Estudo da associação entre hanseníase e diabetes mellitus em população hiperendêmica

Abstract

Introduction: Linhares and Sooretama, cities of Espírito Santo (ES) state, are ranked fourth among leprosy clusters. The incidence of diabetes mellitus is increasing exponentially, which may impact on the development of mycobacteriosis. Objectives: General: study the association between leprosy and diabetes mellitus. Secondary: 1) Describe clinical and epidemiological variables; 2) Compare disability degree between patients with and without diabetes melitus. Methods: Case-control study in wich cases (subjects with leprosy) were submitted to peripheral nerves exam, slit intradermal smear and skin lesions biopsy. Cases and controls (multibacillary patients’ parents and children) were evaluated with dermatological examination and laboratory investigation for diabetes melitus. The association between leprosy and diabetes mellitus was assessed by OR with p0,05 and 95%, chisquare test and logistic regression. The association between disability degree and diabetes mellitus was evaluated by chi-square test. Results: In 78 cases, 61.5% were male, while in 78 controls, 44.8% were men. The patient’s avarage age was 44 years old for the cases, and 33 years old for the controls. Five cases presented indeterminate form, twenty six tuberculoid, fourteen borderline tuberculoid, nine borderline-borderline, thirteen borderline-lepromatous and eleven lepromatous. Ten cases had reaction and twenty six patients showed some degree of disability I or II. Fourteen cases (17.9%) and one control (1.28%) had diabetes mellitus (OR 16.84, 95% CI 2.15 to 131.58). The chi-square test with Yates correction was 10.62 (p = 0.001). Variables diabetes mellitus, age and sex were independently associated with leprosy. Disability of degree I or II was associated with diabetes mellitus, with chisquare test with Yates correction of 5.75 (p = 0.016). Conclusions: Diabetes mellitus was statistically associated with leprosy. Data on gender, age and disability degree were consistent with the literature. The frequency of indeterminate form was lower while borderline was higher than that found in ES in 2011 and the disability was statistically associated with diabetes mellitus.