-0.64, -0.46]), and age groups showed a decreasing trend (S15-44:-103, S45-64:-81, S>65:-61, p<0.05), except for the 0–14 age group (S:-3, p>0.05), which showed no trend. Forecasts predicted that leprosy will not be eliminated by 2022 (3.64, 95%CI: [1.22, 10.25]). Conclusions/Significance Our results highlight the status of leprosy in Formosa and provide information to the provincial public health authorities on high-risk populations, stressing the importance of timely detection of new cases for further elimination of the disease in the province. Leprosy, a neglected tropical disease, is a public health problem in northern Argentina, causing permanent damage, stigmatization and discrimination. The Program for the Control of Leishmaniasis and Leprosy in Formosa province (PCLyLF) is responsible for the diagnosis and treatment of the disease and the active search for household contacts. The present study aimed to determine the spatial distribution of new cases of leprosy and the status of the disease using new case detection rate (NCDR) as the main epidemiological indicator. We determined the NCDR trends (2002–2016 time series) of the general population, age groups, sexes and Departments, and the NCDR forecast for the province by 2022. Our results indicated that leprosy was spread throughout Formosa, with higher rates in men and in patients over 65 years old. The NCDR showed a downward trend in the whole province and in each Department. The Departments of Bermejo and Matacos had the highest decreasing trend and the Department of Patiño the lowest one. Future projections show that leprosy will not be eliminated by 2022.
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Fuller LC, Asiedu KB, Hay RJ. Integration of Management Strategies for Skin-Related Neglected Tropical Diseases. Dermatol Clin 2020; 39:147-152. [PMID: 33228857 DOI: 10.1016/j.det.2020.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The concept of skin neglected tropical diseases has been widely adopted into the policy and strategy of various organizations, governments, nongovernmental organizations, and health agencies. By pooling information and resources across different diseases, whose primary manifestations affect the skin, it is possible to deliver integrated surveillance and control programs and promote advocacy and reduction of disability and stigma. A further key part of the skin neglected tropical diseases program is the development and validation of training methods for front-line health workers. Networks that allow those involved in this work to share and compare expertise are being developed through various organizations.
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Affiliation(s)
- Lucinda Claire Fuller
- Chelsea and Westminster NHS Foundation Trust, London SW10 9NH, UK; The International Foundation for Dermatology, London W1P 5HQ, UK.
| | - Kingsley B Asiedu
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva 1202, Switzerland
| | - Roderick J Hay
- The International Foundation for Dermatology, London W1P 5HQ, UK; The St John's Institute of Dermatology, King's College London, London SE1 9RT. UK
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Osti MH, Sokana O, Gorae C, Whitfeld MJ, Steer AC, Engelman D. The diagnosis of scabies by non-expert examiners: A study of diagnostic accuracy. PLoS Negl Trop Dis 2019; 13:e0007635. [PMID: 31425513 PMCID: PMC6715246 DOI: 10.1371/journal.pntd.0007635] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 08/29/2019] [Accepted: 07/16/2019] [Indexed: 12/31/2022] Open
Abstract
Background Although scabies is estimated to be one of the most common skin conditions globally, prevalence data is not available in most settings. Disease mapping is required to develop and monitor successful control programs. Non-expert health workers are likely to play an important role in scabies mapping activities in endemic settings. Methodology Four non-expert health workers were trained in the diagnosis of scabies and impetigo. The health worker diagnosis was compared to a reference consensus diagnosis of two doctors experienced in diagnosis. The study was conducted in a primary school in Gizo, Solomon Islands, in August 2018. The six examiners consecutively assessed school students, blinded to each other’s findings. Training and diagnostic procedures followed criteria for scabies diagnosis established by the International Alliance for the Control of Scabies in 2018. Principal findings Amongst the 171 students who underwent clinical assessment the prevalence of scabies and impetigo according to the reference standard was 55% and 45% respectively. Sensitivity of the non-expert health workers’ diagnosis compared to the reference standard was 55.3% for scabies (95% confidence interval [CI], 50.1–60.4) with a specificity of 89.9% (95% CI 86–93.1) and 52.6% for impetigo (95% CI 46.9–58.3) with a specificity 97.8% (95% CI 95.7–99). Sensitivity for moderate to severe scabies was 93.5% (95% CI 86.3–97.6) with a specificity of 74% (95% CI 70.2–77.5). Conclusions Following brief training, the diagnostic accuracy of non-expert health workers for scabies and impetigo was promising, especially for moderate to severe disease. Modifications to training and processes are recommended to further improve accuracy. The diagnosis by non-expert health workers may be acceptable for scabies and impetigo mapping in endemic areas. Scabies is a parasitic infection that leads to significant morbidity worldwide. Mapping of scabies prevalence would improve the understanding of the true burden of disease and the need for control programs in specific countries and regions. The diagnosis of scabies in low resource settings, where the disease is most prevalent, is reliant on clinical examination. A task shifting approach, utilizing local health staff, could substantially increase the feasibility to undertake mapping surveys in low-resource settings. In this study, we aimed to evaluate the diagnostic accuracy of clinical assessment of local health workers following brief training. Our study found that these non-expert health workers could diagnose scabies with moderate accuracy and diagnose more severe disease with high accuracy. Further work is needed to develop standardized training packages to ensure a high level of diagnostic accuracy by non-expert health workers.
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Affiliation(s)
- Millicent H. Osti
- Tropical Diseases, Murdoch Children’s Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
- Melbourne Children’s Global Health, Melbourne, VIC, Australia
| | - Oliver Sokana
- Ministry of Health and Medical Services, Honiara, Solomon Islands
| | - Christina Gorae
- Ministry of Health and Medical Services, Honiara, Solomon Islands
| | - Margot J. Whitfeld
- Department of Dermatology, St Vincent’s Hospital, Sydney, NSW, Australia
- School of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Andrew C. Steer
- Tropical Diseases, Murdoch Children’s Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
- Melbourne Children’s Global Health, Melbourne, VIC, Australia
- Department of General Medicine, Royal Children’s Hospital, Melbourne, VIC, Australia
| | - Daniel Engelman
- Tropical Diseases, Murdoch Children’s Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
- Melbourne Children’s Global Health, Melbourne, VIC, Australia
- Department of General Medicine, Royal Children’s Hospital, Melbourne, VIC, Australia
- * E-mail:
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The Skin-A Common Pathway for Integrating Diagnosis and Management of NTDs. Trop Med Infect Dis 2018; 3:tropicalmed3030101. [PMID: 30274497 PMCID: PMC6161075 DOI: 10.3390/tropicalmed3030101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 09/04/2018] [Accepted: 09/05/2018] [Indexed: 12/16/2022] Open
Abstract
Many of the neglected tropical diseases (NTDs) have major skin manifestations. These skin-related NTDs or ‘skin NTDs’ cause significant morbidity and economic hardship in some of the poorest communities worldwide. We draw attention to the collective burden of skin disease and suggest that the skin be used as a platform for the integration of control activities for NTDs. The opportunities for integration are numerous, ranging from diagnosis and disease mapping to mass drug administration and morbidity management. The dermatology community has an important role to play, and will be expected to support research and control activities globally.
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Opportunities for Integrated Control of Neglected Tropical Diseases That Affect the Skin. Trends Parasitol 2016; 32:843-854. [PMID: 27638231 DOI: 10.1016/j.pt.2016.08.005] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 08/04/2016] [Accepted: 08/05/2016] [Indexed: 11/23/2022]
Abstract
Many neglected tropical diseases (NTDs) affect the skin, causing considerable disability, stigma, and exacerbation of poverty. However, there has been relatively little investment into laboratory research, epidemiology, diagnostic tools or management strategies to control tropical skin disease. Integration may advance the control of skin disease across a range of domains, including mapping, diagnosis, clinical management, and community control measures such as mass drug administration. Examples of successful integration strategies include programs targeting scabies, impetigo, yaws, and diseases causing lymphoedema. Future strategies should build on these experiences and the experience of integration of other NTDs, strengthen existing health systems, and contribute toward the attainment of Universal Health Coverage. Strong partnerships and political support and will be necessary to achieve these goals.
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Yap FBB, Kiung ST. Knowledge and confidence in the diagnosis and management of leprosy among Family Medicine Specialists in Malaysia. JOURNAL OF DERMATOLOGY & DERMATOLOGIC SURGERY 2016. [DOI: 10.1016/j.jdds.2015.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Souza ALAD, Feliciano KVDO, Mendes MFDM. [Family Health Strategy professionals' view on the effects of Hansen's disease training]. Rev Esc Enferm USP 2015; 49:610-8. [PMID: 26353098 DOI: 10.1590/s0080-623420150000400011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Evaluating how professionals of family health teams from three municipalities of Pernambuco perceive and interpret the effects of Hansen's disease training. METHODS A qualitative study using the perspective of Habermas. Six focus groups, totaling 33 nurses and 22 doctors were formed. The guide consisted of: reactions to training, learning, transfer of knowledge and organizational results. RESULTS There were recurrent positive opinions on instructor performance, course materials, and an alert attitude to the occurrence of cases; the negative points were about lack of practical teaching, a lot of information in a short period of time and little emphasis on basic content. Low perceived self-efficacy and low locus of control, ambiguity, conflict of skills and the lack of support for the learning application. Nurses showed greater dissatisfaction with the organizational support. CONCLUSION The low effectiveness of training reveals the need to negotiate structured training from work problematization, considering performance conditions.
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Bilan P, Sin C, Wann AR, Grossin M, Courdavault L, Sigal ML, Mahé E. Tuberculose cutanée et érythème induré de Bazin : étude rétrospective de 13 cas. Ann Dermatol Venereol 2015; 142:237-44. [DOI: 10.1016/j.annder.2015.01.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Revised: 11/18/2014] [Accepted: 01/06/2015] [Indexed: 10/24/2022]
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Alves CRP, Ribeiro MMF, Melo EM, Araújo MG. Teaching of leprosy: current challenges. An Bras Dermatol 2014; 89:454-9. [PMID: 24937820 PMCID: PMC4056704 DOI: 10.1590/abd1806-4841.20142444] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 05/02/2013] [Indexed: 11/13/2022] Open
Abstract
In the context of declining leprosy endemicity worldwide, keeping the interest in
knowledge and expertise in leprosy alive has been a matter of concern.
Approaching the problem only in primary care, without the proper integration
with other levels of care in the health system fails to account for the
complexity of the disease. Training professionals to work at different levels of
health care is a current challenge. The objective of this review was to look for
experiences related to the teaching of leprosy both in undergraduate courses in
the field of health sciences and in training programs for professionals who work
in patient care. We highlight the role of the dermatologist in the management of
control programs, diagnosis and treatment of the disease, as well as in the
continuous education of other health professionals.
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Ryan TJ, Hirt HM, Willcox M. Collaboration with traditional health practitioners in the provision of skin care for all in Africa. Int J Dermatol 2011; 50:564-70. [DOI: 10.1111/j.1365-4632.2011.05023.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hay RJ. Cutaneous tuberculosis and the control of infection in resource-poor environments. Dermatology 2008; 217:94-6. [PMID: 18446033 DOI: 10.1159/000128285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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