Rafael Pinto

Búsqueda Activa de Lepra y de Otras Enfermedades de la Piel en Escolares de Agua de Dios, Colombia

Objetivo Buscar lepra, otras enfermedades de la piel y la cicatriz BCG, en escolares de Agua de Dios, municipio con la mas alta prevalencia de lepra en Colombia: 23-39/10 000; educar y difundir los resultados en la comunidad. Metodos Se hizo examen clinico de los ninos por enfermeras, medicos internos y generales y por expertos en lepra. Cuando la clinica lo indicaba, se practicaron baciloscopias y biopsias de piel. En pocos casos se buscaron anticuerpos en sangre contra el glicolipido fenolico 1, del bacilo de Hansen. Resultados Se examinaron 86 % de los 2 844 escolares de las 17 instituciones del municipio; 833 tuvieron patologias cutaneas, de los cuales 16 % requirieron el examen por expertos. Se demostraron cuatro casos nuevos de lepra paucibacilar, dos indeterminados y dos polineuriticos primarios. Las entidades mas frecuentes fueron: pediculosis, pitiriasis alba, pitiriasis versicolor, nevus hipocromicos, picaduras de insectos y miliaria. Cuatro ninos tuvieron maltrato infantil y una nina de 11 anos, micosis fungoides hipocromiante. La vacunacion BCG se aplico en 387 ninos que no la habian recibido. Se trataron las condiciones encontradas. Se informo a la comunidad sobre las enfermedades detectadas, las funciones de la piel y sus cuidados generales, enfatizando la importancia del diagnostico temprano de la lepra. Conclusiones La incidencia de lepra encontrada (16/10 000), es la mas alta en Colombia, 123 veces mayor que la global del pais. Su busqueda activa demostro enfermedad paucibacilar, sin discapacidades y otras enfermedades cutaneas importantes. Es recomendable persistir con este examen clinico y con la investigacion de los factores predisponentes para adquirir la enfermedad.OBJECTIVE Actively searching for leprosy, other skin diseases and BCG vaccination scars amongst school children from Agua de Dios, the municipality having the highest prevalence of leprosy in Colombia. METHODS A clinical examination of the children was carried out by nurses, interns, general practitioners and experts on leprosy. Skin smear tests and skin biopsies were performed when the clinical findings suggested leprosy. Anti-phenolic glycolipid antibodies in blood were determined in special cases. RESULTS 86 % of the 2 844 school children were examined; 833 had skin diseases and 16 % of these required evaluation by specialists. Four new cases of paucibacillary leprosy, two indeterminate and two primary polyneuritic cases were found. Pediculosis capitis, pityriasis alba, tinea versicolor, hypopigmented nevus, insect bites and miliaria were frequently detected. BCG vaccination scars were absent in 387 children; following several logistical problems, they were vaccinated. Four children had signs of childhood abuse. An 11-year-old girl presented hypopigmented mycosis fungoides. All diseases and conditions found were treated. The community received information regarding the results, emphasising the importance of an early diagnosis of leprosy. CONCLUSIONS The incidence of leprosy found (16/10,000) was 123 times higher than the rest of the countrys incidence. It is advisable to continue clinical examinations in Agua de Dios and research into risk factors for acquiring leprosy.

Active search for leprosy and other skin diseases in school children from Agua de Dios, Colombia

Objetivo Buscar lepra, otras enfermedades de la piel y la cicatriz BCG, en escolares de Agua de Dios, municipio con la mas alta prevalencia de lepra en Colombia: 23-39/10 000; educar y difundir los resultados en la comunidad. Metodos Se hizo examen clinico de los ninos por enfermeras, medicos internos y generales y por expertos en lepra. Cuando la clinica lo indicaba, se practicaron baciloscopias y biopsias de piel. En pocos casos se buscaron anticuerpos en sangre contra el glicolipido fenolico 1, del bacilo de Hansen. Resultados Se examinaron 86 % de los 2 844 escolares de las 17 instituciones del municipio; 833 tuvieron patologias cutaneas, de los cuales 16 % requirieron el examen por expertos. Se demostraron cuatro casos nuevos de lepra paucibacilar, dos indeterminados y dos polineuriticos primarios. Las entidades mas frecuentes fueron: pediculosis, pitiriasis alba, pitiriasis versicolor, nevus hipocromicos, picaduras de insectos y miliaria. Cuatro ninos tuvieron maltrato infantil y una nina de 11 anos, micosis fungoides hipocromiante. La vacunacion BCG se aplico en 387 ninos que no la habian recibido. Se trataron las condiciones encontradas. Se informo a la comunidad sobre las enfermedades detectadas, las funciones de la piel y sus cuidados generales, enfatizando la importancia del diagnostico temprano de la lepra. Conclusiones La incidencia de lepra encontrada (16/10 000), es la mas alta en Colombia, 123 veces mayor que la global del pais. Su busqueda activa demostro enfermedad paucibacilar, sin discapacidades y otras enfermedades cutaneas importantes. Es recomendable persistir con este examen clinico y con la investigacion de los factores predisponentes para adquirir la enfermedad.OBJECTIVE Actively searching for leprosy, other skin diseases and BCG vaccination scars amongst school children from Agua de Dios, the municipality having the highest prevalence of leprosy in Colombia. METHODS A clinical examination of the children was carried out by nurses, interns, general practitioners and experts on leprosy. Skin smear tests and skin biopsies were performed when the clinical findings suggested leprosy. Anti-phenolic glycolipid antibodies in blood were determined in special cases. RESULTS 86 % of the 2 844 school children were examined; 833 had skin diseases and 16 % of these required evaluation by specialists. Four new cases of paucibacillary leprosy, two indeterminate and two primary polyneuritic cases were found. Pediculosis capitis, pityriasis alba, tinea versicolor, hypopigmented nevus, insect bites and miliaria were frequently detected. BCG vaccination scars were absent in 387 children; following several logistical problems, they were vaccinated. Four children had signs of childhood abuse. An 11-year-old girl presented hypopigmented mycosis fungoides. All diseases and conditions found were treated. The community received information regarding the results, emphasising the importance of an early diagnosis of leprosy. CONCLUSIONS The incidence of leprosy found (16/10,000) was 123 times higher than the rest of the countrys incidence. It is advisable to continue clinical examinations in Agua de Dios and research into risk factors for acquiring leprosy.

Búsqueda activa de Lepra y de otras enfermedades de la piel en escolares de Agua de Dios, Colombia

Objetivo Buscar lepra, otras enfermedades de la piel y la cicatriz BCG, en escolares de Agua de Dios, municipio con la mas alta prevalencia de lepra en Colombia: 23-39/10 000; educar y difundir los resultados en la comunidad. Metodos Se hizo examen clinico de los ninos por enfermeras, medicos internos y generales y por expertos en lepra. Cuando la clinica lo indicaba, se practicaron baciloscopias y biopsias de piel. En pocos casos se buscaron anticuerpos en sangre contra el glicolipido fenolico 1, del bacilo de Hansen. Resultados Se examinaron 86 % de los 2 844 escolares de las 17 instituciones del municipio; 833 tuvieron patologias cutaneas, de los cuales 16 % requirieron el examen por expertos. Se demostraron cuatro casos nuevos de lepra paucibacilar, dos indeterminados y dos polineuriticos primarios. Las entidades mas frecuentes fueron: pediculosis, pitiriasis alba, pitiriasis versicolor, nevus hipocromicos, picaduras de insectos y miliaria. Cuatro ninos tuvieron maltrato infantil y una nina de 11 anos, micosis fungoides hipocromiante. La vacunacion BCG se aplico en 387 ninos que no la habian recibido. Se trataron las condiciones encontradas. Se informo a la comunidad sobre las enfermedades detectadas, las funciones de la piel y sus cuidados generales, enfatizando la importancia del diagnostico temprano de la lepra. Conclusiones La incidencia de lepra encontrada (16/10 000), es la mas alta en Colombia, 123 veces mayor que la global del pais. Su busqueda activa demostro enfermedad paucibacilar, sin discapacidades y otras enfermedades cutaneas importantes. Es recomendable persistir con este examen clinico y con la investigacion de los factores predisponentes para adquirir la enfermedad.OBJECTIVE Actively searching for leprosy, other skin diseases and BCG vaccination scars amongst school children from Agua de Dios, the municipality having the highest prevalence of leprosy in Colombia. METHODS A clinical examination of the children was carried out by nurses, interns, general practitioners and experts on leprosy. Skin smear tests and skin biopsies were performed when the clinical findings suggested leprosy. Anti-phenolic glycolipid antibodies in blood were determined in special cases. RESULTS 86 % of the 2 844 school children were examined; 833 had skin diseases and 16 % of these required evaluation by specialists. Four new cases of paucibacillary leprosy, two indeterminate and two primary polyneuritic cases were found. Pediculosis capitis, pityriasis alba, tinea versicolor, hypopigmented nevus, insect bites and miliaria were frequently detected. BCG vaccination scars were absent in 387 children; following several logistical problems, they were vaccinated. Four children had signs of childhood abuse. An 11-year-old girl presented hypopigmented mycosis fungoides. All diseases and conditions found were treated. The community received information regarding the results, emphasising the importance of an early diagnosis of leprosy. CONCLUSIONS The incidence of leprosy found (16/10,000) was 123 times higher than the rest of the countrys incidence. It is advisable to continue clinical examinations in Agua de Dios and research into risk factors for acquiring leprosy.