High Frequency of M. leprae DNA Detection in Asymptomatic Household Contacts

Abstract

Background: Characterization of the Mycobacterium leprae genome has made possible the development of Polymerase Chain Reaction (PCR) systems that can amplify different genomic regions. Increased reliability and technical efficiency of quantitative PCR (qPCR) makes it a promising tool for early diagnosis of leprosy. Index cases that are multibacillary spread the bacillus silently, even before they are clinically diagnosed. Early detection and treatment could prevent transmission in endemic areas. Methods: In this study, the qPCR technique is used to detect DNA of M. leprae in samples of slit skin smears (SSS) of the ear lobe and blood of leprosy patients and their asymptomatic household contacts residing in Governador Valadares, MG, Brazil, a hyperendemic area for leprosy. A total of 164 subjects participated in the study: 43 index cases, 113 household contacts, and, as negative controls, 8 individuals who reported no contact with patients nor history of leprosy in the family. The qPCR was performed to amplify 16S rRNA fragments and was specifically designed for M. leprae. Results: Of asymptomatic household contacts, 23.89% showed bacillary DNA by qPCR in samples of SSS and blood. Also, 48.84% of patients diagnosed with leprosy were positive for qPCR while the bacillary load was positive in only 30.23% of patients. It is important to note that most patients were already receiving treatment when the collection of biological material for qPCR was performed. The level of bacillary DNA from household contacts was similar to the DNA levels detected in the group of paucibacillary patients. Conclusion: Considering that household contacts comprise a recognizable group of individuals with a high risk of disease, as they live in close proximity to a source of infection, qPCR can be used to estimate the risk of progress towards leprosy among household contacts and as a routine screening method for a chemoprophylactic protocol.

Leprosy: A Review of Epidemiology, Clinical Diagnosis, and Management

“…Quantitative polymerase chain reaction (qPCR) is at least 20 times more sensitive than microscopic detection and has become increasingly important for early diagnosis and difficult-to-diagnose cases [78]. e summary sensitivity of the qPCR test was 78.5% (95% CI 67.9-89.2), and the specificity was 89.3% (61.4-97.8) [78,79].…”

Desafios atuais para a erradicação hanseníase: do diagnóstico ao tratamento

“…O diagnóstico e tratamento precoce são pontos essenciais para diminuição do risco de desenvolvimento de incapacidades (Kumar, Girdhar, Girdhar, 2012). Assim a demora e o incorreto diagnóstico são pontos recorrente quando se trata de um desafio a ser superado, para evitar que isso ocorra, o desenvolvimento de testes rápidos e sensíveis que possam ser aplicados em configurações não especializadas e que permitam a identificação precoce da doença em estágios subclínicos tem sido alvo das pesquisas (Geluk et al, 2012, Gama et al, 2018.…”

High rate of Mycobacterium leprae infection and nasal colonization among household contacts of previously undiagnosed leprosy patients

“…Hence, qPCR can be used to estimate the risk of progress toward leprosy among HHCs. 18 The Ethiopian national leprosy control strategic interventions recommend tracing close contacts of newly diagnosed leprosy patients to promote early identification of leprosy, thus decreasing its severity, and reducing transmission. 19 However, the magnitude of leprosy from HHC tracing is not well studied in Ethiopia.…”