Background: East Java has become one of the provinces that have higher prevalence of leprosy, especially in the coastal region. Environment has also influenced for leprosy transmission and early detection could reduce the incidence rate of new leprosy cases. Epidemiological studies of leprosy in children can give an illustration of the important aspects of the environment. Presence of Mycobacterium leprae (M. leprae) DNA in nasal swabs and seropositivity level among them can describe M. leprae exposure in that area. Objective: Analyzing PCR from nasal swab and seropositivity level among elementary school children between northern coast and southern coast of East Java province. Methods: Five hundred and thirty children in Pacitan and Lamongan were involved. Both areas are representation of northern and southern coastal region in East Java Province. After clinical examination, nasal swab and blood samples were obtained. ELISA test was performed to measure the titer of IgM anti Phenolic Glicolipid-1 (PGL-1) antibody then continued by PCR to detect M. leprae DNA. Results: From 301 students in Pacitan, 25 students (8.3%) are sero-positives and 9 students (2.9%) are PCR positives. from 229 students in Lamongan, 110 (48,3%) students are sero-positives and 49 students (21.4%) are PCR positives. Both are analyzed by Chi-Square, and from the PCR and ELISA, it concluded that there are statistically significant differences between the two regions.
Leprosy still a health problem in Indonesia, where many leprosy pocket areas still persists, especially in the eastern part of the country. Although the program of WHO – Multidrug Therapy (MDT) regiment has been conducted elsewhere since 1980s, only the prevalence can be reduced but not the incidence of new leprosy cases. Theoretically after the source of leprosy (the infectious leprosy cases) has been treated, no more transmission of the disease and should be no more new leprosy cases will be found. To explain this phenomenon, the non-human resource of M.leprae became a new topic of debates, especially the existence of bacteria in the environment. A field study of the existence of M.leprae in the environment of leprosy endemic area had been conducted in a leprosy endemic area of the northern part of East Java. The aim of the study is to find any correlation of the existence of these bacteria in the environment with the presence of leprosy patients who live in that area, in order to study its role in the transmission of the disease. Ninety water samples from wells in the house of inhabitants who live in one endemic sub district were collected. The owner of the well was interviewed whether any leprosy patients who routinely use the water for their daily life activities. Water samples were examined by Polymerase Chain Reaction (PCR) method to detect M.leprae DNA, using the LpF-LpR and Lp3-Lp4 nested primers (99bp). The PCR results showed positive band for M.leprae in 22 out of 90 (24%) water samples. Water samples from wells that used by leprosy patients showed positive PCR in 11/48 (23%), while 11 out of 42 (26%) water samples from wells that never been used by leprosy cases showed positive result. Statistically there was no difference (p>0.05) in the positivity of M.leprae between the two groups. It was concluded that the existence of M.leprae in the daily water resource was not correlated with the present of leprosy cases in the area. Possible symbiosis between protozoan and mycobacterium in the environment were discussed.
SHORT COMMUNICATIONMultidrug therapy (MDT) regiment has been used for leprosy all over the world for more than 20 years. Drug resistances of Mycobacterium have been reported from many areas. The resistance mostly occurred due to mutation on the gene coding protein targeted by anti-leprosy drugs. Two hundreds and seventy M. isolates from some area in Indonesia were examined for studying the profile of mutation among isolates collected during 2003-2011. Drug resistance determining region of the folP1 gene and the rpoB gene was sequenced. The results showed 5 isolates of M. leprae harboured mutation only in the folP1 gene and another isolate harbored mutation in both the folP1 and rpoB gene. The point mutation in the folP1 gene that was found in 2 isolates occurred in codon 53 (ACC GCC; Thr Ala). Double point mutations on codon 53 that was found in two isolates were ACC AGA (Thr Arg) and ACC AGG (Thr Arg). The point mutation in the folP1 gene occurred in codon 55 were found in two isolates were CCC CTC (Pro Leu) and CCC CGC (Pro Arg). Whereas mutation in the rpoB gene in one isolate occurred in codon 410 was GAT TAT (Asp Tyr). These mutations that altered the amino acids of the protein revealed that isolates of M. leprae were resistant to drug with variable profiles.
In M. leprae infection, Rab5, Rab7, and Lep-LAM play important roles in the failure of phagolysosome process via a membrane trafficking pathway, while PGL-1 plays a role via blocking lysosomal activities. These inventions might be used for the development of an early diagnostic device in the future.
The existence of leprosy or kusta or Morbus Hansen or Hansen's disease has been known for years, including in Indonesia. Starting from the discovery of Mycobacterium leprae isolates from ancient bone (about 1.000 years B.C), the archaeological excavations results in East Nusa Tenggara, interesting questions arise about how the development of leprosy in eastern Indonesia is. Biology molecular study would become a powerful tool to investigate the presence of leprosy bacillary whether there are similarities between the genomes of M. leprae isolates in the primeval and the present. PCR examinations were performed on mandibular bone fragments from ancient human who lived 1000 years B.C. discovered in archaeological surveys on the island of Lembata and three leprosy patients from East Nusa Tenggara. The DNA extraction was performed using a kit from Qiagen products and its TTC repeating pattern was seen with the method of direct sequencing. It turned out that the TTC profile obtained from samples of archaeological was as many as 13 copies, while the repetition of TTC in three samples of leprosy patients were 15, 17 and 26 copies. The different number of TTC repetition shows the different isolates of M. leprae between in the ancient times and the present. Further studies are needed to verify the differences in the genome that occur, for example from the study of SNPs (single nucleotide polymorphisms).
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