Historic aspects of human susceptibility to leprosy and the risk of conjugal transmission

Joyce, Mary

doi:10.1590/s0074-02762012000900004

Cited by 23 publications

(25 citation statements)

References 4 publications

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“…Leprosy detection in two symptomatic HHCs of the same family whose index case was an MB patient confirms the transmission of leprosy between family members, which has been considered a main mode for the propagation of the infection in BI positive patients without treatment [ 33 ]. The index case corresponds to the father and the HHC to the son.…”

Section: Discussionmentioning

confidence: 99%

Evaluation and Monitoring of Mycobacterium leprae Transmission in Household Contacts of Patients with Hansen's Disease in Colombia

2017

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Leprosy in Colombia is in a stage of post elimination—since 1997, prevalence of the disease is less than 1/10000. However, the incidence of leprosy has remained stable, with 400–500 new cases reported annually, with MB leprosy representing 70% of these case and 10% having grade 2 disability. Thus, leprosy transmission is still occurring, and household contacts (HHCs) of leprosy patients are a population at high risk of contracting and suffering from the effects of the disease during their lifetime. We performed a cross-sectional study with the aim of evaluating leprosy transmission within Family Groups (FGs) from four Colombian departments: Antioquia, Bolívar, Córdoba and Sucre. This study included 159 FGs formed by 543 HHCs; 45 FGs were monitored twice, first in 2003 and again in 2012. Migration, forced displacement by violence, loss of contact with the health center and the lack of an agreement to participate in the second monitoring were the primary reasons not all FGs were tested a second time. In each HHC, a clinical examination was performed, epidemiological data recorded, the bacillary index determined, DNA was isolated for M. leprae detection by nested PCR and IgM anti-phenolic glycolipid-I (PGL-I) titers were inspected. Further, DNA from M. leprae isolates were typed and compared among FGs. Twenty-two (4.1%) of the 543 HHCs had IgM anti-PGL-I positive antibody titers, indicating infection. Nasal swabs (NS) taken from 113 HHCs were tested by RLEP PCR; 18 (16%) were positive for M. leprae DNA and two new leprosy cases were detected among the HHCs. Of the confirmed HHCs with leprosy, it was possible to genotype the bacterial strains from both the index case and their HHCs. We found that the genotype of these two strains agreed at 9 markers, showing the individuals to be infected by the same strain, indicating familiar transmission. HHCs of leprosy patients not only are a high-risk population for M. leprae infection, they can act as M. leprae carriers and therefore serve as sources for transmission and infection. Our results confirm familiar leprosy transmission and suggest that follow-up of HHCs is a good strategy for early diagnosis of leprosy and to monitor its transmission.

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Section: Discussionmentioning

confidence: 99%

Evaluation and Monitoring of Mycobacterium leprae Transmission in Household Contacts of Patients with Hansen's Disease in Colombia

2017

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“…The main location for the spread of infection is in the family setting where contact is constant. In eventual contact with untreated patients, only 2-5% will become ill [2]. …”

Section: Introductionmentioning

confidence: 99%

Leprosy treatment dropout: a sistematic review

Girão¹,

Soares²,

Pinheiro³

et al. 2013

Int Arch Med

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BackgroundLeprosy is a chronic infectious disease endemic in some undeveloped areas, and still represents a public health problem in Brazil. Therefore, the control of this endemic disease depends necessarily on the institution of correct treatment and containment of treatment dropout. This study aims to conduct a systematic review of published studies on treatment dropout of leprosy.MethodsWe conducted a systematic review of articles on treatment dropout of leprosy, published between january 2005 and april 2013, on MEDLINE and SciELO databases. The search was performed using the MeSH terms: “leprosy”; “patients dropouts” and the keywords: “leprosy, treatment” and “noncompliance, leprosy” in association, beside the equivalents in Portuguese.ResultsThere were originally 196 references. After analyzing the titles and abstracts of articles, 20 articles were obtained and included in the final sample.DiscussionLeprosy is a notifiable disease known as its disfiguring capability and the high rate of non-compliance to treatment. The low adhesion is responsible for the remaining potential sources of infection, irreversible complications, incomplete cure and, additionally, may lead to resistance to multiple drugs. Many factors are responsible for the interruption or dropout treatment: socioeconomic factors, education level, knowledge about the disease, lack of efficiency of health services, demographics, side effects of drugs, alcoholism, among others.ConclusionThe recent scientific literature about the subject diverge regarding the factors that most affect the dropout problem in treating leprosy patients. However, better integration between professionals and users, and greater commitment of the patient, are common points among the authors of the studies.

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“…Although, household contacts of multibacillary (MB) cases have an increased risk of developing leprosy compared to the general population, infection acquired outside the household and subclinical infection is being recognized as an potential route of transmission, sustaining the high new detection rate of leprosy [ 10 – 13 ]; 90–95 % of spouses to infective leprosy patients did not acquire the infection in the pre-antibiotic era. Children of leprosy patients have an increased risk of acquiring the infection compared to the spouse, indicating that genetic similarity to the infected parent makes one more susceptible to the infection [ 14 ]. Even though some studies have shown an association between susceptibility to leprosy and certain genes/chromosomal regions, more studies are needed to fully understand the genetics of susceptibility to leprosy [ 15 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

Leprosy in Denmark 1980–2010: a review of 15 cases

2016

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BackgroundLeprosy, caused by Mycobacterium leprae, is a chronic and progressive granulomatous disease affecting mainly the skin and the peripheral nervous system. If left unrecognized, the infection can lead to permanent nerve damage and disability. The clinical presentation depends on the immune response of the patient and can result in a wide spectrum of symptoms. Leprosy is a rare encounter in Scandinavia but remains endemic in some parts of the world, with some areas reporting an increasing incidence. We performed a retrospective record review of leprosy cases in Denmark from 1980 to 2010 with the purpose of presenting the most common geographical, demographic and clinical findings and to discuss the diagnostic and therapeutic challenges of patients with leprosy.Case presentationIn total 15 cases were reviewed. The majority (87 %) of leprosy patients in Denmark were born in South- and Southeast Asia, and were presumed to have contracted the infection in their countries of origin. Patients were predominately young males (mean age: 28.6 years). Anaesthetic skin lesion with or without nerve enlargement were the most common clinical presentations (73 %). Immunological leprosy reactions were seen in 40 % of the cases. Diagnoses were based on clinical findings and skin biopsies. Treatment length varied but all patients received multidrug regimens.ConclusionLeprosy should be kept in mind when encountering patients with suspicious skin lesions originating from leprosy endemic areas or with history of travel or work in the tropics. Due to the long incubation period with symptoms presenting long after immigration or return, clinicians often do not have the diagnosis in mind. The wide spectrum of symptoms and immunological reactions further complicates the diagnostic process. Treatment of leprosy and the complicated immunological reactions, which frequently accompanies the infection, should be performed in collaboration with a specialist.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1768-6) contains supplementary material, which is available to authorized users.

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Historic aspects of human susceptibility to leprosy and the risk of conjugal transmission

Cited by 23 publications

References 4 publications

Evaluation and Monitoring of Mycobacterium leprae Transmission in Household Contacts of Patients with Hansen's Disease in Colombia

Evaluation and Monitoring of Mycobacterium leprae Transmission in Household Contacts of Patients with Hansen's Disease in Colombia

Leprosy treatment dropout: a sistematic review

Leprosy in Denmark 1980–2010: a review of 15 cases

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