Fatores associados à soropositividade do teste ML Flow em pacientes e contatos de pacientes com hanseníase menores de 18 anos

Abstract

This article presents the results of a cross-sectional study involving 115 newly-diagnosed leprosy patients and 1,011 household contacts, all under the age of 18. Seropositivity ratios and factors associated with a positive ML Flow were determined. The test was positive in 21.7% of patients and in 19.7% of contacts. Among patients, logistic regression indicated the association of seropositivity with positive slit skin smear and having more than five skin lesions. The tree method analysis indicated associations with skin smear, Madrid classification, number of nerves affected and age. In the contact group, index case classification, age and type of health service were associated with seropositivity in both analyses. The variables that best explained seropositivity are those associated with higher bacterial load. Therefore, the ML Flow test could be used in children to aid correct classification of patients for treatment and to identify contacts at greater risk of developing leprosy.

Uso do teste ML Flow em escolares diagnosticados com hanseníase no município de Paracatu, Minas Gerais

“…The seropositivity observed of 46.4% among the students diagnosed with leprosy in the study was lower than that observed by other authors 4 . However, in this study, the majority of patients were younger than 19 years-old and most presented the paucibacillary clinical forms, similar to the reports by other authors 7 .…”

“…Among the cases studied in Paracatu, 45.6% of the students presented one lesion, with two, three, four and more lesions observed in 32.3%, 1.4%, 5.8% and 5.8% of cases, respectively. While studying the behavior of the ML Flow test in the age group under 18 years-old, Ferreira 7 concluded that a correlation existed between seropositivity in the test with patients presenting positive bacilloscopy and with more than five skin lesions. However, any comparison with this study was impaired, since only one patient presented a positive bacilloscopy and another three had more than five skin lesions.…”

Leprosy: prevalence and factors associated with seropositivity for anti-NDO-LID antibodies in children under 15 years of age

“…Similar to our research, a study carried out in the state of Minas Gerais, Brazil, with minors under 18 years of age, found a higher anti-PGL-I positivity among female contacts. 22 Another study using PGL-I conducted among 6-18-year--old students and contacts of leprosy patients in an endemic region of the state of Pará found similar results in women. 23 However, both studies failed to find statistically significant results.…”

Sensibilidade do teste ELISA anti-PGL-1 com dois antígenos sintéticos derivados do PGL-1 do Mycobacterium leprae

“…Entretanto, o estudo de Chanteau et al 16 encontrou que o antígeno trissacarídeo é mais sensível para o diagnóstico da hanseníase PB, ao contrário deste estudo, que observou que o antígeno dissacarídeo é que se apresentou mais sensível ao diagnóstico da hanseníase PB. É importante ressaltar que o estudo em questão foi realizado em área de baixa endemicidade, a Polinésia Francesa, e tal fato sugere que o desempenho do antígeno trissacarídeo é melhor para o diagnóstico dos pacientes PB em virtude de não haver proporção significativa de indivíduos clinicamente sadios infectados com o M. leprae, os quais seriam positivos à sorologia, reduzindo, desta forma a sensibilidade dele, diferente das regiões hiperendêmicas 5,6,7,8,9,22,23,24,25 , pois, nessas regiões, a proporção de indivíduos clinicamente sadios infectados é normalmente alta 3,4,5,6,7,26 .…”

“…Neste estudo, observou-se que o antígeno trissacarídeo apresenta melhor desempenho na identificação de contatos de pacientes com hanseníase com maior risco de adoecimento por hanseníase comparado ao dissacarídeo, 22,41% e 8,62%, respectivamente (Tabela 2). A positividade geral entre contatos (CCOS + CNCOS) foi 16,51% (18/109), semelhante às taxas encontradas em outros estudos 22,23,24,25,26 .…”