The Leprosy Control Program of Antioquia, (post-elimination leprosy state of Colombia), had registered by 1999, 56 lepromatous leprosy patients and their household contacts (HHC). Our interest was to detect Mycobacterium leprae infection in these HHC. Clinical examination, acid-fast bacillary staining (AFB) in nasal secretions, and slit skin samples, IgM anti-PGL-I in serum and negative. These results are an indication that the transmission of the infection is still happening in a region considered in the post elimination phase. The two new patients represent an infection source for others contacts, and groups 2 and 3 are infected HHC that could develop the disease in future. Follow up of high risk population is necessary to achieve real elimination of leprosy.Key words: post elimination leprosy region -household contact infection -Mycobacterium leprae -ColombiaThe total number of leprosy cases around the world is decreasing; at the beginning of 2003 the total of cases was 534,000 (WHO 2004). The principal factor contributing to this success worldwide has been the implementation of the standardized multiple drug therapy (MDT) regimen against the causative agent Mycobacterium leprae. Leprosy elimination campaigns for case detection in communities, training of physicians and leprosy field workers, and promotion of public awareness are additional key elements in this infectious disease control approach. Actually, WHO has a commitment to "the final push to reach elimination by 2005", a target originally set for 2000 (WHO 2003). However, the opinions of experts in clinical and research field range from optimistic to pessimistic concerning the reach of this target (Naafs 2000, Visschedijk et al. 2000, Lockwood 2002.The apprehension arises from the incomprehensible incidence rate that is still high in six countries (4.19 per 10,000), which represents 88% of the world's new cases detected in 2002, and the insufficiency of consistent in- formation on the core elements of this infectious disease, namely, what is the source, the reservoir and the mode of transmission, and the host factors related to immunity or disease (Reich 1987, Naafs et al. 2001. Additionally, while prevalence has been reduced, since MDT implementation, there has not been a compelling difference in the number of newly detected cases in the same period and population (incidence rates) before and after introduction of MDT (Feenstra 2003).The prevalence of leprosy in Colombia has decreased over the last 15 years. While in 1985, leprosy prevalence was 5,5/10,000, it is now reduced to 0,5/10,000 (www.minsalud.gov.co). The introduction of MDT in Colombia in 1985 has contributed to the decrease in disease burden. According to WHO, leprosy in Colombia is not a public health problem, and control of leprosy is in the "post-elimination phase" (Pinto 2000).Nevertheless, the reduction in prevalence is not a real reflection of the problem with respect to population distribution. For instance, Colombia has some regions where the actual prevalence is 1 to 3/10,000 a...
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