Physical Disabilities and Individual Vulnerability: Perspectives in Hyperendemic Municipalities for Leprosy

Introduction: Epidemiological, operational and socio-demographic data on leprosy, as well as its direct and indirect impact on the affected person, his/her family, and community, are included in the group of neglected diseases. Objective: To analyze the association between the occurrence of physical disabilities in leprosy cases and individual vulnerability in hyperendemic municipalities. Methodology: population-based cross-sectional study of leprosy cases reported from 2001 to 2014 in two municipalities of Piauí/Brazil. Interviews and descriptive, bivariate and multivariate analyses were conducted to study eventual associations. Results: Of the 603 cases evaluated, the most frequent were female (52%), brown (46%), with low schooling, married/united (50%) and retired (28%). A significant proportion of cases was multibacillary (46%), Virchowian clinical form (14%), reactional episodes (20%), disability degree I or II (70%). The explanatory variables for the presence of some degree of physical disability were gender, age group, perceived health, operational classification, clinical form, and hypertension (p<0.05). Conclusion: The physical disabilities caused by leprosy involve, in addition to dermatoneurological damage, psychological damage resulting from the strong stigma they produce. This result reinforces the need for differentiated care and nursing in disability prevention, physical rehabilitation and psychological follow-up to ensure comprehensive care.