Prevalence of Mycobacterium leprae in armadillos in Brazil:A systematic review and meta-analysis

Submitted by Claudete Fernandes ([email protected]) on 2020-05-16T22:26:34Z No. of bitstreams: 1 Deps_Patrícia_etal_IOC_2020.pdf: 1467527 bytes, checksum: ef8f62d4fc63c82ab7fd67dd605c87b1 (MD5)Approved for entry into archive by Claudete Fernandes ([email protected]) on 2020-05-16T22:37:58Z (GMT) No. of bitstreams: 1 Deps_Patrícia_etal_IOC_2020.pdf: 1467527 bytes, checksum: ef8f62d4fc63c82ab7fd67dd605c87b1 (MD5)Made available in DSpace on 2020-05-16T22:37:58Z (GMT). No. of bitstreams: 1 Deps_Patrícia_etal_IOC_2020.pdf: 1467527 bytes, checksum: ef8f62d4fc63c82ab7fd67dd605c87b1 (MD5) Previous issue date: 2020Universidade Federal do Espírito Santo. Departamento de Medicina Social. Vitória, ES, Brasil / Universidade Federal do Espírito Santo. Postgraduate Programme in Infectious Diseases. Vitória, ES, Brasil.Universidade Federal Rural do Semi-Árido. Hospital Veterinário Jerônimo Dix-Huit Rosado Maia. Mossoró, RN, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biologia Molecular Aplicada a Micobactérias. Rio de Janeiro, RJ, Brasil.National Infection Service. Public Health England. London, United Kingdom.Understanding the prevalence of M. leprae infection in armadillos is important because of evidence from Brazil and other countries of an association between contact with armadillos and the development of Hansen’s Disease (leprosy). Our aim was to characterize studies which have investigated natural M. leprae infection in wild armadillos in Brazil, and to quantify and explore variability in the reported prevalence of infection. We conducted a systematic review (PROSPERO CRD42019155277) of publications in MEDLINE, EMBASE, Global Health, Scopus, LILACS, Biblioteca Digital Brasileira de Teses e Dissertações, Catálogo de Teses e Dissertações de CAPES, and Biblioteca Virtual em Saúde up to 10/2019 using Mesh and text search terms (in English, Portuguese, Spanish, and French). The 10 included studies represented a total sample of 302 armadillos comprising 207 (69%) Dasypus novemcinctus, 67 (22%) Euphractus sexcinctus, 16 (5%) Priodontes maximus, 10 (3%) Cabassous unicinctus, and 2 (1%) Cabassous tatouay from 7 different states. Methods used included histopathology (4 studies), PGL-1 and LID-1 antigen detection (4 studies) and examination for clinical signs of disease (4 studies). Eight studies used PCR of which 7 targeted the RLEP repetitive element and 3 tested for inhibitory substances. M. leprae prevalence by PCR ranged from 0% (in 3 studies) to 100% in one study, with a summary estimate of 9.4% (95% CI 0.4% to 73.1%) and a predictive interval of 0–100%. The average prevalence is equivalent to 1 in 10 armadillos in Brazil being infected with M. leprae, but wide variation in sample estimates means that the prevalence in any similar study would be entirely unpredictable. We propose instead that future studies aim to investigate transmission and persistence of M. leprae within and between armadillo populations, meanwhile adopting the precautionary principle to protect human health and an endangered species in Brazil

Detecção de infecção pelo Mycobacterium leprae em tatus selvagens da espécie Dasypus novemcinctus utilizando o teste rápido ML Flow

Mycobaterium leprae infection was investigated in armadillos from the State of Espírito Santo, Brazil. The ML Flow test was performed on 37 nine-banded armadillos and positive results were found in 11 (29.7%). The ML Flow test may be used to identify possible sources of Mycobaterium leprae among wild armadillos.Tem sido pesquisado infecção pelo Mycobaterium leprae em tatus provenientes do estado do Espírito Santo-Brasil. O teste rápido ML Flow, foi realizado em 37 tatus selvagens, tendo sido positivo em 11 (29,7%). O teste de ML Flow pode ser utilizado para identificar possíveis fontes de Mycobaterium leprae em tatus selvagens.Universidade Federal do Espírito Santo Centro de Ciências da Saúde Departamento de Medicina SocialUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de DermatologiaUNIFESP, EPM, Depto. de DermatologiaSciEL

Case Study of Onychomycosis Patients Treated with 1,064-nm Nd:YAG Laser

Onychomycosis is the most frequent nail disease, with an estimated prevalence of 2–8%. Current treatment strategies include the use of oral and topical antifungals, despite low cure rates following these treatments. The objectives of this study were to assess the therapeutic response of patients with onychomycosis to 1,064-nm Nd:YAG laser treatment, the clinical evaluation method available for this therapy, and the possible side effects of this treatment. Twenty patients with onychomycosis underwent laser therapy. A total of 34 nails with onychomycosis were assessed according to the Onychomycosis Severity Index (OSI). This index generates scores that classify onychomycosis as mild, moderate, or severe. The OSI was determined before treatment and after a mean follow-up period of 8 months. The comparison between the initial and the final OSI for all 34 nails treated with laser therapy showed a significant difference; however, a low association was shown between these variables. A general reduction in the area of involvement and in the OSI numerical scores was observed. These data show a trend toward improvement in onychomycosis treated with 1,064-nm Nd:YAG laser. The OSI allowed an adequate clinical assessment of the response to laser therapy. Laser treatment did not cause marked discomfort in most patients, indicating that laser is a well-tolerated procedure

Armadillos and leprosy: from infection to biological model

Mycobacterium leprae is the primary causative agent of Hansen’s disease or leprosy. Besides human beings, natural infection has been described in animals such as mangabey monkeys and armadillos. Leprosy is considered a global health problem and its complete pathogenesis is still unknown. As M. leprae does not grow in artificial media, armadillos have become the primary experimental model for leprosy, mimicking human disease including involvement of the peripheral nervous system. Leprosy transmission occurs through continuous and close contact of susceptible people with untreated infected people. However, unknown leprosy contact has been reported in leprosy-affected people, and contact with armadillos is a risk factor for leprosy. In the USA, leprosy is considered a zoonosis and this classification has recently been accepted in Brazil. This review presents information regarding the role of wild armadillos as a source of M. leprae for human infections, as well as the pathogenesis of leprosy

Case Report:Leprosy Osteoarticular Alterations Mimicking Rheumatoid Arthritis

Deformities of bones of the face and extremities are markers of leprosy (Hansen’s disease) which contribute to stigma associated with this disease. Among these deformities are articular alterations that can mimic rheumatoid arthritis (RA). In this case, a 64-year-old man presented with a history of having been treated for lepromatous leprosy and erythema nodosum leprosum episodes, which evolved with joint alterations similar to those of RA. Most cases of leprosy-related arthritis are associated with reactional episodes, of which a large number do not respond to conventional therapy for leprosy reactions. In cases of chronic arthritis not associated with leprosy reactions, although patients show considerable relief with anti-leprosy therapy, arthritis is not completely resolved. This emphasizes the need for early diagnosis and treatment of leprosy to prevent the development of osteoarticular alterations

Research regarding anti-PGL-I antibodies by ELISA in wild armadillos from Brazil

Armadillos have been involved in leprosy transmission and are considered a source of Mycobacterium leprae in numerous reports. Clinicians from certain areas of the USA consider contact with armadillos a risk factor for leprosy. However, there is a challenge associated with the role of wild armadillos perpetuating human leprosy in the American Continent. The presence of anti-PGL-I antibodies was investigated in wild nine-banded armadillos from leprosy-endemic areas in State of Espirito Santo, Brazil, by ELISA performed on serum samples from 47 armadillos. Positive ELISA was obtained from 5 (10.6%) armadillos. Infected armadillos may play some role in leprosy transmission, disseminating bacilli in the environment, perhaps making it more difficult to interrupt transmission and reduce the number of new leprosy cases. ELISA is an efficient tool for seroepidemiological investigations of Mycobacterium leprae in armadillos.Tatus têm sido envolvidos na transmissão da hanseníase e considerados como fonte de Mycobacterium leprae em muitas publicações. Médicos de partes dos EUA consideram o contato com tatus um fator de risco para hanseníase. Entretanto, há um desafio associado ao papel do tatu na perpetuação da hanseníase no Continente Americano. Foi pesquisada a presença de anticorpos anti-PGL-I em tatus selvagens de áreas endêmicas em hanseníase do Estado do Espírito Santo, Brasil, através de ELISA realizado em amostras de soro de 47 animais. Elisa positivo foi encontrado em 5 (10.6%) tatus. Tatus infectados podem ter algum papel na transmissão da hanseníase disseminando bacilos no meio ambiente, talvez tornando mais difícil a interrupção da cadeia de transmissão e redução do número de casos novos de hanseníase. A técnica de ELISA é um eficiente método para investigação soroepidemiológica da presença do Mycobacterium leprae em tatus.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Universidade Federal do Espírito Santo Departmento de Medicina SocialLondon School of Hygiene & Tropical Medicine Departmento de Infectologia e Doenças TropicaisEscola de Medicina da Santa Casa de Misericórdia Departmento de PatologiaRoyal Tropical InstituteUniversidade Federal de Goiás Instituto de Patologia Tropical e Saúde PúblicaUniversidade Federal de São Paulo (UNIFESP) Departmento de Biologia CelularInstituto Lauro de Souza LimaUniversidade Federal de São Paulo (UNIFESP) Departmento de DermatologiaUNIFESP, Departmento de Biologia CelularUNIFESP, Departmento de DermatologiaSciEL