Hansen’s disease (HD) is an ancient disease, but more than 200,000 new cases were reported worldwide in 2019. Currently, there are not many satisfactory immunoassay methods for its diagnosis. We evaluated antibodies against Mce1A as a promising new serological biomarker. We collected plasma from new cases, contacts, and endemic controls in the city of Parnaíba and treated patients at Carpina, a former HD colony in Piauí state, northeastern Brazil. Receiver operating characteristic (ROC) curves were used to assess the assay thresholds, specificity and sensitivity of the IgA, IgM, and IgG antibodies against α-Mce1A by indirect ELISA and compared it with IgM anti-PGL-I and molecular diagnosis by quantitative polymerase chain reaction (qPCR). Venn diagrams were generated to represent the overlap in the antibody positivity pattern. Multivariate analysis was performed to assess the potential predictor of antibodies for the outcome of having an HD diagnosis. IgA and IgG were positive in 92.3 and 84% of patients, respectively. IgM was negative for all treated patients. IgG had a sensitivity and specificity of 94.7 and 100%, respectively. IgM-positive individuals had a 3.6 chance of being diagnosed with HD [OR = 3.6 (95% CI = 1.1–11.6);p= 0.028], while IgA-positive individuals had a 2.3 chance [OR = 2.3 (95% CI = 1.2–4.3);p= 0.005] compared to endemic controls. We found that the Mce1A antibody profile can be an excellent diagnostic method of HD. IgA is an ideal biomarker for confirming contact with the bacillus. IgM has potential in the detection of active disease. IgG antibodies confirm the performance of these serological markers in diagnosis and therapeutic follow-up.
Objetivo: analisar o perfil epidemiológico da hanseníase no estado do Piauí. Método: estudo epidemiológico transversal, com coleta retrospectiva. Utilizaram-se dados do Sistema de Informação de Agravos de Notificação, de pacientes com hanseníase, referentes ao período de 2005 a 2014. Foram avaliadas a taxa de detecção, grau de incapacidade física no diagnóstico e na cura e a proporção da cura. Resultados: totalizaram 13.787 casos de hanseníase, o coeficiente de detecção diminuiu ao longo dos anos, o grau de incapacidade física a ser avaliado no diagnóstico e na cura apresentou uma tendência de redução de avaliação, o percentual de cura foi regular (%?). Conclusão: a proporção de casos detectados com grau de incapacidade e o predomínio de formas passivas de detecção sugerem diagnóstico tardio e corroboram a importância da integração das ações de controle da hanseníase na atenção básica.
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