Misdiagnosis of leprosy in Brazil in the period 2003 - 2017: spatial pattern and associated factors

Neves, Karine Vila Real Nunes; Nobre, Maurício Lisboa; Machado, Lúbia Maieles Gomes; Steinmann, Peter; Ignotti, Eliane

doi:10.1016/j.actatropica.2020.105791

Cited by 20 publications

(23 citation statements)

References 18 publications

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“…Los hombres son diagnosticados con lepra MB con el doble de frecuencia que las mujeres en diferentes partes del mundo. Por otro lado, las mujeres y los niños tienen más probabilidades de presentar tipos de lepra PB localizada, con lesiones más discretas, lo que puede explicar las mayores posibilidades de diagnóstico erróneo para estos grupos poblacionales ( 31 ).…”

Section: Discussionunclassified

Comportamiento epidemiológico de la lepra en varios países de América Latina, 2011-2020

Durán

2022

Revista Panamericana De Salud Pública

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Objetivo. Describir el comportamiento epidemiológico de la lepra en varios países latinoamericanos durante 2011-2020, tomando como base los indicadores de la Organización Mundial de la Salud (OMS). Método. Estudio transversal, descriptivo y cuantitativo con datos oficiales sobre incidencia y prevalencia en la población en general, niños, forma clínica y casos de discapacidad de grado 2 registrados por la OMS entre 2011 y 2020. Se seleccionaron los ocho países latinoamericanos con más casos y se realizaron análisis de estadística descriptiva simple y comparativa entre las variables. Resultados. Entre 2011-2020 se reportaron 301 312 casos de lepra en los países seleccionados: Argentina, Brasil, Colombia, Cuba, México, Paraguay, República Dominicana y Venezuela. Brasil fue el único con una prevalencia mayor a 1 por 10 000 habitantes y representó 93,77% de casos. En Brasil y República Dominicana se observó un aumento de la prevalencia durante 2011-2019, mientras que en los demás países esta tendió a disminuir. La enfermedad fue más frecuente en hombres, y los casos multibacilares superaron significativamente a los paucibacilares. En Brasil se encontraron las mayores incidencias de casos de lepra infantil y discapacidad de grado 2 durante el período evaluado. Conclusión. A pesar de que en América Latina la lepra solo es considerada un problema de salud pública en Brasil, la mayoría de los países de la región continúa reportando casos cada año, lo que revela una falta de atención médica adecuada. El estudio confirmó la importancia de la vigilancia activa, el diagnóstico temprano y la planificación de acciones contra la enfermedad en todos los países evaluados, con el propósito de disminuir o detener su transmisión.

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Section: Discussionunclassified

Comportamiento epidemiológico de la lepra en varios países de América Latina, 2011-2020

Durán

2022

Revista Panamericana De Salud Pública

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“…When observing the epidemiological characteristics of patients with chromoblastomycosis- leprosy co-infection, we can find common aspects present in both co-infection and in the two diseases separately: male predominance, all age groups are affected, occupation and origin mainly related to the rural area, poverty, living conditions, inequity, difficulty in accessing public health services. Factors that are present in different countries in tropical and subtropical regions where these diseases are endemic [1,4,5,13,[17][18][19][20][21][22][23]. There is no predisposing relationship from one disease to another, except for prolonged treatment with corticosteroids in leprosy reactions or other complications of this disease, which can cause immunosuppression and predispose patients to other infectious diseases such as chromoblastomycosis, as described in the various cases published.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Chromoblastomycosis and leprosy are highly prevalent diseases in tropical and subtropical regions. Brazil, China, Madagascar, Mexico, and Venezuela are the countries mainly affected by chromoblastomycosis, while leprosy is predominantly reported from Brazil, India and Indonesia [1][2][3][4][5][6][7]. Both diseases are characterized by social, cultural, economic, lifestyle, poverty and inequality factors, in addition to the host its genetic susceptibility to develop leprosy [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Chromoblastomycosis-Leprosy Co-Infection in Central West Brazil. Presentation of Three Cases and Literature Review

et al. 2022

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Chromoblastomycosis and leprosy are chronic diseases with high prevalence in tropical and subtropical regions. Brazil is one of the countries with the highest incidence and prevalence for both diseases, however, reports of co-infections are scarce. The aim of this study was to describe three cases of chromoblastomycosis-leprosy co-infection in patients from Mato Grosso state, Brazil. A review of chromoblastomycosis-leprosy co-infection was performed of English, Portuguese and Spanish publications in LILACS, SciELO, PubMed and Web of Science databases using the descriptors (chromoblastomycosis OR cromoblastomicose OR cromoblastomicosis) AND (leprosy OR hanseníase OR lepra), without time period delimitation. Nineteen cases were included, 16 cases were published in 11 articles, plus the three cases reported in the current study. Most reported coninfection cases came from Brazil. Majority of the patients were male with a mean age of 52.2 years. Farmer was the main occupational activity reported. In 12 patients, the clinical signs and symptoms of leprosy started first. No contacts with patients affected by leprosy, armadillos or history of injuries at the anatomical site of chromoblastomycosis lesions were reported. Five leprosy patients who received steroid treatment for leprosy reactions or neuropathies, were diagnosed with chromoblastomycosis during immunosuppressive therapy. Four cases (21.1%) were reported among the elderly patients. Co-infections in patients with chromoblastomycosis or leprosy are uncommon, but the possibility should always be considered, especially if the patient is undergoing immunosuppressive treatment or is elder.

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“…In areas with underdeveloped medical facilities, delayed diagnosis and incorrect treatments can cause substantial medical expenses and waste of medical resources. Consequently, delayed treatment of leprosy-related nerve damage may lead to permanent limb deformities, dysfunction, or even death [ 10 ]. This paper introduces and summarises the diagnosis and treatment process of leprosy misdiagnosed as erythema multiforme for a long time and provides new insight for the clinical diagnosis of leprosy.…”

Section: Introductionmentioning

confidence: 99%

Next-generation sequencing-assisted diagnosis of a case of leprosy misdiagnosed as erythema multiforme

Zhang

Lei

2022

Ann Clin Microbiol Antimicrob

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Background Leprosy is a chronic infectious disease caused by Mycobacterium leprae or Mycobacterium lepromatosis that is mainly transmitted through droplets from the nose and mouth of untreated patients. Owing to the lack of specific serological markers and clinical manifestations, leprosy can be easily confused with other skin lesion-related diseases and is difficult to distinguish. Case presentation This study introduces and summarises the diagnosis and treatment process of a case of leprosy misdiagnosed as erythema multiforme for a long time. A 43-year-old female was admitted to our hospital because of “repeated fever with superficial lymphadenopathy and systemic rash in May”. The diagnosis of the patient was based on the two main clinical characteristics of superficial lymphadenopathy and systemic pleomorphic erythema by using a combination of multiple samples of lymph nodes and skin, routine pathological examination, immunohistochemistry, acid-fast, silver hexamine, periodic acid-Schiff (PAS) staining, and second-generation gene sequencing of fresh biopsy tissue. The patient was treated with dapsone, rifampicin, and clofazimine at the Institute of Dermatology and Venereal Diseases. After treatment for 1 year, her temperature returned to normal, the area of facial erythema decreased, and the volume of axillary lymph nodes had gradually reduced. Conclusions In conclusion, special pathological staining and second-generation gene sequencing show promising advantages in distinguishing leprosy from other skin lesion-related diseases.

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Misdiagnosis of leprosy in Brazil in the period 2003 - 2017: spatial pattern and associated factors

Cited by 20 publications

References 18 publications

Comportamiento epidemiológico de la lepra en varios países de América Latina, 2011-2020

Comportamiento epidemiológico de la lepra en varios países de América Latina, 2011-2020

Chromoblastomycosis-Leprosy Co-Infection in Central West Brazil. Presentation of Three Cases and Literature Review

Next-generation sequencing-assisted diagnosis of a case of leprosy misdiagnosed as erythema multiforme

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