麻风患者的逆转反应:印度尼西亚西爪哇一家三级转诊医院的患病率、社会形态特征和诱发因素研究

H. Gunawan, Risa Miliawati, Renasha Firda Hanannisa
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引用次数: 0

摘要

背景:迄今为止,麻风病仍然是最具污名化的疾病之一,具有严重的社会后果。麻风病患者可能会出现炎症反应,这种反应会中断稳定和慢性疾病,称为麻风病反应。1型麻风病反应,也称为逆转反应(RR),是由免疫反应引起的,免疫反应最初减少,然后“逆转”变得更加强烈,导致相当大的残疾。本研究的目的是确定麻风病患者逆转反应的患病率、社会人口学特征和诱发因素。方法:这是一项横断面设计的回顾性研究,采用的方法是从2015年1月至2019年12月西爪哇万隆皮肤性病科麻风诊所Hasan Sadikin综合医院的医疗记录中收集数据。结果:在214例麻风患者中,53例(24.7%)出现了逆转反应。有逆转反应的麻风病最常见的类型是边缘型麻风(BL)(56.5%)。大多数患者是男性(68%),年龄在25-44岁之间(47.2%),失业患者(35.8%),最后一次受教育是高中(71.7%)。身体压力被怀疑是逆转反应患者的最大诱因(50.9%)。结论:在印度尼西亚西爪哇的一家三级转诊医院,有逆转反应的麻风病患者的患病率为24.7%,具有基于社会人口学的各种特征。身体压力被怀疑是麻风病患者RR的最促发因素。逆转反应的早期诊断对于预防神经损伤和残疾非常重要。
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Reversal Reaction in Leprosy Patients: Study on Prevalence, Sociodemographic Characteristics, and Precipitating Factors at a Tertiary Referral Hospital in West Java, Indonesia
Background: Heretofore, leprosy remains one of the most stigmatizing diseases with serious social consequences. Patients with leprosy might develop inflammatory reactions that interrupt with stable and chronic disease which are called leprosy reactions. Type 1 leprosy reactions, also known as reversal reactions (RR), are caused by immune responses that initially decreases, then “reverses” to become more intense, leading to considerable disability. The aim of this study was to identify the prevalence, sociodemographic characteristics, and precipitating factors of reversal reaction in leprosy patients. Methods: This was a retrospective study with a cross-sectional design, with an approach to collecting data from the medical records of the Leprosy Clinic, Department of Dermatology and Venereology Dr. Hasan Sadikin General Hospital Bandung West Java, during January 2015–December 2019. Results: The results showed that 53 patients (24.7%) of the total 214 leprosy patients experienced a reversal reaction. The most frequent type of leprosy with reversal reaction was borderline lepromatous (BL) (56.5%). Most of the patients were male (68%), aged between 25–44 years (47.2%), unemployed patients (35.8%), and the last education was senior high school (71.7%). Physical stress was suspected as the most precipitating factor in reversal reaction patients (50.9%). Conclusions: The prevalence of leprosy patients with reversal reaction in a Tertiary Referral Hospital West Java, Indonesia is 24.7%, with various characteristics based on sociodemographic. Physical stress is suspected as the most precipitating factor of RR in leprosy patients. Early diagnosis of reversal reaction is important to prevent nerve damage and disability.
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