Assessment of the Degree of Neurofunctional Disability in Leprosy Patients in a Municipality in Bahia, Brazil

Abstract

Mycobacterium leprae is an intracellular bacillus with a specific affinity for Schwann cells. The inflammatory process caused by the bacillus leads to demyelination, axonal degeneration, and loss of neural function, resulting in leprosy neuropathy, which manifests as deformities and physical disabilities. This study aimed to evaluate the degree of physical disability and neurological impairment in leprosy cases in an endemic region of Bahia, Brazil. Methods: This retrospective descriptive study utilized secondary data from patients with leprosy treated at a specialized reference center in Paulo Afonso, Bahia, between 2009 and 2020. Data were collected from patient notification records and medical files, tabulated, and analyzed. Results: A total of 194 leprosy cases were analyzed. Among these, 39.7% exhibited some degree of physical disability, and 49.5% were classified as multibacillary. A statistical association was found between physical disability and factors such as low education (illiteracy or incomplete elementary education), male gender, age of 60 years or older, multibacillary cases, dimorphic or virchowian clinical forms, more than five skin lesions, at least one affected nerve, and positive bacilloscopy. The ulnar nerve was the most commonly affected nerve trunk, although physical disabilities were predominantly located in the lower limbs. Conclusion: The high prevalence of physical disabilities and neurological impairment among leprosy patients in this endemic region underscores the need for improved health education, early diagnosis, and strategies to prevent deformities and disabilities. Enhanced understanding of risk factors and preventive measures could help mitigate the impact of leprosy neuropathy on patients’ lives.