Hanseníase: investigação da não realização do exame dermatoneurológico em contatos intradomiciliares.

Abstract

Leprosy, a slowly evolving infectious disease, has the means to maintain the endemic in household contacts. The epidemiological investigation carried out through the surveillance of patients' household contacts is one of the activities carried out, after confirmation of a case of the disease, since family members are the people most exposed to infection and, therefore, those who also have the highest risk of infection. contract the disease. In view of the epidemiological situation of the municipality, based on what is shown by its health indicators in relation to leprosy, it is not favorable to control the disease, in an attempt to modify the real situation of leprosy contacts, as well as to improve the current epidemiological picture of the disease in the city of Cajazeiras - PB, we propose, then, the investigation of the non-performance of the dermatoneurological exam, in household contacts, of cases of leprosy in this municipality. Exploratory-descriptive study with a quantitative and qualitative approach; an interview script was used during home visits to 31 contacts of leprosy cases notified and treated (or under treatment) in 2009 and 2010 in Cajazeiras - PB. It was identified that the main reason mentioned by the contacts for not carrying out the dermatoneurological examination was the absence of signs and symptoms of leprosy, as well as feelings generated, from the lack of information from these contacts, also removed them from the service and contributed to they did not undergo the exam, such as: fear of the exam, lack of confidence in the service, shame of the exam and shame and / or prejudice against the disease. We conclude that in an attempt to favor adherence to contact with prophylaxis, as well as the approach to the unit and the professionals, they must explain how the dermatological examination is carried out and encourage them to avoid and face the feelings of fear, shame and prejudice , which can disrupt the entire therapeutic process. It is considered important to improve the organization and control of leprosy contacts in Cajazeiras - PB, intensify the active search, improve data recording and control the application of BCG-ID; establish partnerships in order to recover the missing contacts, diagnose and treat the disease early; and promoting, and implementing educational actions, and actions to minimize the effects still caused by prejudice to patients and family members in Cajazeiras - PB, with the objective of guiding the patient, family and community, in general, about the disease. Therefore, it becomes necessary to improve the service of contacts, intensifying epidemiological surveillance, making it more lasting and demanding results from the professionals responsible for the PNCH. We suggest the implementation of identification and follow-up forms, and an appointment card for the leprosy contact.