Avaliação do seguimento terapêutico de pacientes acometidos por leishmaniose tegumentar atendidos pela atenção básica: implicações e propostas para o aperfeiçoamento

Abstract

Cutaneous Leishmaniasis (CL) is a neglected infectious disease and a public health problem in Barra do Garças - MT. In the New World, the etiological agent of CL, from the genus Leishmania, is transmitted by insects of the genera Brumptomyia, Warileva and Lutzomyia. The clinical forms of CL affect the skin and mucous membranes and may produce deformities. The pharmacological treatment of CL often results in the emergence of side effects, which may favor the interruption of treatment, causing recurrence or continuity of the disease. In view of the above, the objective of this study was to evaluate the epidemiological and therapeutic profile during the treatment of patients with CL, treated at Basic Health Units in the municipality of Barra do Garças, from 2015 to 2020. This is a descriptive, longitudinal and retrospective type of study, where epidemiological aspects were evaluated in notification forms and in medical records, with emphasis on clinical assessments and exams. A higher frequency of CL was observed in male patients (72.8%) and mixed race (57.1%). The predominant clinical form was cutaneous, in patients under 50 years of age (58.2%) and mucosal, in patients over 50 years of age (66.7%). Hypertension (52.2%) and diabetes (20.7%) were the most prevalent comorbidities in patients with CL. Regarding clinical management, it was observed that the request for exams during treatment for cardiological, renal and hepatic evaluation was not required, or recorded, in most cases (ranging between 77% and 91% of patients), making it impossible to identify the clinical parameters that can guide the therapeutic response during treatment and possible adverse effects caused by the use of drugs. By the results of this study, we prepared a technical sheet to disseminate information to civil society about CL, as well as a draft of a clinical protocol and therapeutic follow-up as a way to promote the treatment and management of CL in the municipality of Barra do Garças. The results of this study demonstrate that the need to organize and implement surveillance actions and the improvement of patient care should be a reason for reflection within managers. We hope to contribute to public health policies, as well as local management, in order to contribute to the confrontation of CL in Barra do Garças -MT.