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Revista Costarricense de Salud Pública

Print version ISSN 1409-1429

Abstract

ESPINOZA AGUIRRE, Azálea. Prevalence of leprosy in Costa Rica between 1998 and 2003. Rev. costarric. salud pública [online]. 2007, vol.16, n.31, pp.36-41. ISSN 1409-1429.

A study of the prevalence of leprosy was conducted during the time period comprised between the years 1998 to 2003 with the purpose of characterizing the distribution of this illness in the country. Cases were those patients with a diagnosis of leprosy or Hansen´s disease confirmed by a physician which had consulted in the health establishments of the Costa Rican Social Security System (hereby, abbreviated as C.C.S.S.) during the study period as well as patients who abandoned treatment without having achieved a cure. Cases which were cured, who died or foreigners were excluded. By means of an active search in the CCSS, health records of patients between 1998 and 2003 were identified as well as their laboratory reports of skin biopsy and cutaneous lymph confirmatory of the diagnosis. Notified cases were obtained from the Ministry of Health and population data from the National Institute on Statistics and the Census. A form with clinical as well as epidemiological, laboratory and socio-economic variables was designed. Analysis was carried out by geographical area (both province as well as county), age groups and sex. A prevalence rate was calculated as well as a case-detection rate and the respective percentages. While 114 cases were identified in the health services, only 89 were included in our study which represents a prevalence of 0,3 cases per 100,000 inhabitants. The illness affected mainly those older than 15 years of age; 65 percent of the cases were male. The province of Puntarenas showed the highest prevalence with 0,6 per 10,000 inhabitants. All these patients received treatment for the lepromatous type of leprosy and the San Juan de Dios Hospital took care of 60% of them. 28% of the cases relapsed. Since 1998, the Ministry of Health did not conduct any epidemiological investigation of the cases of Hansen´s disease nor had any follow-up of the contacts been carried out. Health-services` personnel didn´t have any protocol nor any clinical treatment guidelines available to them. Costa Rica eliminated leprosy as a public health problem in 1995 and the incidence rate has been lower than one case per 100,000 inhabitants since then. Our recommendations include: beginning immediately epidemiological investigation of each case and the appropriate contacts; the implementation of a plan directed towards health personnel and, finally, supervised treatment and strengthening of the elimination strategies in order to move forward rapidly towards erradication.

Keywords : Leprosy; prevalence; elimination; erradication; Hansen’s disease; M. leprae.

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