Introduction: The purpose of this study was to evaluate risk factors for physical disability at the moment of leprosy diagnosis. Methods: This is a retrospective, descriptive and exploratory investigation of 19,283 patients with leprosy, registered in the State of Minas Gerais, Brazil, between 2000 and 2005. Results: The risk of Grade 2 disability was 16.5-fold higher in patients with lepromatous leprosy, and 12.8-fold higher in patients presenting the borderline form, compared to patients presenting indeterminate leprosy. The occurrence of more than one thickened nerve increased the odds of a patient developing Grade 2 disability, 8.4-fold. Age <15 years, multibacillary leprosy and no formal education presented 7.0, 5.7 and 5.6 odds of developing physical disability, respectively. Conclusions: These factors should be considered as strong prognostic indicators in the development of physical disability at diagnosis.

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16. Schwartz D. Methodes statistiques a l'usage des m6decins et des biologistes.

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Serological tests can be helpful in classifying leprosy patients as having either the paucibacillary or the multibacillary form. The aim of this study was to evaluate the concordance between two serological assays, i.e. ML Flow and ELISA, in a population of leprosy patients in Brazil. The investigation involved 60 patients with newly diagnosed leprosy. Together with the application of the serological assays, selected demographic, clinical and epidemiological data relating to the study population were recorded. ML Flow detected anti-PGL1 antibodies in 70% of the leprosy patients, while ELISA was positive in 53.3%. The degree of concordance between the tests was substantial (83.3%). A positive correlation was demonstrated between the results obtained in the semi-quantitative ML Flow test and ELISA absorbance values. We concluded that both serological assays were found to be efficient in detecting anti-PGL1 antibodies. The ML Flow test may be a cheaper and easier to perform alternative to ELISA in leprosy patients.

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Background Leprosy in children under 15 years of age, and in particular, the presence of leprosy grade 2 disability (G2D) in children, signifies ongoing transmission and the need for improved surveillance. Our objective was to describe the epidemiology of pediatric leprosy in Minas Gerais, Brazil and to explore associations with access to medical facilities. Methods A cross-sectional study was conducted using data from the Brazilian Notifiable Diseases Surveillance System (SINAN) from 2002–2017. Incident cases were included if they resided in a municipality with both adult and pediatric cases. Municipalities were divided by the number of medical facilities per municipality: &lt; 5, 5–17, and 18 or higher. Analyses compared pediatric cases across two time periods (2002–2009 and 2010–2017) and number of medical facilities / municipality using chi-square, t-tests, and logistic regression. Results A total of 27,725 cases were reported with 1,611 under 15 years of age. Overall incidence declined from 34.8 per 100,000 to 13.6 per 100,000 during the study period with pediatric incidence declining from 2.6 per 100,000 to 0.8 per 100,000. Time period 2 (TP2) showed an increase in the proportion of pediatric G2D (2.58% vs 1.91%, p &lt; 0.0001) when compared to time period 1 (TP1). Mean age of diagnosis in children was younger in TP2 then in TP1 (10.06 vs 10.43, p=0.02). In 2017, the pediatric incidence in municipalities with the fewest medical facilities was 0.95 per 100,000 compared to 0.23 per 100,000 in municipalities with &gt; 5 facilities (p=0.009). There was significantly higher odds of disability at diagnosis (grades 1 and 2) in pediatric cases residing in municipalities with &lt; 5 medical facilities (aOR 1.88; 95% CI 1.37–2.59), adjusted for age and sex. See map (Fig 1). Figure 1. Cases of Pediatric Disability By Number of Municipality Medical Facilities from 2002–2017 (White areas without reported pediatric leprosy) Conclusion The increasing proportion of G2D in children in the second half of the study period despite declining incidence suggest occult infections among children and adults alike in Minas Gerais. Furthermore, the average age of diagnosis in children should increase, not decrease, if M. leprae transmission was truly declining. Lastly, the association between fewer municipality health facilities and increased disability suggest barriers to timely diagnosis and a critical area of focus for research into access to healthcare and leprosy risk. Disclosures All Authors: No reported disclosures