Diferenças clínicas e demográficas da hanseníase entre homens e mulheres em um ambulatório de referência no Nordeste brasileiro dos anos 2010 a 2019

Abstract

Introduction: Leprosy is a chronic infectious and contagious disease with a prolonged course, primarily affecting neural tissue and presenting dermato-neurological manifestations. When left untreated, it can lead to deformities and irreversible disabilities. Despite having established therapeutic protocols, it still poses a challenge to Brazilian public health today. Leprosy is understood as a socially determined disease because its pathological process is directly influenced by the individual's context. Consequently, gender and biological sex impact the exposure, susceptibility, and clinical aspects of the disease. Objective: To evaluate the clinical differences of leprosy between men and women treated at a outpatient clinic in a reference hospital in the Northeast region. Methods: This cross-sectional analytical observational study with a quantitative approach was conducted by analyzing data obtained from a leprosy outpatient clinic at a reference hospital in the state of Sergipe. Consecutive convenience sampling was used, and data were collected from 2010 to 2019 using a structured form. Data analysis was performed using GraphPad Prism 9 software, employing appropriate statistical tests for each type of data—categorical or quantitative—with statistical significance considered at p ≤ 0.05. This research is part of a larger project and received approval from the Research Ethics Committee of the Federal University of Sergipe under CAAE No. 31167014.4.0000.5546. Results and Discussion: In the analyzed sample, the sociodemographic profile of individuals affected by leprosy consisted of self-identified mixed-race individuals (pardos), residing in urban areas with poor sanitary conditions, low educational levels, and in the economically active age group. There was a slight numerical difference between sexes, with males being predominant in the study. This suggests greater exposure to the bacillus and a higher susceptibility to underdiagnosis among men due to social habits such as involvement in hunting and alcohol consumption. Additionally, men were more affected by multibacillary forms and were more vulnerable to sequelae from physical disabilities, suggesting the possible influence of hormones on these clinical outcomes. Furthermore, the analysis of serum testosterone levels in a subgroup of participants showed no association between the presentation of leprosy complications and steroid hormone levels. Conclusion: The study reinforces the socioeconomic characteristics of people affected by leprosy in Brazil and highlights the intrinsic relationship between this disease and social vulnerabilities. In evaluating the clinical differences of the infection between men and women, numerical disparities in cases, social habits, operational classification, and clinical outcomes were observed as divergent. This suggests that gender and biological sex are relevant determinants for guiding public policies in Primary Health Care and for a broader understanding of the disease.