Article
Twenty-five years after the development and adaptation of Semmes-Weinstein Monofilament Testing Kits in Brazil
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Authors
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Linda Lehman
- American Leprosy Missions, Belo Horizonte, Brazil
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Maria Beatriz Orsini
- Betim Municipal Health Service, Belo Horizonte, Brazil
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Anthony Nicholl
- SORRI-Bauru, Bauru, Brazil
| Published: | February 6, 2020 |
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Outline
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Clinical issue/s: In 1993 the American Journal of Hand Therapy asked the authors to write an article about the development and adoption of using Semmes-Weinstein Monofilaments in Brazil. This presentation takes a look at what has happened with S-W monofilament testing in Brazil Hansen's disease(HD) program over the last 25 years where there continues to be over 30,000 new cases diagnosed yearly.
Clinical reasoning: Early disease detection in addition to identifying and treating early peripheral nerve impairments are important for preventing irreversible nerve impairments in HD. Immunological reactions cause nerve impairments and can happen before, during and after disease specific treatment in 30-60% of cases. If there is permanent nerve damage than self-care activities are taught to prevent secondary impairments and surgical options are evaluated.
Innovative, analytical or new approach: The presentation will describe the process of adoption of S-W monofilament testing within routine public health disease control activities in 27 states of Brazil and how this experiences may be applicable to other countries and public health programs.
Today, Brazil's national, state and local Hansen's disease control activities consider the use of S-W monofilaments as best practice for both primary and referral health services. National guidelines and protocols include the use of multiple monofilaments within clinical monitoring and evaluation activities. The availability of a portable, reliable kit of low cost is critical to the adoption of the S-W monofilaments test. In addition, training and supervision activities includes nerve function assessment practice, interpretation and discussion of appropriate actions when impairments are identified.
Contribution to advancing HT practice: This presentation aims to stimulate Hand Therapist in early detection and monitoring of peripheral nerve impairments within public health, clinical and surgical settings. Their involvement can influence and change behaviors needed to adopt new technology and procedures within public health settings.
