Early Detection of Leprosy in Children

Abstract

Healthy children contacts of leprosy patients had their humoral and cell-mediated immunological status assessed using the Fluorescent Leprosy Antibody Absorption Technique (FLA-ABS) and the Lepromin test, respectively. Subsequently, they were followed up for 2 1/2 years to study the development of overt disease. Two-hundred children were studied and classified into four groups, viz. Group I comprised of children who were FLA-ABS positive and Lepromin positive; Group II = FLA-ABS positive and Lepromin negative; Group III = FLA-ABS negative and Lepromin positive; Group IV = FLA-ABS negative and Lepromin negative. The good cell-mediated immune (CMI) response in the 107 children in Group I prevented them from developing the disease though they had been infected. Out of the 37 children in Group II, 15 developed the disease. There were no children in Group III. None of the 56 children in Group IV developed the disease, possibly because they had not been significantly infected. All these findings were statistically significant (P less than 0.01). This study highlights the protective role of cell-mediated immunity in leprosy. It also suggests the need to carry out surveillance surveys in the endemic population to identify and follow up those at risk.

Impact of PGL-I Seropositivity on the Protective Effect of BCG Vaccination among Leprosy Contacts: A Cohort Study

“…Although the highest leprosy rates were expected among contacts aged 15–35 years, i.e., in the age group with the highest seropositivity, this group of contacts had the lowest incidence rate of leprosy after BCG vaccination. Regardless of their anti-PGL-I serological status, children are more susceptible than adults to acquiring leprosy infection and developing overt leprosy due to their incompletely developed immune systems and close and prolonged contact with possible intra-family sources of infection [34], [35]. Additionally, because BCG vaccination induces IFN-γ production [27], the strong immune response in young adults will control subclinical infection if present.…”