Social contact patterns and leprosy disease: a case-control study in Bangladesh

Feenstra, S.; Nahar, Quamrun; Pahan, David; Oskam, Linda; Richardus, Jan Hendrik

doi:10.1017/s0950268812000969

Cited by 24 publications

(27 citation statements)

References 17 publications

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“…Higher leprosy rates among household contacts of patients with multibacillary leprosy might be explained by the exposure to relatively higher bacillary load. 20,21 Similar to our findings, previous research has reported higher odds of leprosy detection among contacts who are older 5,22,23 and male. 2 In this study, we found lower leprosy detection among contacts with lower educational levels.…”

Section: Discussionsupporting

confidence: 91%

Incidence of and Factors Associated With Leprosy Among Household Contacts of Patients With Leprosy in Brazil

et al. 2020

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IMPORTANCE Despite progress toward reducing global incidence, leprosy control remains a challenge in low-and middle-income countries. OBJECTIVE To estimate new case detection rates of leprosy among household contacts of patients with previously diagnosed leprosy and to investigate its associated risk factors. DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study included families registered in the 100 Million Brazilian Cohort linked with nationwide registries of leprosy; data were collected from January 1, 2007, through December 31, 2014. Household contacts of patients with a previous diagnosis of leprosy from each household unit were followed up from the time of detection of the primary case to the time of detection of a subsequent case or until December 31, 2014. Data analysis was performed from May to December 2018. EXPOSURES Clinical characteristics of the primary case and sociodemographic factors of the household contact. MAIN OUTCOMES AND MEASURES Incidence of leprosy, estimated as the new case detection rate of leprosy per 100 000 household contacts at risk (person-years at risk). The association between occurrence of a subsequent leprosy case and the exposure risk factors was assessed using multilevel mixed-effects logistic regressions allowing for state-and household-specific random effects. RESULTS Among 42 725 household contacts (22 449 [52.5%] female; mean [SD] age, 22.4 [18.5] years) of 17 876 patients detected with leprosy, the new case detection rate of leprosy was 636.3 (95% CI, 594.4-681.1) per 100 000 person-years at risk overall and 521.9 (95% CI, 466.3-584.1) per 100 000 person-years at risk among children younger than 15 years. Household contacts of patients with multibacillary leprosy had higher odds of developing leprosy (adjusted odds ratio [OR] , 1.48; 95% CI, 1.17-1.88), and the odds increased among contacts aged 50 years or older (adjusted OR, 3.11; 95% CI, 2.03-4.76). Leprosy detection was negatively associated with illiterate or preschool educational level (adjusted OR, 0.59; 95% CI, 0.38-0.92). For children, the odds were increased among boys (adjusted OR, 1.70; 95% CI, 1.20-2.42). CONCLUSIONS AND RELEVANCE The findings in this Brazilian population-based cohort study suggest that the household contacts of patients with leprosy may have increased risk of leprosy, especially in households with existing multibacillary cases and older contacts. Public health interventions, such as contact screening, that specifically target this population appear to be needed.

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Section: Discussionsupporting

confidence: 91%

Incidence of and Factors Associated With Leprosy Among Household Contacts of Patients With Leprosy in Brazil

et al. 2020

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“…It has been shown that, in addition to household contacts, people living in the vicinity of a leprosy case and their social contacts have a higher risk of infection [18], [26], [37]. In fact, because M. leprae is highly infective but has a low pathogenicity, most people who harbor a subclinical infection will never develop clinical signs and symptoms of leprosy; indeed, only about 10% of all infected individuals eventually develop leprosy symptoms [38].…”

Section: Discussionmentioning

confidence: 99%

“…The importance of performing periodic surveillance among household contacts and including different classes of social and neighboring contacts has been highlighted by several authors [33], [37], [48]. Bakker and colleagues [18] observed increased subclinical infection for contact groups living ≤75 meters of anti-PGL-I-positive leprosy patients.…”

Section: Discussionmentioning

confidence: 99%

Spatial Analysis Spotlighting Early Childhood Leprosy Transmission in a Hyperendemic Municipality of the Brazilian Amazon Region

Barreto

Bisanzio

Guimarães³

et al. 2014

PLoS Negl Trop Dis

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BackgroundMore than 200,000 new cases of leprosy were reported by 105 countries in 2011. The disease is a public health problem in Brazil, particularly within high-burden pockets in the Amazon region where leprosy is hyperendemic among children.MethodologyWe applied geographic information systems and spatial analysis to determine the spatio-temporal pattern of leprosy cases in a hyperendemic municipality of the Brazilian Amazon region (Castanhal). Moreover, we performed active surveillance to collect clinical, epidemiological and serological data of the household contacts of people affected by leprosy and school children in the general population. The occurrence of subclinical infection and overt disease among the evaluated individuals was correlated with the spatio-temporal pattern of leprosy.Principal FindingsThe pattern of leprosy cases showed significant spatio-temporal heterogeneity (p<0.01). Considering 499 mapped cases, we found spatial clusters of high and low detection rates and spatial autocorrelation of individual cases at fine spatio-temporal scales. The relative risk of contracting leprosy in one specific cluster with a high detection rate is almost four times the risk in the areas of low detection rate (RR = 3.86; 95% CI = 2.26–6.59; p<0.0001). Eight new cases were detected among 302 evaluated household contacts: two living in areas of clusters of high detection rate and six in hyperendemic census tracts. Of 188 examined students, 134 (71.3%) lived in hyperendemic areas, 120 (63.8%) were dwelling less than 100 meters of at least one reported leprosy case, 125 (66.5%) showed immunological evidence (positive anti-PGL-I IgM titer) of subclinical infection, and 9 (4.8%) were diagnosed with leprosy (8 within 200 meters of a case living in the same area).Conclusions/SignificanceSpatial analysis provided a better understanding of the high rate of early childhood leprosy transmission in this region. These findings can be applied to guide leprosy control programs to target intervention to high risk areas.

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“…The study conducted in Gujarat India stated that out of 250 respondents of lepers, 8.30% of them had a contact history of family and environment (Thakkar & Patel, 2014). Research conducted by Feenstra, Nahar, Pahan, Oskam, & Richardus (2013) showed that household contact has an influence with clinical leprosy with an OR value of 1.09. Contacts in the nearest environment are also associated with clinical leprosy with an OR value of 1.07.…”

Section: Influence Of Risk Factors On New Leprosy Casesmentioning

confidence: 99%

“…The possibility of transmission of the disease still exists even though the leper has received treatment. Leprosy is associated with close family contact and contact with leprosy in the social environment, which identifies contact exposure as the main determinant of leprosy transmission (Feenstra, Nahar, Pahan, Oskam, & Richardus, 2013). The possibility of transmission through the respiratory tract is increasing where the respiratory tract is one of the portals of exit Mycobacterium leprae.…”

Section: Influence Of Risk Factors On New Leprosy Casesmentioning

confidence: 99%

The Effect of Contact History and Immunization Status on the New Case of Leprosy

Nurzila

Adriyani

2019

JBE

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Background: The highest new case of leprosy in Indonesia was occupied by East Java Province for four consecutive years, with the number of new leprosy patients as many as 3880 in 2017. Purpose: This study aims to determine the characteristics of individual factors and risks factor for new leprosy cases. Methods: This research is observational analytic research with case control research design. The population of the case is new lepers that were diagnosed since January-September 2018. Meanwhile, the control population is skin poli patients who have not been diagnosed with leprosy and tuberculosis. Sampling technique used was simple random sampling. Variables studied were individual characteristics (age, gender, income) and individual risk factors including immunization status, contact history and population status. Results: Majority of the (57.90%) case respondents never received BCG immunization. 78.90% of the respondents case had history of contact with lepers before. 89.50% of respondents in cases and controls were permanent residents in Mojokerto Regency. Results of analysis of immunization status and contact history has significant influence to the new leprosy case. Status of not having BCG immunization (OR= 5.16; 95% CI= 1.23 <OR <21.55), p= 0.04) and history of having contact with lepers (OR= 6.43; 95% CI= 1, 52 <OR <27.24), p= 0.02) significantly affected new cases leprosy. Conclusion: There is an influence between non-immunization status and history of contact with new leprosy cases. It is important to carry out early detection of individuals in contact with lepers, especially household contacts and recommendations for repeated BCG vaccination

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Social contact patterns and leprosy disease: a case-control study in Bangladesh

Cited by 24 publications

References 17 publications

Incidence of and Factors Associated With Leprosy Among Household Contacts of Patients With Leprosy in Brazil

Incidence of and Factors Associated With Leprosy Among Household Contacts of Patients With Leprosy in Brazil

Spatial Analysis Spotlighting Early Childhood Leprosy Transmission in a Hyperendemic Municipality of the Brazilian Amazon Region

The Effect of Contact History and Immunization Status on the New Case of Leprosy

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